ArtM

Satiety throws me for a loop sometimes. For someone who has been a binge eater all their life it is a difficult concept at times. What I can say is I don’t crave food anymore and I can typically stop when I am satisfied but at times I wonder if I am eating too much or too little. I like to think I am eating just enough to be satisfied but then I have my days where I will actually skip a meal either because I am just not hungry or I get so involved with work that I just forget. Then I get into my own head whether or not I am sabotaging myself somehow. I also have had my moments where I think ‘crap, I should not have taken that last bite’.
Twice last week and again today I had Breakfast at 6:30 and then ended up working through lunch to then realize it is now 4:30 and too late for lunch as dinner time is right around the corner…
I guess I am just over-thinking it all…

How do you like your band? Tight? Tighter? Tightest?


MORE, MORE, MORE

Americans love MORE: more of anything and everything. More food, more fun, and (for some of us) more fill in our bands. But striving for maximum fill in the effort to achieve maximum weight loss can be a terrible mistake.

Fat folks become obese enough to qualify for bariatric surgery because we’ve been eating more, more, more, so it’s not surprising that bandsters long for more, more, more fill. The tighter the band, the better, right?

Wrong. Here’s why: tighter doesn’t automatically yield more weight loss. It can cause eating problems, side effects and complications that none of us want. It can compromise our quality of life. It can make us miserable when all we hope for from bariatric surgery is a better life.

You’re not impressed by all that? You’re willing to risk everything in the pursuit of skinny? Then try this on for size. A tight band doesn’t guarantee weight loss. Just the opposite: it can stall your weight loss or even make you gain weight.

Do I have your full attention now? Good. Listen up and I’ll explain why tighter isn’t always better.


THE RESTRICTION FALLACY

Traditionally, the adjustable gastric band has been considered a “restrictive” weight loss surgery. Bandsters were taught to look for signs of restriction: the proofs that their bands were working. Instead of paying attention to her own eating behavior and lifestyle, the bandster waited impatiently for the flashing signs, ringing bells and slamming doors that would stop her from overeating. The idea was that the small upper stomach pouch would “restrict” food intake and result in weight loss. Sound familiar?

That was well-intentioned thinking, but it was wrong. In the past 5 or so years, band manufacturers and bariatric surgeons have come to believe that it’s a mistake to eat and eat until you set off your band’s emergency warning system, for the reasons mentioned above. Unfortunately, the re-education process is slow going, and in the meantime, the restriction fallacy lives on. Even now, approximately every third word out of a bandster’s mouth is “restriction”. It’s a catch-all term for the feelings that limit how much a bandster eats. Post-op band life tends to become a Quest for enough fills to reach the Holy Land of Restriction. Next stop: Skinnyland.

Or not.


HAZARD AHEAD! THE DANGERS OF SOFT CALORIE SYNDROME

Soft Calorie Syndrome is one of the least publicized dangers of a band that’s too tight. Psychologists would call it a maladaptive behavior, that is: a nonproductive behavior that prevents you from adapting to situations, or changes in yourself or your environment, in a healthy way. It can begin as an attempt to deal with or avoid an unpleasant experience but it does not solve the original problem and eventually becomes dysfunctional. You can read more about maladaptive eating behaviors by clicking here: http://www.bariatricpal.com/page/articles.html/_/healthy-living/is-your-eating-maladaptive-r50
A bandster experiencing Soft Calorie Syndrome is responding to the unpleasant experience of eating with a band that’s too tight by eating the soft and liquid calories that slide most easily past their gatekeeper band. Instead of eating the healthy and solid foods (like dense animal Protein, veggies, fruits) that provide the most satiety (both early and prolonged), that person favors easy-to-eat food that’s often junky and high in calories (for example: potato chips, ice cream, milkshakes). Even healthy foods( like yogurt, cottage cheese and, fat-free/sugar-free pudding) can fall into the soft calorie category, and they don’t provide any better satiety than the junky stuff. The net result is that you end up consuming more calories than you need because the soft stuff doesn’t provide enough early and prolonged satiety. And the result of that is a weight loss plateau, or even weight gain.

I discovered the perils of Soft Calorie Syndrome for myself when I traveled to New York City to attend a trade show when I was about 8 months post-op. I had gotten a fill the day before I left, and by the time I got to New York I had realized that my band was too tight for me to tolerate. I couldn’t eat any solid food, so I spent the next 3 days eating soft, high-calorie, low-satiety foods like creamy Soups, milkshakes, and ice cream. I was just trying to survive long enough to go home and get an unfill. My maladaptive eating behavior achieved a temporary goal (comfortable survival) while sabotaging my long term goal of losing weight. In fact, I gained weight during that trip and ended up feeling disappointed in myself. I promised myself no more fills on Fridays and no more fills the day before a business trip. I called my surgeon’s every time I suspected my band was too tight and found that even tiny unfills could make all the difference in my quality of life as well as my weight loss.

I know I’m not the only person who’s discovered the perils of Soft Calorie Syndrome. I also know that you’re not alone in believing that more fill is better and that unfills will slow or stall your weight loss. A few months ago I talked about this with a smart and successful bandster named Denise. When her surgeon reacted to her too-tight band by suggesting an unfill of .5 cc, her dazed and frightened face made him reassure her that she could start being re-filled in a month. The month ahead scared her, but she agreed to the unfill, and discovered that rather than returning her to Bandster Hell, it had restored sanity to her eating life. She said, “I was able to eat again. Solids went down easily. bread was on my menu. Meals lasted me several hours. I didn’t snack because I was able to eat enough to keep me satisfied.”

When Denise went back to her surgeon a month later, he was delighted her hear her say that she didn’t even need a re-fill. She told him, “I can eat anything, but I’m not eating everything.”

And that, my friends, is what healthy eating is all about.

It can take some time to get to the right level of restriction. Some sooner than others. But to your point I will say this: I lost the majority of my weight before achieving any real restriction. The reason for this is my belief that once the band kicked in, it would help me maintain my weight loss, something I had never been able to do before. So I worked on losing and waiting for my band to start working.
It took me getting to 8.5cc to get restriction, which meant a LOT of fills, in comparison to most. Once I was there, it was a cake walk maintaining the weight I'd lost up til then, and in fact I continued to lose for the following year without trying.
They will go slow because they don't know what fill level will get YOU to your green zone. So, as trite as this might sound, be patient. And keep trying to lose, because it's not for nothing.

I asked my doc that on my post op visit. He said there is just a bit of Fluid in there, but nothing significant.

It's amazing to eat so little and be satisfied. Whole new experience to me too. Hope you're as thrilled about it as I am.

I took my kids (ages 4 and 6) on a float trip yesterday! 50 pounds ago you could not have convinced me to get in a canoe! We had soooo much fun. Just thinking about the memories that I am making with my kids now brings me to tears! No more hiding in the house and wasting life. I look forward to each new day!

I hate to tell you this, but the band's job isn't to physically stop you from eating anything. You say you can "eat whatever you want" and that's not likely to change. If you want to over eat, you will, band or no band.
The band is there to control your hunger. Once you have adequate Fluid in it it'll allow you to go much longer periods of time without hunger after eating much less food. It's not there to make food choices for you- that will always be your job.
Have a look at this link: http://drsimpson.net/fills/Lap-band-eating/lap-band-not-restriction/lap-band-and-restriction.html

Glad to hear everyone is doing so well. I am sorry i have been MIA, my first week back at work was crazy. I am doing great, still on full liquids, can start "soft" foods at the end of this week - I think I will choose Thursday . I saw my surgeon this past Wednesday and he was very pleased with my progress, I am as well. I am out of pain for the most part, I do feel a little pinch once in a while and my back hurts - but other than that I am back to normal. I do not go back until the 30th of July and he will give me my first fill. He warned me that somewhere in weeks 4-6 that i will feel like I never had surgery and will be hungry and able to eat more than i have been, but assured me it is temporary and for me to push through it. As all of you I am ready to "chew" - by the time I can have soft foods it will have been 5 weeks since I have anything but liquids... wooeeee - I cannot believe i have made it.

It's amazing to eat so little and be satisfied. Whole new experience to me too. Hope you're as thrilled about it as I am.

Great discovery, now remember to stop at 1 cup of food, not when full!

As far as the Protein Shakes go, try Unflavored Unjury Protein powder you can add it to any food or drink. I had to get it because i couldnt stand the thought of drinking another shake! Unjury is what my surgeon recommended and alot of others. Unflavored is 90 cal, zero carbs and 25g protein. I gladly add that to my mashed potatoes, yogurt, etc to get the protein in, anything but the shakes!

It's amazing to eat so little and be satisfied. Whole new experience to me too. Hope you're as thrilled about it as I am.

It's amazing to eat so little and be satisfied. Whole new experience to me too. Hope you're as thrilled about it as I am.

Today I experienced something. I served myself two scrambled eggs and a half cup of mashed watery boiled pinto Beans. I'm the mushy stage. I ate the eggs no problem. Eating the beans I had about a quarter cup or less of the beans and I could almost feel a stuck feeling. It wasn't stuck, it was a I'm way too full feeling, I figured out. I felt a little pressure in my chest, and I could feel the food a bit in my throat. Not so bad I wanted to vomit, but I knew I did something wrong, or was just on the edge of it. I just relaxed for a bit and the food went down and all better. But the funny thing is that I had almost no hunger all day. I had a little yogurt at lunch and some Protein Powder at dinner. Just wasn't hungry. I learned that I don't need eat until I feel full like I used to. I need to know how much I can eat and feel satisfied, and just make my meal that approximate size every time . Learning day.

Today I experienced something. I served myself two scrambled eggs and a half cup of mashed watery boiled pinto Beans. I'm the mushy stage. I ate the eggs no problem. Eating the beans I had about a quarter cup or less of the beans and I could almost feel a stuck feeling. It wasn't stuck, it was a I'm way too full feeling, I figured out. I felt a little pressure in my chest, and I could feel the food a bit in my throat. Not so bad I wanted to vomit, but I knew I did something wrong, or was just on the edge of it. I just relaxed for a bit and the food went down and all better. But the funny thing is that I had almost no hunger all day. I had a little yogurt at lunch and some Protein Powder at dinner. Just wasn't hungry. I learned that I don't need eat until I feel full like I used to. I need to know how much I can eat and feel satisfied, and just make my meal that approximate size every time . Learning day.

Today I experienced something. I served myself two scrambled eggs and a half cup of mashed watery boiled pinto Beans. I'm the mushy stage. I ate the eggs no problem. Eating the beans I had about a quarter cup or less of the beans and I could almost feel a stuck feeling. It wasn't stuck, it was a I'm way too full feeling, I figured out. I felt a little pressure in my chest, and I could feel the food a bit in my throat. Not so bad I wanted to vomit, but I knew I did something wrong, or was just on the edge of it. I just relaxed for a bit and the food went down and all better. But the funny thing is that I had almost no hunger all day. I had a little yogurt at lunch and some Protein Powder at dinner. Just wasn't hungry. I learned that I don't need eat until I feel full like I used to. I need to know how much I can eat and feel satisfied, and just make my meal that approximate size every time . Learning day.

Congrats and thanks for posting this. Very motivating for me!

I'm very sorry you're having to go through this.
I can't tell you if you should have bypass. Only you know what is best for you. However, before jumping to something so drastic, I would really examine your options first.
For instance, you talk about restriction and being so tight it could damage your esophagus. When you say restriction, what exactly are you looking for the band to do? The reason I ask is, too often we see people wind up too tight because they're expecting the band to do something it's not meant to do. For instance, many incorrectly expect the band to physically stop them from eating and that is not what the band is meant to do. What the band is meant to do is allow you to be satisfied on much less food for much longer periods of time.
Dr. Simpson wrote a great article on this topic called "The Lap Band is NOT About Restriction". Have a look because I think it may help you considerably: http://drsimpson.net...estriction.html
Another great article is by Jean McMillan called "Tighter Isn't Always Better": http://www.lapbandta...ays-better-r118
Another question- how many calories a day have you been eating? Keep in mind weight loss boils down to simple math. If you consume less calories than you burn, you will lose weight. The simplest way to assure this happens is to track calories and measure portions.
Best wishes to you.
PS: After note- it's also important to remember that no matter which surgery you choose, you must remember that WLS is just a tool not a magic fix for fat. It doesn't matter if you use the band, bypass, or the sleeve you will still have to change your eating habits for a lifetime to be successful.

Best of luck!

Good luck!

Everyone may have seen this before, but I came across a youtube video that demonstrates our new pouches. Specifically, it demonstrates why drinking with meals is discouraged.
I just wanted to share it with all.

Enjoy,
Art

Everyone may have seen this before, but I came across a youtube video that demonstrates our new pouches. Specifically, it demonstrates why drinking with meals is discouraged.
I just wanted to share it with all.

Enjoy,
Art

Everyone may have seen this before, but I came across a youtube video that demonstrates our new pouches. Specifically, it demonstrates why drinking with meals is discouraged.
I just wanted to share it with all.

Enjoy,
Art

Thanks for sharing! Pretty awesome and simple visual!