My adventure with my lap band: June 2010

The band goes around your stomach, not around your brain, or your lips....

This simple concept, of eating a specific volume of food -- eating it slowly, and then walking away, is the key to successful eating habits of patients. This means that the band works with effort from you -- not by it doing everything for you. You have to make the decision to eat a small volume of food, and let the band work with you.

The sensation that we would want the band to produce is the "soft stop." The soft stop is when you eat a small portion of food and walk away. Sometimes this is difficult, like most things, practice makes perfect. To set yourself up for success -- we recommend you use smaller plates, along with smaller utensils. If you go out to eat, ask for the to-go bag immediately, and remove the excess food from your plate. You can physically always eat more food, but the advantage about practicing small portions and walking away, is ultimately your eyes will get use to what the stomach is telling it, and it will be much easier to eat smaller portions as time goes on.

It isn't uncommon for patients to want an adjustment because they say they can eat more. The first question we ask is, "Why are you eating more?" The typical answer is, "Because I can." The typical response, "Just because you can does not mean you should." Since the band's job is not to restrict the amount of food you eat, do not leave that to chance -- that is your job. Part of personal accountability is to account for, to measure, to know how much you are eating at a time. The band is empowering; if you eat an appropriate amount and make appropriate food choices, you will be satisfied for several hours. This results in either weight loss, or weight maintenance (if you are at your goal). The purpose of the band is to assist you to lose weight -- and this occurs only with active participation by you: you chose what to eat, you choose how much to eat, and you practice walking away after eating that amount. The band is a tool to allow you to eat less and have your appetite dimmed resulting in weight loss, or maintenance. It is a tool to help you adopt a healthy lifestyle -- you still have the choices to make, but the band allows you to be satisfied with those choices.

"If I could eat less and walk away, what would I need this band for?" -- a common question we are asked. Without the band, if you eat a small amount of food and walk away your appetite would rise within a couple of hours -- you would find yourself hungry and wanting more food, possibly leading to unwanted snacking. You would also find, if you willed yourself to withstand the hunger, that your weight loss gradually decreases. The band fools your brain into thinking you ate more.

Think of it another way -- the hypothalamus does not have eyes -- it doesn't know how much you ate, it doesn't know if there is a lot of food around and you are not eating it, or if there is a band on your stomach. The hypothalamus reacts very simply to the stimulation provided by the upper part of your stomach. Stretch that thermostat, it thinks you are eating a lot -- do that consistently over time, and it behaves as if you are eating a lot all the time and will allow your body to release fat stores and not cause your body to go into a metabolic slow-down. Conversely -- if you go on a diet, without the band --and that part of the stomach is not stretched, your hypothalamus thinks you are in a famine -- it doesn't know that there is a lot of food around you.

The purpose of banding is weight loss. Patients who are successful do not "feel tight," or "feel restricted." Instead, successful patients report that they rarely have an issue with the band, they do not "feel restriction." Successful patients come for adjustments when they notice that their appetite is returning between meals -- patients who are not successful rely upon the band to tell them when to stop eating.

The band, in successful patients, is empowering. While, on occasions, the band is "fickle" the proper way for the band to work is for it to allow you to eat less and not be moved by an appetite.

There is another group of Lap-band patients who do not like any sensation of restriction
--a group we call volume eaters. They want to eat a lot, when they want to eat, and they do not like the sensation of a "hard stop." Nor does this group want to eat a small volume and walk away and allow their appetite to be suppressed. One patient even asked for pills for nausea, because she could not eat "a quart of chili." Yes, this person thought a quart was a normal serving size -- not a cup, a quart! Sometimes these patients come in for an adjustment, then come back thinking that the band is too tight, because when they overeat they become acutely uncomfortable, or feel as if they are "obstructed." Often these patients will come in for a fill, then an unfill, then another fill.

It does take a bit of work to change a person's perspective about the volume of food they eat. For some there is a feeling of deprivation, a period of mourning, but ultimately the band can become a tool to overcome this sensation, and allow the patient to eat. Remember, if you want to be a 125 pound person, you have to eat like one. The band allows your body to re-set the thermostat to the amount of food that it takes to keep you satisfied between meals.

To be more specific - food does not stay in the pouch above the band for a long period of time. Typically it travels through this area fairly quickly, usually less than a couple of minutes. The effect of the band is NOT to have food stay above the stomach in that small pouch - the effect of the band is on your appetite after a small amount of food stimulates that. Does this mean you can eat more -- yes, you can. The question is should you/ or will you. That is always in your control.

You know it's been three months since being banded and I have been thinking.
In three months I have lost 12 kilos. I am now sitting on about 86.5. That is bloody amazing for me really. I have gone down at least a pant size and can now stop shopping in the larger areas of shops! I have more energy, but on some days would like to have a bit more.

Last year I applied for some pretty swish schools in Melbs and got four very swish interviews. I weighed about 98 kilos then. I didn't get any of those jobs, even though I look great on my cv. I have held some leadership positions in schools and had then had 6 years teaching experience. I do often wonder if I didn't get those jobs because of my weight? I'll never know that answer.

Loosing 12 kilos has given me confidence within myself. I am wearing nicer clothes, not just clothes that cover me up and over my fat arse... I am wearing make up! Huge chance. I NEVER used to wear make up. My Mum tells me that I am a million times happier!!
I am about to start a Graduate Certificate in Educational Leadership through the Uni, which in turn will give me half my masters subjects.

I have applied for a principal position at a wonderful school that I have previously have taught at. It closed on Friday. I really would like that job! Dooley would even move back to Tassie if I get it. It means moving a bit away from Hobart but not too far.

Hopefully my confidence came through in my answers.. I should hear late this coming week if I have an interview. Finger crossed. The best bit is the person who is principal wants to leave!!! Woot..