The "mush" stage refers to the periods both prior to and after the operation when you are instructed to eat only pureed foods.

The main reason given for having to restrict yourself to pureed foods for 2-3 weeks PRIOR to the operation is that it reputedly shrinks the liver which is necessary for the operation.

In fact, there is not yet any concrete evidence that the pureed food diet actually achieves this. However, there does appear to be some anecdotal evidence because, since recommending the puree diet, the NZ surgeons have not had to deal with enlarged livers.

In addition to possibly shrinking the liver the pre-op pureed food stage gives you an opportunity to think about food in a different way in preparation for life after the band.

Finally, many people experience significant weight-loss by restricting themselves to pureed foods, which gives you a good confidence boost prior to the operation.

The main reason for eating pureed food for 2-3 weeks AFTER you have graduated from the fluid diet, is to gradually introduce the stomach back to normal foods in a way that is unlikely to induce vomiting (which can dislodge the band) or stretch the stomach.

The general rule of thumb is that you can eat anything as long as it is either already liquid or can be blended into a thick liquid paste without any lumps.

You will be able to eat the following foods:

Individualised guidance on specific quantities can be provided by your dietician.

Breakfast:

Fruit (pureed or juiced) OR Smoothie

Weetbix OR porridge OR scrambled eggs

Fruit (pureed or juiced) AND/OR Yoghurt

Soup OR Smoothie OR scrambled eggs

Fruit (pureed or juiced)

Fruit (pureed or juiced) AND/OR Yoghurt

Meat/Chicken/Fish pureed with gravy/sauce and mashed potatoes and blended vegetables OR shepherd’s pie OR Fish Pie

Custard OR Rice pudding OR Tapioca

Fruit (pureed or juiced) AND/OR Yoghurt

There is no limit on the amount that you can eat in the puree diet PRIOR to the operation. The important thing is just to make sure you are eating a healthy balanced diet and that everything you eat is pureed to the right consistency.

When eating pureed foods after the operation, dish up small quantities and eat very slowly. It is really important that you don’t generate sufficient feelings of fullness so that you have to vomit as this could cause movement in the band.

You should start by measuring out a ½ cup per serving which you could gradually increase to 1 cup depending on your capacity.

If you are vomiting or regurgitating or have any discomfort, reduce the amount of food eaten at any one serving and slow down how quickly you are eating.

The following hints may make the fluid stage a little easier:

• Try to get as much variety into your diet as possible. Aim to have a good balance of fruit and vegetables, cereals, protein and calcium-rich foods every day.
• If you are in a hurry, you can try blending heated frozen dinners from Lean Cuisine or Healthy Choice.
• Try to drink as much water as you can in addition to the more substantial fluids. This can help you avoid headaches, fatigue, constipation and gouty attacks which are linked to under-hydration.
• Beg, borrow or buy either a blender or Braun Multimix. This is an invaluable piece of equipment for blending and pureeing foods.
• Eat little and often throughout the day to stop you getting hungry. With morning tea, afternoon tea and supper, you should probably average between 5-7 mini-meals.
• In the post-op mush phase it is helpful to have a cup or small bowl with the ½ cup line clearly marked (with a permanent marker) as a reminder of the optimal serving size.
• Include prune juice, blended kiwifruit or Metamucil to ease constipation.
• If you find you are getting genuinely hungry between meals then use slightly thicker blends and/or using meal replacement supplements.
• If you are finding it difficult to stick to pureed foods, you could add soft foods such as low-fat pasta dishes using tomato-based sauces for variety.

1 Banana

1 Egg

300ml low-fat milk

2 Tbsp Sustagen Milk powder

2 scoops low fat dairy dessert or yoghurt

Blend together and serve immediately

1 banana

¼ cup plain low-fat yoghurt

1 Tbsp sugar

½ cup orange juice

1 tsp lemon juice

6 large strawberries

Put all ingredients in blender and process until smooth. In winter, replace plain yoghurt and strawberries with ½ cup strawberry yoghurt. Serves 2.

4 ripe kiwifruit (peeled and cut)

2 ripe bananas

8 ice cubes

½ cup unsweetended pineapple juice

¼ cup apple juice

1 tablespoon honey

In blender, combine all ingredients and blend until smooth. Pour evenly into 4 chilled glasses.

1 large banana

½ cup plain yoghurt

1 Tbsp All Bran

2 tsp honey, sugar or maple syrup

¼ cup low-fat milk

Put all ingredients into blender or food processor and process until smooth. Serves 1.

½ cup evaporated milk (skim if available)

1 tsp vanilla essence

1 tsp liquid honey

1 cup mixed berry fruit (strawberries, blueberries, raspberries)

Put all ingredients in blender and process. In winter use frozen berries.

500g watermelon pulp

1 cup strawberries

4 ice cubes

1 tsp lemon juice

2 mint leaves

Blend all ingredients together and serve immediately. Serves 2.

1 small carrot (chopped)

1 cup unsweetened pineapple juice

¼ cup crushed pineapple

1 cup crushed ice cubes

Put all ingredients in blender and process well.

½ c Mango, cubed

½ c Banana, cubed

¼ c Orange Juice

¼ c Nonfat Vanilla Yoghurt

1 tsp Wheat Germ

1 Tbsp Honey

½ tsp Candied Ginger (Optional)

Place all ingredients in a blender and process slowly until the mixture is creamy. For a thicker texture, freeze the cubed fruit beforehand. Makes one serving.

1 1/4 cups plain yoghurt

1 cup chopped, ripe manago

3 Tablespoons sugar or to taste

1/4 teaspoon ground cardamon seeds

8 ice cubes

Combine all the ingredients in an electric blender and blend. Some ice pieces may remain. Pour into 2 or 3 glasses and serve.

1 large clove garlic

4 tomatoes (fresh or tinned)

½ Onion (finely chopped)

½ Green Pepper (roughly chopped)

½ Cucumber (peeled & chopped, no seeds)

¾ pint tomato juice

1 tsp salt

¼ tsp cayenne pepper

3 Tblsp extra virgin olive oil

4 Tbsp lemon juice

Blend the garlic, onion, green pepper, tomatoes and cucumber. Stir in the oil, lemon juice, sale, pepper and tomato juice. Refrigerate before serving.

1 cup masoor dhal (red lentils)

1 tsp salt

½ tsp tumeric

2 fresh red or green chillies, finely chopped

½ onion, finely chopped

2 cloves garlic, finely chopped

1 med tomato (fresh or tinned), finely chopped

2 Tblsp oil

1 lemon

Pick lentils over and remove any debris. Put in large bowl. Fill with water and, using your hands, stir until water is cloudy. Drain and repeat 3 or 4 times. Finally, cover with water and let soak 45 minutes.

Drain and place in saucepan with 3 cups of water, salt, tumeric, chillies, onions, garlic, ginger, tomato and bring to boil. Simmer 15-20 minutes until soft. Blend.

Reheat and add lemon juice just before serving.

Beef & Vegetable Casserole (to puree)

750g chuck or blade steak

¼ cup flour

1 ½ cups beef stock

2 tsp brown sugar

1tsp paprika

¼ tsp thyme

2 onions, chopped

2 stalks celery, sliced

2 carrots, sliced thinly

1 bay leaf

1 ½ cups water

1 cup frozen peas

2 Tbsp chopped parsley

Cube steak. Shake with flour in a roasting bag to coat. Brown in frypan with small amount of oil or butter.

Mix together stock, sugar, paprika and thyme. Pour this mixture over beef and chopped vegetables in casserole dish.

Cover and cook for 1 ½ to 2 hours at 150 degrees celsius. Puree and serve with runny mashed potato.