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I'm not just happy....I'm thankful. What a wonderful tool this is. But, just like any tool it must be USED and it takes CONCENTRATION. Eat too much, too fast, and BAM!. Just like a hammer. Lose your concentration and BAM! a very sore thumb. So should I throw away my hammer? Silly. I'm down more than a hundred pounds. IF it all stopped right now I'd still be happy. It's wonderful. Now, here's something I wrote about a friend of mine. Read it and you'll know the real reason I'm happy about my band, and you'll know how I feel about UNREASONABLE worrying about complications. Look into it, yes, heed warnings, yes. Let hearing about the complications of others make your decision for you? NO. Kent: I saw an old friend today................but he didn't see me. He didn't greet me, or shake my hand, or grace my ears with his booming laugh. He couldn't. He couldn't get out of the casket he lay in. He was a big man, and it was a big casket. You see he loved to hunt, and camp, and fish, and....eat. His wife was out the other day, and when she got home, Kent was no longer in. I had known him for many years. Since Patty and I met some seventeen years ago. He always had a good word, and a smile, and a merry twinkle in his eye. His beard went white while his hair was still dark, and his laugh was so joyful, so infectious that it made Santa seem depressed by comparison. And, oh yes. He had the kindest eyes I've ever seen. When I went to my first meeting for the Lap Band Kent was there. He was just sixty years old and he was being refused the surgery because Dr. Cudjoe doesn't do them on folks over sixty. But Kent was the kind of guy who didn't fit the actuarial charts. After he met with the good Doctor it was settled.....if the insurance would cover it. He was scheduled for the surgery on three occasions, and each time the insurance fell through. He had enough money to cover the $40,000.00 that Cudjoe wanted but Kent's wife wouldn't let him rob their nest egg. So now he resides in an oversize wooden box, festooned with satin, and trimmed in death. To the insurance company, and even his wife it seems, he wasn't worth it. Yet he was shown three nights in a row. And each time it was an hour and a half wait in line to pay respects. Three days of people lined up out the door and down the block. Not worth it? How many lives like mine and Patty's were darkened by his passing? He had children who had just given him grandchildren. He had friends. Yet someone, somewhere, decided what the fat man was worth. And, yes, that angers me. But something angers me even more. Each day I read about fears on other WLS sites. Fear of complication. Sad and fearful laments "What if something goes wrong? What if I erode, what if I reject, what if I get infected?" The complications of Weight Loss Surgery. Ask Kent about the complications of NOT getting weight loss surgery. Risky? Yep, it's risky. So is apnea, diabetes, stroke, hypertension, heart attack. They seem risky too. So, you're thinking about WLS? And you're worried that something bad MIGHT happen? Well it might. BUT.........if you don't do it.......Something bad WILL happen. And I wonder something else. Could all the worry over complications be your addiction trying to survive? Could it be a subconscious stalling tactic? A tricky form of denial? I beg anyone who is wavering to think of Kent. He had no doubts. He was ready to forge ahead. He knew the risks, and he knew that SOME chance is still better than NO chance. If you have this tool at your disposal why continue to plod slowly but surely up Death's walk and to His doorstep? Turn aside, and take a chance to live. To put life in your years. Fear is the enemy. Love, Ryan.

I am fat because that has always been my role. Fat Shelly. And you know what, I grew up in Jamaica at a time when no one had a real problem with fat, so calling someone Fat Shelly, like Fat was their title, was considered perfectly polite. In fact I was a teenager on a commuter flight from Kingston to Montego Bay early one morning, when a well dressed (blacksuit) gentleman saw me struggling with my little carry-on. He hurriedly stored his breif-case and then reached for my bag. He was so kind, and as he reached for the bag he said "I'll help you fatty." Thanx! Now, even in JA, it is no longer acceptable to be fat. But it is still my role. In describing siomeone, a member of my family might say "she is not as big as ...say Shelly, but she is a big girl." or "I am not going to get as big as Shelly, don't you worry." All of this while lovingly stroking my hair. Ahhh yes. Toxic love. And on my part, since I have always been fat, I have always had to appear to be dieting, or else be considered a real slob - one friend of a friend whom I barely knew once asked me "don't you care about your size?" when I ordered a burger in her presence. Everyone else was having one BTW. So anyway, my response to the constant appearance of dieting or trying to get my size under control was to stop. I just quit doing it on my own time. So I eat butter and icing sugar and sometimes butter with Icing sugar cause I can, and because I feel like I ought to be able to and everyone else can and it is soooo unfair. Real adult right? I must like the name Fat Shelly :Banane34:. But now I am on a path and this band, when I get it, will be my own secret, and I will own my weight loss and own my body..is that a weird thought?

I was going through the same thing about a month ago and while I haven't really changed my diet (which is my New Years resolution) or started taking any supplements, I did talk to my stylist and this is what we did... ~ I changed the side that I part my hair on (which is where I was getting a bald spot) ~ I cut three inches off my hair (brought it to my shoulders) and layered it....this takes some weight off and helps ease hair loss supposedly ~ I wash every other day, and condition every day....this helps keep my hair looking healthier ~ Avoid pulling your hair back and don;t sleep with it up in a band So far it seems like the hair loss has slowed down. I really think that since I am 4-5 months post op I was experiencing the loss because of the anesthesia (someone mentioned this in another post). I wouldn't worry too much....my friend went through this when she had her surgery and she is now almost 2 years post op and has a full head of hair! Good luck!

A lot of things can cause your hair to fall out. And not just loosing weight from wls. If you loose large amounts of weight, it can happen, hence why its common in wls patients. I was shedding tons of hair, and was really freaking out about 8 months ago. I wasn't loosing weight, but I did discover I had a thyroid promblem. Get your blood work done and make sure everything is on par. If it is, your hair probally just has it "cycles" messed up. You see normally we shed hair, but not alot at one time, because our hair folicules are on cycles. When the cycles get messed up you might have 2 or 3 groups on the same cycle...hence lots of hair loss at one time. The good news is...shedding hair this way is not a permanant side effect, and it will grow back. I know how scarey thinking you are going bald is...try not to worry to much. Make sure you are getting enough protien (min 45 grams a day) and are taking your viatamins. My hair thickened back up...I'm sure yours will too. Melissa

I had my first fill the other day - 4.5cc's (apparently, my band takes a total of ten). Now, that only leaves me with 5.5cc of expansion. Could this represent a problem? Should I be concerned? Thank you in advance, Andy B P.S. On the positive side, I notice one-or-two people are worried about hair loss. Personally, before the band, I had less hair than a shaved egg, and I'm fully expecting no change:)

I started having hair loss after a couple of months. When my weight loss plateaued (six months out) my hair stopped falling out. Now that I am losing again, it is falling out some....I have really thick hair and I am not worried about it... My Dr said I probably wasnt getting enough protien, so who knows... Patty

Your hair loss is a normal occurence that happens after anesthesia. It usually starts a few months after surgery, but will grow back, so not to worry. It doesn't happen to everyone, but it does happen more frequently than not. Your hair will return to normal before you know it. As for the rest of it, I had a period of exhaustion that I'm sure was a symptom of surgery followed by major diet reduction, life change, etc. Good Luck to you however it pans out! BTW: There are posts about post anesthesia hair loss here somewhere.

Lately my husband has come full circle with the marriage thing, so I've fallen in love all over. But I'm still envious of single gals at my age, because the excitement of new love is one of the best feelings in the world. My single girls here at LBT are dating after losing weight, and there's a recurring topic here about "should we tell the guy about our loss and the surgery?" For me, I'd test the guy awhile before telling him. I'd have to know that he thinks I'm desirable from the inside before discussing my outside. Kare, you are a stunning LBT model. From my end, you don't even look like you have a weight problem. I think we should have an LBT beauty contest because with your smarts and bouncy hair, that pink satin sash could very easily be yours. As far as having to tell a guy, why? Why not just enjoy being companioned (did I make that word up?) Have a little fun, live life on the wild side for us married gals. Hold hands, kiss. Wait, that's a whole new topic. The kiss: Who has time to date, anyway? I don't consider it dating, I consider it an interview. So meet him, shake his hand, if you might like him, shove him against the wall and plant a wet one on him. If he can't kiss, move on. What a slut. Who said that? I did. Shut up, DeLarla. No, you shut up, Lisa. GEEZE. HELP. My point is that I'm a very good kisser (it's my thing.) Like when Kevin Costner in Bull Durham said, "I believe in long kisses that last all night long" holy bananas, I melted. So, what if you date the guy a couple weeks then find out he kisses horribly? That's happened a few times in my life, and it's devastating. So stop worrying about YOU and start worrying about him. He better kiss good, and he better be good with tools, and he better treat you like a queen. Or, just fake him out by wearing pheromones. I've been learning a lot about pheromones, and there's literature that it's lying to a guy by wearing it because it fakes him into being attracted to you. Nothing like an honest start!

Well, I just went to the market. Partly to get out of the house, partly to get in some supplies. I feel OK. A little light headed and a little bit of stinging around my wound, but the walk was no problem. I bought some consomme soup and pro-biotic drinks. I also bought some Spirulina. Does anyone else take this? My local health food store said it is a good source of protein if you're on a liquid diet. It also has B12 and Iron in it so should prevent hair loss. My doc also recommended Prune juice to try and get things moving - and dammit if I can't find it anywhere! I bought some prunes and will make my own in the blender with some apple juice and water. If I pass it through a seive it should be thin enough I hope. I came home and had half a can of consomme (in two attempts) and I feel full as an egg. Hoping I'm not eating too much, but I'm also worried about passing out - I do feel quite light headed and can't even concentrate to the Telegraph crossword, which I usually do in an hour. Another query for you guys - Driving - how long until it's OK to drive? I suppose I should check with my insurance. I know after a Caesarian it's 6 weeks but I'm hoping to get back to driving soon. I succumbed to the temptation to step on the scale this morning. 2lbs down! Doesn't meant anything I know, but at least I can update my signature!

I worried about hairloss post surgery, as I allready have alopecia, however my hair has grown in thicker, I am not sure why. I did speak with My doctor, and a dermatologist who explained that most hair loss after baritric surgery can be linked to protien dificiency. There are lots of vitamins, and protien drinks available. I prefer vitamist. I took the bottle to the dietician at the hospital and she said it is great. they also have a great protien drink that is boosted with calcium. the web address is www.vitamist.com I have also used infinity product, and I noticed on the link for usa fills they sale infinity products. I have used several of the infinity vitamins and protien drinks, and they are great. You might also contact your surgeons office and see if they recommend a certian product. Sorry about my spellin I need hooked on phonics lol Good luck! kristie

Thanks so much for these comments - really helped me - both practically and mentally. Vera - hubby loved your car/gas analogy! We feel we haven't "used" this band properly yet - and you are right, we ARE all different - it's amazing how many different opinions/experiences I read last night - it's like childbirth!!! Donali (((((((((I miss you!!)))))))))))) - I haven't had the second fill yet - going tomorrow (thurs) and am v anxious to get it right this time - Love the applesauce theory - someone on Spotlight suggested bringing yoghurt so I will definitely bring one of them....would a Twix work ja think??? Alex/Penni - I know the magical elusive unicorn of a "sweet spot" doesn't really exist, and the nature of the band is, if you find it, it may not last for long - I guess I am just worried about being overfilled, and getting frustrated, end up eating icecream and cookies all day long! I was planning to ask the doc to fill me to 5cc - then someone on Spotlight is at 5cc but has very little restriction - whereas a friend of mine in Paris, is filled to 7cc but is not losing any weight as she's too tight to eat healthy proteins etc - After my surgery, I was completely tight "psychologically" - I was focused and motivated but ate too little and loads of my hair fell out - I have tons of one inch growth all over my head now - and I fair so it's really noticable! I want to do this sensibly yet take advantage of my first 2 years being banded....And yeah, I am really trying to cut down on my drinking with meals - It's just I can't finish a muffin without a mug of coffee.....sigh.... Blacknamaste: (what's with the name???) Wow - you are here in little ol' Ireland too? i had no idea - thought you were english!!!! Wa hoo! Where are you living? Who did your surgery? Tell me EVERYTHING!!!! Yup, it's very isolating here with no band docs - my gp actually told me she'd give me some hypodermic needles & saline, if I ever wanted to do a fill for myself! She said "shur it'll be no bother to you" Irish style! I was like okaaaaaaaaaaaaaaay buh bye....!!!! Thanks for the compliment - I am the largest woman in co meath at the moment so dunno about the looker comment! We should meet up - Are you near Dublin or what? Let me know xx And I am delighted with the 70lb loss but I'm bloody still 18 stone and can only shop in Evans!!!

You know how sometimes the answers come to you right when you need them? This article did that for me...and there are many messages in it that we discuss here. I couldn't find a link to it, so I typed it up because I thought it was so important for everyone here to read. It's long, so grab a bottle of Water and settle in. Size and Sensibility Losing half her body weight was no picnic. But living thin—and expanding her sense of self—nearly made Frances Kuffle’s world blow up I had been summoned to The Show, the Holy Grail for authors and the fulfillment of all my mother’s dreams. In a harried day of phone calls from Chicago, at the tail end of a snowstorm, the producers of Oprah decided, with 90 minutes to catch the last shuttle out of LaGuardia, that they might want me. You’d think, on the eve of what could catapult my book to national attention, that I would be too nervous to eat. I am never too nervous to eat. As I grazed the basket of goodies in my expensive suite, I had two questions. First: Would Harpo Productions’ bean counters go over my hotel tab and ask, “Isn’t that the woman who lost all that weight? What are these charges for chocolate-covered almonds and honey peanuts doing here?” Second: Why am I eating all this stuff? I might be on TV tomorrow! What with Oprah replaying 24/7, everyone in America could count the bread crumbs on my velvet dress. So much for the can-do kid, who, after 42 years of obesity and missed opportunities, had lost 188 pounds and written a book about it. Passing for Thin: Losing Half My Weight And Finding My Self is an account of how I used my radical change in weight to turn a small, private worlds of eating and surviving into one as big as my former size 32 dresses. I climbed mountains! I swaddled myself in cashmere and had lovers; I went to Italy. I floated out of the gym after lifting weights, I sat in restaurant booths, wore bracelets, and crossed my legs and took the middle seat in airplanes. Then I used my weight loss to do the next impossible thing: I became and author. Being thin opened the doors to experience and intimacy. National exposure, however, was an intrusion I hadn’t considered. I am not a pundit or a role model. You’re going to be pilloried, Frances, I thought with the vehemence of a Sicilian curse. And yet, there I was gobbling Oprah’s $12 Cookies. I put on my pajamas and pulled back the comforter on the king-size bed. It was littered with wrappers. My cheeks were burning with shame and calories. Tomorrow, I promised myself solemnly. And when tomorrow came, I smiled and joked, and I was gracious when I wasn’t, after all, needed for the show. I ached not from disappointment but with the hangover of sugar in my muscles, the sour gas in my gut and the heartbreak of being a liar. After a failed romance and a change of jobs, I drifted into relapse in March 2003, a year before Oprah, I had time on my hands—and time, in my case, is the enemy. I filled it by studying where and how I went wrong, at the office, in the bedroom. Intellectually, I knew that the boyfriend was emotionally frozen and that my former employer was abusive and infantilizing, but I couldn’t shake my ingrained conviction that I was responsible for everything that went wrong. I stopped going to the gym: I started eating peanuts or rice cakes between meals. A little of this, a little of that, and one morning I announced to a friend that I saw no reason why I couldn’t eat blackberry pie and ice cream, get the craving out of my system and return to my abstinence by noon. I wasn’t talking about a slice of pie a la mode. I was talking about a whole pie and a pint of ice cream. A whole pie? That summer I was reminded at every turn that I needed to be thin to promote my book. “You don’t want those cookies, honey”, my mom said as I carried off a stack I’d grabbed from the cooling rack. “Remember: You’re going to be in Oprah’s Magazine.” She was wrong. I did want those cookies, and I didn’t need reminding about Oprah. I sighed and took two more. When I asked myself what I needed, I was met with an unconsoling barrage of hungers. I needed to know I was not disposable. I needed a resting place. I needed to know I had enough stuff to carry off the rest of my life—enough talent, discipline, and intelligence—and enough sufficiency to protect myself from more heartbreak. I needed enough hope to find the friends and man I mourned the lack of. From August 1999 to August 2003, I’d gambled that losing weight would get me closer to all that, and I was told what to eat in those years. Now, after three years of maintaining my weight loss, I needed to be told what to feel when everyone but me has an opinion of who I am. I knew I—not just my body but my very self—was in trouble when I brushed aside a fleeting thought about how fat I looked with the answer “Never mind. You’ll like yourself when you get thin.” How does one live with self acceptance as a future and an always-conditional state of mind? More pragmatically, in lieu of my size 8 clothes, my career depended on self assurance. When asked, I admitted that I’d gained weight, adding that I never presented myself as the poster girl of thin. I said this with poise, which is not the same thing as confidence. Poise is teachable; confidence is one of the elements missing from the periodic table, three parts self respect to two parts experience. To get to confidence, I was going to have to listen to my self-accusations and sit with the rejections. Maybe shame had something to teach me. My next recovery period from food addiction would be based on therapy, heretofore more a matter of coaching than peeling back the layers of self. My psychiatrist’s and therapist’s offices became the places I could air my feelings about myself and the hopes I could change my self-perception. “There’s no point in getting depressed just because I’m depressed” I told my psychiatrist, who increased my morning meds anyway. That October, on a blue-and-gold afternoon, I had Indian food with Lanie, a friend visiting from my hometown, Missoula, Montana. I described how depressed I was by my weight gain until she preempted me. “You’ve been very fat, Frances, and you’ve been very thin. Welcome to where the rest of us live.” I twiddled my fork in my plate of saag panir. I think of Lanie as being very tall and very thin, but a few months earlier I’d helped her pick out a dress. Her dress size was similar to what I was wearing that day. The event we shopped for had been a gathering of Montana writers, many of them old friends, all middle-aged. One had a rounder face than I remembered; another wore layers of a truly terrible print in the style that catalogs and store clerks describe as “flattering”. Someone else was still very thin but looked drawn and brittle as age caught up with her bone structure. These were woman I’d long envied for their pretty thinness, and yet I’d been less like them when I was a size 8 than I was now. At size 8, I had to admit, I was so self-conscious (and secretly, overweening proud of it) that often that was all I was. I could have programmed my answering machine to announce, “Hi, you’ve reached a size 8. Please leave a message and either the size 8 or Frances will get back to you.” None of the women at that party, or Lanie savoring her lamb jurma across from me, claimed their identities from their weights that night. They wanted to gossip, compare stories of their kids and discuss what they were writing, tell old jokes more cleverly than thy had at the last party, and sample the Desserts weighing down the potluck buffet. I was not unlike them. Smaller by a size than Lanie, larger by a size than Laura, a little fresher looking than Diane. Of the Americans who lose weight, 95 percent gain it back within five years. I had gained a third of it back. Not all of it. To some extent, I had beaten the odds. I was stronger than the echoes of the boyfriend and boss allowed me to hear. I was determined not to repeat the mistake of being, rather than having, a thin body. I’d lived through my size all of my life, so acutely aware and ashamed of my obesity that the likable things about me—my sense of humor, my intelligence, talent, friendliness, kindness—were as illusory to me as a magician’s stacked card deck. As long as I defined myself by my body size, I would not experience those qualities for myself. As fall turned to a snowy winter, I picked through the spiral of relationships that had unglued me the year before. I didn’t blame the boyfriend or my boss for my relapse. I had been half of the problem; healthier self esteem would not have collapsed under their judgments of me. In obesity, I had clamped my arms to my sides to keep from swinging as I walked. I craned my body over armrests in theaters and airplanes, stood in the back of group photos to minimize the space I took up. I got thin and continued to hide. Whatever reasons the boyfriend had come up with for not seeing me, I met with amicability and sympathy. Had I reacted honestly, even to myself, I might have ended the relationship. Instead I’d gambled all my sweetness only to find out I was disposable. Likewise, I had not pressed my boss for an agenda of responsibilities from the start, nor had I clarified with her that her work and recreation styles frustrated and frightened me. Slowly I began to find toeholds in the avalanche of food and doubt. I worried about how fat I looked to potential readers and what I could possible wear to flatter or disguise the 40 pounds I’d gained. At the same time, however, I had become the canvas of makeup artists, stylists, photographers and publicists. They weren’t looking at my stomach. “Give me a hundred-watt smile,” commanded a photographer whose censure I thought I’d seen when I walked in. I licked my teeth and flashed a grin only somewhat longer than her camera flare. “Wow.” She straightened up at the tripod. “That really is a hundred watts. These are gonna be great.”. When I saw myself in the magazine, my smile was, in fact, the focal point. When I began dating, at the age of 45, my smile was an attribute men commented on, but I hadn’t really seen it until it was emblazoned on glossy paper. It was bigger, it seemed, than my face itself. I’d been a size 8 in my author photo, taken as my food plan was wobbling but not yet in smithereens, in June 2003. I was surprised to see I still looked like….myself, apparently. The power of my smile fueled me through more publicity, giving me a sense of authentic attractiveness that allowed me to enjoy the process. When I had a couple of days in Santa Monica between readings, I had a chance to assess and absorb at my own pace. Walking along the Palisades, I admired the sea-twisted pines and pearly mist funneling out of Malibu Canyon. I felt as lucky as I had once felt by being hired, by being loved, and I felt worthy of my luck because I appreciated the prettiness of the place, the serendipity that brought me there and my particular grateful awareness that knitted the moment together. I’d tried to rob myself of that by punishing myself for the boss and the boyfriend. You should not have treated me that way, I thought. The emphasis was on “me”, and just then I knew who that was. I looked around carefully. There was a family reunion going on, or so I assumed until I got closer and realized it was cookout hosted for the park’s lost and unfound citizens. I smiled to myself. How…California. No gritty, iron-shuttered Salvation Army outposts here, no Soup and Jell-O punishment for being a bum. No siree Bob. In California, the homeless are just one more variant on the Beach Boys. I laughed out load. I’m here, I gloated. I like my own company. I was tired of the games—with food, with hiding what I looked like under big clothes and my big smile, with waiting until I was a size 8 again to like myself. I recommitted to chipping at my food addiction, but I let go of some of the rigidity I’d had in the first years of losing and maintaining my weight loss. “I want to be praised when I do things right, and I want to be forgiven when I mess up.” I told people closest to me. “And I want milk in my coffee.” It was a small list, but significant because it allowed me to fumble as I gained my momentum of eating sanely. Esteem, kindness, patience, forgiveness: By cloaking myself in these qualities, I could build a self that was not afraid of authority figures and charming men who have one eye on the door. Maybe these attributes will curb the millions of things that make me want to eat, starting with seeing my parents or returning to Montana. I turn into the kid whose mother had to make her school uniform, whose big tummy stretched the plaid into an Etcher cartoon; I became the sad, joking fat college student who was reading The Fairy Queene while her girlfriends were soaking up the half-naked wonder of being 20 years old. I think of my parents’ kitchens, and my mouth waters for gingerbread and well-buttered toast. I regress when I let people like Lanie, whose struggle is different, comment or take chare of what I eat. “That’s two Entrees, Francis,” Lanie pointed out when I said I wanted goat cheese salad and roast chicken for our first lunch together in Paris. “Oh, Well, then, I’ll have the salad I guess,” I settled, grumpily. That’s the way I eat, that’s how I lost 188 pounds; vegetables and Protein. I was allowing her to limit me to a smidgen of cheese, or insufficient vegetables, and allowing her supervision is how I got so mad--the fatal elixir of anger and crazed desire—that I bought all the chocolate in Charles De Gaulle for my untasting delectation. I am the kid who, when told not to put Beans up her nose, heads directly to the pantry. “I have got to learn to tell people to stay out of my food,” I reported to my therapist back in new York. Then again, perhaps this is an evolutionary process rather than a one-time miracle cure. In 2003, I denned up for two months in Montana and ate. In 2004, I struggled again in Montana but I also did a lot of hiking, alone with my dog and with my niece. My slow pace didn’t frustrate either of them. I went horseback riding and got a terrific tan while swimming every afternoon. My thighs did not chafe in the August heat along the Seine, and I was thrilled to cross the Appalachian Trail later that autumn. I had spells of disappointment and fear from the way I ate, but I was living in my body, on my body’s terms. It’s a small world I’ve pulled from the wrappers, boxes and crumbs in the past two years, but a very human one. I’ve seen my family, close friends and therapists hold on to the stubborn believe that I would come through this. They loved me enough to countenance my mistakes and let me start over. Each day, I venture a little farther from the safety of food, and my courage comes from understanding that I am a lot like a lot of people—a family member, a friend, a dog owner, a recidivist, a middle aged woman, a writer who got a good rhythm going and forgot to brush her hair. There is safety in numbers. Depression and relapse would have to wait for a different excuse than my size. I am ready to hope again. Frances Kuffel is the author of Passing for Thin: Losing Half My Weight And Finding My Self (Broadway books, 2004). Her website is www.franceskuffel.net

I wonder if it's a number the doctor just pulled out his a--. Sorry to be blunt and skeptical (I am by nature) but it seems like the kind of statistic that would get media attention, especially with weight loss surgery rising considerably among the population (seems like there would be a concurrent rise then in the overall divorce rate). I've also never read anything about that--it would mean 8 out of 10 patients who have WLS get divorced. That is just astronomical. I do believe weight loss surgery results in some people getting divorced; I've read about it on other boards. But I think there are other underlying reasons. For example, one woman posted that her husband had cheated on her through thirteen years of marriage but because of her obesity she blamed herself and lacked confidence to do anything. After surgery and weight loss, she left because she realized she wasn't to blame and deserved better. Another guy said his wife apparently was attracted to "dependent" personalities and when he lost weight he was no longer a dependent/needy person and she couldn't deal with her "loss of stature". My husband has stayed with me literally through thick and thin, and I expect he'll stay here when/if I'm thin again. But he's made it known he prefers me thinner. I have only ever found that as I lose weight our relationship improves. At the same token, when I'm at a lower weight I get much more male attention, and I admit I enjoy it. Maybe for some people this temptation is very hard to resist? It's one reason I've decided to join an all-woman's gym. Last time I lost weight (50 pounds on Atkins), I had a difficult time with a few guys at the gym showing interest in me, etc., and it made me too uncomfortable to work out so I stopped going. When you start feeling like you have to look good and put on make up or fix your hair to work out, you know you're at the wrong gym (or in the wrong mindset)! My husband says he's worried I'll lose weight and be so beautiful I'll leave him. I remind him the one time I left him (we separated for a time years ago), I had just had a second baby and was hardly thin and gorgeous so that's not a pre-requisite for me to leave if I wanted to. I think if you and yours have a solid relationship, it will endure. I also think Lisa's story is germane. If you have two overweight people and one is motivated to change while the other cannot/won't, it's not so different from other situations in which people grow apart because one partner experiences something life-changing (like finding God or wanting to adopt/have a child or a traveling or a housewife pursuing a career or even a man retiring). Any major life-altering situation puts strain on a marriage. It's a very complicated issue, and I concur with the counselor that if there seem to be any problems along the way, have counseling. It's a good idea.

hair loss can follow any bodily changes, and I experienced it after both of my children were born. I shed like CRAZY for months starting at about the 4th month post-delivery both times. I couldn't believe I wasn't bald, but all that happened was that my hairline receded a tiny bit--I was the only one who noticed. It also happened after I did Optifast back in 1990. It stopped by itself after a while. I think it always looks a lot worse in the bathtub and hairbrush than it really is, and by the time you really start to worry the shedding is ending. I don't have any suggestions about stopping it--nothing really seems to work--but if it's getting to you a sassy new haircut can go a long way toward making you feel better about it.

Pretty good article...http://www.washingtonpost.com/wp-dyn/articles/A25474-2003Jul21.html?nav=hptoc_h A Kinder Cut? Obese Patients Weigh Safety, Effectiveness, Lifestyle Issues of Lap Band, Bypass Surgeries By Sandra G. Boodman Washington Post Staff Writer Tuesday, July 22, 2003; Page HE01 After his weight ballooned to 285 pounds, John Bischoff, a veteran of failed diet and exercise programs, figured he had no alternative to a gastric bypass that would permanently shrink his stomach. His internist suggested it. A surgeon told him the operation might alleviate his hypertension and lower his worrisome cholesterol level as well as his weight. The retired America Online executive was about to schedule the surgery when he mentioned it to his daughter, a nurse practitioner. "She looked at me like, 'What, are you crazy?' " recalled Bischoff, 56, who lives in Loudoun County. "She said it was radical surgery, life-altering, and there's no reversing it." Bischoff's daughter instead suggested a new, less invasive and reversible weight-loss operation called adjustable laparoscopic banding, which restricts food intake without cutting or stapling the stomach or permanently rerouting the intestines, as does bypass surgery. That appealed to Bischoff, who had the "lap band" surgery six weeks ago at Reston Hospital. Surgeon Eric D. Pinnar made a series of one-inch cuts in Bischoff's abdomen, through which he inserted an inflatable hollow silicone band around the top of Bischoff's stomach. The band reconfigured the organ into an hourglass shape, drastically shrinking the top. This serves a dual purpose: It limits the quantity of food Bischoff can eat and quickly triggers a feeling of fullness that lasts for several hours. Four hours after the 60-minute procedure, Bischoff was walking around his hospital room. The next day he went home. A week later he was back on the golf course. So far he has lost about 22 pounds, at a rate of one to three pounds per week, the amount Pinnar recommends. "I think this surgery is a great option," said Bischoff, who said he has suffered no complications, isn't hungry and eats a fraction of what he used to. "The big thing for me is that it's controllable." Bischoff said he was willing to trade the possibility of lesser weight loss for the band's adjustability. As Bischoff loses weight, the device can be periodically tightened or loosened to allow more or less food to pass through it. Adjustments are made by controlling the amount of saline Pinnar inserts into itthrough a portal implanted under the skin of Bischoff's abdomen. The port is connected to the band by a slender plastic tube. In the two years since it was approved by the Food and Drug Administration (FDA), the adjustable band, widely used in Europe and Australia, has emerged as a kinder, gentler -- and less effective -- alternative to gastric bypass. Although bypass patients usually lose more weight rapidly -- sometimes a pound a day -- the operation carries a higher risk of death and permanent complications than the band. The reason lies in the nature of the gastric bypass procedure: The most common operation, known as the Roux-en-Y, not only reduces the amount of food that can be eaten, but also causes significant malabsorption of calories and nutrients. Malabsorption places patients at greater risk of anemia, osteoporosis and bone disease, problems that can usually be prevented by taking high doses of Vitamins. About 20 percent of bypass patients also require further surgery to correct complications, which can be life-threatening; the mortality rate from bypass is estimated to be about 1 percent. The mortality rate after the band is roughly 0.1 to 0.2 percent. Some band-related complications can be reversed by removal of the device, which requires another operation. An FDA official said manufacturer Inamed has reported seven deaths and 97 serious injuries associated with the band between 1999 and 2002. An Inamed official said that about 15,000 U.S. patients have received bands. Recipients include television personality Sharon Osbourne, singer Ann Wilson of Heart and actor Brian Dennehy. Whether the lap band will become popular enough to compete with gastric bypass surgery remains to be seen, particularly because bypass operations are increasingly being performed laparoscopically rather than through a single large incision, enabling patients to recover more quickly with less pain. Both band and bypass procedures are recommended by federal health officials only for selected patients who are morbidly obese: those approximately 100 pounds or more above their healthy weight. That description fits nearly 5 percent of American adults. A Growth Industry In the past two years, the number of Americans turning to weight loss, or bariatric, surgery has skyrocketed. The American Society for Bariatric Surgery, the trade association for weight loss surgeons, estimates that 103,000 Americans, most of them women, will undergo obesity surgery this year, compared with approximately 40,000 in 2001. This explosive growth reflects the accelerating epidemic of obesity, which affects more than 25 percent of the U.S. population coupled with growing media coverage of the problem and of celebrities' surgeries (most recently the laparoscopic gastric bypass performed on "Today" show weatherman Al Roker). It's also spurred by the lack of viable long-term weight-loss alternatives for the morbidly obese. There is also growing evidence that surgery works: A recent analysis by the Cochrane Review, a respected British collaborative that disseminates research about the safety and efficacy of medical practices, examined 18 clinical trials involving nearly 1,900 morbidly obese patients. The group found that bypass surgery resulted in greater weight loss and more improvement in health problems like type 2 diabetes than conventional diet and exercise programs. But which surgery works best for what kind of patient? And what are the long-term risks and benefits? So far no one knows. The National Institutes of Health (NIH) is poised to fund a $15 million program in which investigators at several medical centers will spend five years attempting to answer these and related questions. "Hopefully at the end of this we'll have some answers," said Susan Yanovski, executive director of the National Task Force for the Prevention and Treatment of Obesity at the National Institute of Diabetes and Digestive and Kidney Diseases, the NIH branch overseeing the effort. Hospitals aren't waiting for answers. Many are attempting to capitalize on the extraordinary growth potential of bariatric surgery, which Health Care Strategic Management, an industry newsletter, has characterized as "a real moneymaker for a hospital that does it right." Many are recruiting surgeons and racing to add obesity surgery programs to lure patients, whose procedures are increasingly being reimbursed by insurance. Also at stake is the most lucrative quarry: the self-pay patient like Bischoff, who spent $15,000 of his own money after his insurance company refused to cover lap band surgery, which it and other insurers have deemed experimental. Months-long waiting lists, particularly for bypass surgery, are common, because fewer than 1,000 surgeons nationally are believed to be performing gastric bypass. Michael A. Schweitzer, a bariatric surgeon at Johns Hopkins Hospital, says he is so busy he is booked for the next year. "I would say the demand for surgery has increased logarithmically," said Arlington surgeon Hazem Elariny, who said he performed the Washington area's first laparoscopic gastric bypass at Fairfax Hospital several years ago. "A lot of it is due to patient interest in the minimally invasive laparoscopic approach." Minimal Invasion Although patients are seeking out doctors who perform gastric bypass laparoscopically, there's a dearth of evidence to show that laparoscopy is superior -- and widespread agreement that it makes a difficult operation even tougher to perform. "This is very, very hard surgery," said New York laparoscopic surgeon Christine J. Ren, an assistant professor of surgery at New York University School of Medicine. Ren, who has performed more than 300 laparoscopic bypasses, noted that proficiency varies widely. "There are surgeons who are used to doing open procedures who are going to a weekend course, doing it on a pig and then operating on people," she said. Laparoscopic training is now usually part of residency training for surgeons, and advanced skills can be acquired during a one-year post-residency fellowship. But most doctors older than about 45 typically have little or no training in laparoscopic techniques, which require a surgeon to manipulate special instruments inserted in small incisions along with a tiny camera. Images from the camera are projected on a monitor the surgeon watches during the operation rather than peering into an incision. There is little dispute that the learning curve for laparoscopic bypass is steep. A recent study of 188 University of Massachusetts Medical Center patients published in the Archives of Surgery found a significant decrease in complications after 120 procedures. That conclusion was echoed by Swiss researchers who recommended that "only surgeons with extensive experience in advanced laparoscopy as well as bariatric surgery should attempt this procedure." With the Band It's much easier to achieve proficiency in lap band surgery. An official of Inamed, the California company that makes the only approved device on the market (a second band is in clinical trials) estimated that it takes about 25 procedures to become proficient. The cost of the band and gastric bypass are roughly equivalent, doctors say, although the latter often requires a longer hospitalization. Although surgeons agree that band surgery is easier and probably safer than bypass, it tends to be less successful: Most band patients lose much less weight. One reason may be that the device requires recipients to confront those twin demons of weight loss: diet and exercise. Patients who don't do both will gain weight. And many scientists believe that bypass operations trigger hormonal changes beneficial to weight loss, a hypothesis NIH researchers will be studying. In the FDA clinical trials, 299 band patients lost an average of 36 percent of their excess weight, about half the amount that bypass patients lose. Seven percent of band patients lost no weight and some even got fatter. "You can defeat this operation with high-calorie liquids such as milk shakes," said Reston surgeon Eric Pinnar, one of the few Washington area surgeons who performs only lap band surgery for weight loss because he regards it as less risky than bypass. "This really focuses patients on what they're eating." But not always. Because the band does not cause malabsorption or a related phenomenon called the "dumping syndrome" -- an extremely unpleasant reaction that includes nausea, sweating, fainting and diarrhea that most bypass patients experience if they eat sugar -- it's not hard for band recipients to revert to their old bad habits, especially if they love sweets. Ice cream, soda and chocolate slide easily through the band without triggering an aversive reaction. Bread and other carbohydrates tend to be harder to digest and can cause reflux or regurgitation. And while band-related complications tend to be less serious, they are common. Although the band is intended to be permanent, 25 percent of patients in the FDA trial had the device removed, often because of side effects, which 89 percent of patients experienced. These include abdominal pain, nausea and vomiting, and heartburn. Some surgeons say that recent refinements in technique may decrease the rate of complications but others predict that inferior weight loss will limit the procedure's popularity. Ren, who has done 450 band operations, said she tells patients that the device is a tool, not a panacea "A lot depends on the patient's motivation," she said. "I tell patients, 'You're going to get where you want by making healthy food choices and exercising. That's a lot easier to do when you're not hungry.' " "I think the lap band is a good operation for the right patient," said Schweitzer, an assistant professor of surgery at the Johns Hopkins University School of Medicine who has done 50 band procedures and more than 500 laparoscopic bypasses. "For most patients, gastric bypass is the best procedure," particularly those who crave sugar or have a body mass index (BMI), a ratio of height and weight, above 50. (A woman who is 5 feet 5 inches tall and weighs 300 pounds would have a BMI of 50.) Aimee Lindquist, 23, of Fairfax said she chose the band over bypass because she worried the latter might be too drastic if she wanted to become pregnant. Since her surgery four months ago, Lindquist has lost half of the 80 pounds she hopes to lose. "The best thing is that I'm no longer obsessed with my weight. I take it as it comes," she said. Her biggest adjustment has been slowing the pace of her eating. A typical dinner, which currently consists of about half of a Lean Cuisine meal, now takes her about 30 minutes to eat because she must chew her food so thoroughly. If she doesn't, she will probably throw up. Daryl Newhouse, 42, of Gaithersburg said she knew the band wouldn't work for her because she craves sweets. She said she spent several months researching various surgeries and chose laparoscopic over open bypass "because I thought the risks were lower and the recovery period was faster." Newhouse, who said she weighed 125 pounds when she graduated from college, gained about 10 pounds annually over the next 20 years. A veteran yo-yo dieter, she carried 320 pounds on her 5-foot-10 frame when she underwent surgery in April 2002. "I was definitely a sugar addict," said Newhouse, an editor at legal publisher Lexis-Nexis who felt she needed the negative reinforcement the dumping syndrome has periodically provided. So far, she said, she has lost 125 pounds. Newhouse said she would like to lose 20 more and get down to 170, a weight she considers her ideal. Her only complication has been hair loss, which occurred six months after surgery and has stopped. She no longer suffers from type 2 diabetes, hypertension, stress incontinence, arthritis or sleep apnea, all of which plagued her before her operation. Her life now, she said, is immeasurably better. Most days she takes four-mile walks with her dog, something that would have been a physical impossibility a year ago. "Even my dog has lost 20 pounds," she said. Bischoff said he is looking forward to getting down to 210 pounds, which is what he weighed when he was discharged from the Marine Corps several decades ago. "I want to be around to see my grandchildren grow up," he said. © 2003 The Washington Post Company