question about calorie restrictive only methods like lap band

[cduval04 7]

Hi, I am not new here, but I dont post on the boards much b/c I have been kind of on the fence about the surgery, but now I am pretty sure of my decision, so you might be seeing more of me. Those of you from the chat room might recognize me, I have hung out there a little bit more.

I am beginning the process of looking into getting banded I had a consult..but got cold feet and cancelled it and now I have swtiched hospitals and am back on the road..am going to an info session on the 22nd of March..then I can schedule a consult...but I have a pretty basic question that I just don't get....

from what I know, out of all the different weight loss surgeries, they work in two different ways....one is...calorie restriction, purely reducing the size of the stomach so you cannot consume as many calories without regurgitating or feeling sick..that is lap band...others...like Roux-en-Y have two methods...calorie restriction as well as creating a small degree of malabsorption by reducing the intestinal area that absorbs nutrients and calories, so it alters the way you actually absorb the calories.

my question is, with the calorie restriction only methods like the band, this may sound stupid....but isn't that what we all have tried every time we have tried to lose weight at any time in our life, just reducing the amount of calories we eat? for those of us with altered metabolisms (i.e, hypothyroid), is a calorie restrictive only method like the band going to be effective?

I am only asking becuase I am so young and I just dont like the permanancy of anything except the band, but if it is going to be a waste of my time, I am willing to rethink it.

I am just confused on this, maybe someone can clear it up. I am a 23 yo female with a BMI of 45

[LeighaMason 19]

I look at the calorie restriction part as a by-product of the band, the band is more of a Portion Control product to me. You can eat just as many calories as before if you choose to eat the wrong foods or to graze continuously.

In portion control what I mean is I can eat a small meal then I feel full and I don't get hungry for 3-5 hours depending on what I ate, what I am doing, etc. In the past when I was doing either portion control or calorie restrictive diets I was HUNGRY! the whole time, that is what kept me from keeping the weight off, sooner or later I couldn't stand the HUNGRY! feeling anymore. I have good restriction with my band and now I feel hungry and need to eat something but not "HUNGRY!" unless I wait too long to eat and then I occasionally get that feeling. But before I was banded I lived with HUNGRY! 24-7. I was HUNGRY! an hour after I ate. This is what gives me the belief that I will not regain my weight, I never have to go back to being HUNGRY! again.

I think your chances of success are more tied to your eating habits than anything. Will you be willing to eat 3 small meals a day with 2 small Snacks instead of grazing constantly? Will you be willing to make the choice to eat quality food instead of junk food? Will you give up sodas? I believe these are the questions that will mean more to your success. But I would like to offer you my admiration that you are taking this so seriously, I think that also helps with your success. Being willing to walk away if you are not willing to follow the "rules" is a very mature stance. I am impressed.

[Jachut 487]

Calorie restriction only is what most people TRY but they dont manage it very well. Most people lose focus, arent quite as accurate, underestimate, and eventually drift bck to eating more.

Calorie restriction works but only if you're consistent,which is what the band enforces. I've never actually had to count, log or even think about calories since being banded - but I have attacked it from both directions by doing a lot of exercise too.

Many people DO need malabsorptive measures too though to get all of their weight off.

[kkarryall 0]

Well this calorie restriction has worked for me!!

[Cocoabean 430]

We have tried calorie restriction in the past, yes. The difference now is that the reduced amount of food satisfies me for longer than it ever did before surgery.

If your hypothyroidism is being treated, it will not be a factor.

Best wishes in your decision.

[cduval04 7]

thanks for all the replies....can some of you share with me a few things about the process...first off... how did you all come to your descision of the band as opposed to other methods.....did you ever think about other methods like the Roux-en-Y or the Biliopancreatic diversion and did you go in with something in mind and your doctor recommended something else?....did you take your doctors advice or did you still want to do the band? did something change your mind? was it a really difficult descision for you b/c you hated the idea of the irreversability? (esp. those of you that are younger)

how long did it take you to lose your weight? I know with the other methods you lose like 75% of your excess weight in the first 6 months, which is really tempting.....but I want to choose the right method for the right reasons...not for how fast it is going to come off...just that it IS going to come off....

and lastly....what was your time from your very first phone call, to when you got your first consult, and then how long from there till your actual procedure (assuming there were no insurance beefs)....the consult that I was supposed to go to where I got cold feet...I waited for over 7 months from when I booked the appt....I came on here and ppl said that was nuts...I dunno the guy must have been god or something :smile2: .....I was just wondering if now that I am at a different hospital....just how long some of you had to wait.....I was hoping to maybe be on the table by summer/fall....I dont think thats unreasonable considering I got experimental brain surgery done in 5 months from start to end....and it wasnt even approved by insurance

these are just 3 general questions that I am wondering most about and I know all of your answers are going to be different but it would be nice to hear other peoples experiences. It is amazing how much knowledge you can gain on forums that goes unsaid elsewhere

Edited March 5, 2010 by cduval04

[chrisdirects 0]

As someone else has mentioned, it's not just the portion sizes, but it's also the quieting of hunger that is a mainstay of the band, once you reach your "sweet spot" with fills. The way it was explained to me, and it made sense, is that the nerve receptors that transmit the "I'm full!" signal to the brain are in the upper part of the fundus of your stomach, which is where the pouch is created. So, you eat less volume before that signal is engaged (of course, you have to recognize and stop eating when that happens, because if you eat beyond it, very unpleasant things can happen, both in the near- and long term). Because the stoma between the pouch and the rest of your stomach provides some control over how fast the pouch empties (depending on the consistency of your meal), you potentially stay "full" longer, even with a reduced volume.

Caloric restriction plans don't help with the hunger issues as effectively.

However, as well as the band works, it doesn't help with head hunger, which is a psychologic, rather than a physiological issue- where your mind/emotions tell you that you're hungry, even when you're not from a physical aspect. Based on what I've read so far, head hunger has contributed the downfall of more than one person. It's definitely something you have to combat as you go.

OK, now you all know that I'm just an incorrigible technoweenie! :smile2:

Best wishes to you!

Christine

[cduval04 7]

As someone else has mentioned, it's not just the portion sizes, but it's also the quieting of hunger that is a mainstay of the band, once you reach your "sweet spot" with fills. The way it was explained to me, and it made sense, is that the nerve receptors that transmit the "I'm full!" signal to the brain are in the upper part of the fundus of your stomach, which is where the pouch is created. So, you eat less volume before that signal is engaged (of course, you have to recognize and stop eating when that happens, because if you eat beyond it, very unpleasant things can happen, both in the near- and long term). Because the stoma between the pouch and the rest of your stomach provides some control over how fast the pouch empties (depending on the consistency of your meal), you potentially stay "full" longer, even with a reduced volume.

Caloric restriction plans don't help with the hunger issues as effectively.

However, as well as the band works, it doesn't help with head hunger, which is a psychologic, rather than a physiological issue- where your mind/emotions tell you that you're hungry, even when you're not from a physical aspect. Based on what I've read so far, head hunger has contributed the downfall of more than one person. It's definitely something you have to combat as you go.

OK, now you all know that I'm just an incorrigible technoweenie! :smile2:

Best wishes to you!

Christine

well that is pretty good news becuase I really tend not to eat when I am not hungry...except for occasional boredom...I dont eat emotionally...anger sadness all tend to take away my appetite...I went to weight loss camp when I was 17 was away from home for a month was so home sick I didnt eat for a week straight, they would put a plate of food in front of me and I just could not eat it...I lost 15 lbs that month haha....I dont think that was the intention...anyway...I tend to Celebrate with food...but not out of control...like when I make the deans list for the semester or get an A on a test I will treat myself to taekout or something, but I know I should treat myself to perfume or makeup or something, but its nothing huge, most of the time I dont eat if I am not hungry.

the problem with me is two things. 1 is am am a total computer nerd so I will literally spend like 6 hours on the computer and just forget to eat and let myself get WAY past hungry and thats when i get in trouble....2 is my appetite is SO unpredictible i dunno whether its hormones or what but some days I wont be hungry at all or I will have a normal appetite like 2000 cals and then other days I feel like I could just eat the walls off my house I just eat and eat and eat and eat and eat....my body seems to do what it wants when it wants.....

I guess I am just so scared becuae the feeling of NOT being hungry is like impossible to me....everything I have tried out there that people said will supress my appetite...(high Fiber....filling up on veggies....drinking buckets of water)....has done nothing. even other medications I have gone on that have nothing to do with weight loss (I was on wellbutrin for depressson and am now on topamax for migraines) where at least some weight loss/appetite supression is almost a guaranteed side effect-NOTHING with me...its like I CAN'T not be hungry....its like when my hungry spends a day in my house, nothing can get it out the door....and I really dont feel its psychologicial b/c like I said I can feel when I am not hungry and I dont normally eat just b/c something is there.

did anyone else feel that way before getting banded? like, "not feeling hungry, no way not me, no way no how"

Edited March 5, 2010 by cduval04

[TinaM 0]

hi there-

i'll try to answer your question but if I miss one just message me.

The time from phone call to surgery really depends on insurance

self pay - you really get it doen fast

ppo usually 3 month process

hmo usually a 6 month process

and this is after your 1st official weigh in

the part about calorie restriction- the band restricts the amount of food you put in the tummy - it doesn't pick the kind of foods you eat - you still do - so if you want want to eat choc mousse, ice cream and red velvet cake - hmm you are eating way more calories than you ned to.

So you still need to make the right food decisions it really quites the hunger as others have said.

i looked at rny and sleeve and band - the decison was 100% mine

my physican and his team gave me all the facts they had, i walked in wanting the band and 6 months later it was still my choice. This may sound strange but for me it was still being somewhat in control. Yes, I'm a control freak.

During my reaserach I found that at 5 years the RNY and Band have the same % of weight loss - RNY drops faster of course but slow and steady was fine for me.

The major difference between the other surgeries and band is the amount of work you must do - the band does require significant follow up care - fills, unfills until you get to your sweet spot. The others are more of a set it and forget it with exception of daily supplements.

A few suggestions-

1. Attend as many support groups for WLS you can during your decision process. I was fortunate enough that we had a micxed group of pre and post op patients from all WLS surgeries.

2. Take all board comments with a grain of salt both the good and the bad. You are a unique person so follow the advice of your medical team.

3. Know regardless of your decision - its the 'right' one for you:blushing:

good luck-

[BetsyB 9]

You're quite right. We all have tried calorie restriction in the past. However, we've done it without a tool that permits us to do so comfortably.

No one can choose which surgery is best for you other than you, with the guidance of your surgeon. But most of us are really, really happy with the results we've achieved.

I would like to correct a misconception. You write, re: RNY:

as well as creating a small degree of malabsorption

The malabsorption associated with bypass is significant. The portion of the bowel that is bypassed may be small, but it is where a vast percentage of nutrient absorption occurs.

That doesn't mean RNY is a bad procedure. It just means that it carries with it other considerations---the need for lifelong supplementation (Protein, other nutrients) becomes far more critical. And the eating limitations are far, far greater. Some people view the latter as a bonus. Only you can decide whether that's the case for you.

[Cocoabean 430]

Hello Again!

Biliopancreatic Diversion is generally used for the highest BMI's I believe--due to the very high risk of malnutrition. That is a very effective procedure, but at great potential risk.

RNY also has malabsorption. As I can barely remember to take my Multivitamin, I did not really want to have to take many prescription Vitamin pills each day. At a seminar I went to there was an RNY patient who spoke. She showed us her packet of Vitamins. It was more than all the pills I was taking for cholesterol, blood pressure, and the like combined.

I chose the band for the above reasons. Plus I like that it doesn't reroute everything and can be unfilled if for some reason I should need extra nutrition.

But I will say, after my experience with the band, all positive--that if for some reason I have to have it removed, I would not hesitate to convert to RNY if that is what my doctors felt was needed for my continued good health.

My surgeon will not do a band on someone with diabetes. As RNY has an immediate effect on blood sugar, he feels RNY is a much better treatment for diabetes than a band.

As I am not diabetic, he was fine with my choice to have a band.

Ah, Topamax...I started it last September for Migraines as well. I was told most people lose weight with it. SCORE!!!

Yeah, well, if a drug will make 95% of people on it lose weight, I am in the 5%. Initially I lost about 5 lbs in a few weeks. Then that came back. But my migraines are much improved.

I am also one of the chosen few who when my thyroid was high I could gain weight. Most people lose when that happens.

But with the band, I have successfully lost weight. I aids me with the Portion Control I so desperately needed.

My timing for surgery....went to info seminar with my surgeon in August, had surgery the following February. I did not have to do a 6 months supervised diet. It just took that long to get all the testing done. I also had a psychologist that took 2 months to write the letter saying I was ready for the surgery. Why it took that long I don't know. My meeting with him was 20 minutes. GRRR!

I did go through my insurance, if you are self-pay, I understand it can go much faster.

Getting too hungry...that gets me into trouble with the band because I will either eat too fast or take too big of a bite.

Either one can cause trouble by getting food stuck. So, before I take a bite I stop myself and do some self-talk to slow down, take little bites, and chew, chew, chew.

[cduval04 7]

Betsy its really interesting that you pointed that out

would like to correct a misconception. You write, re: RNY:

Quote:

as well as creating a small degree of malabsorption

The malabsorption associated with bypass is significant. The portion of the bowel that is bypassed may be small, but it is where a vast percentage of nutrient absorption occurs.

I actually copied and pasted that from the hospital web site, lahey clinic but I am sure it was just mis-wording on the part of whoever typed it, I know lahey is very well respected world-wide and they were willing to do brain surgery on me that had never been done before and they have given be a second chance at living a normal life, so I would put my life, stomach, or whatever it may be in their hands any day. You are correct about that statement though, I do beleive it is worded wrong, but I also don't beleive the surgeon himself is sitting at the computer typing that lol.

Cocoabean,

Yeah, well, if a drug will make 95% of people on it lose weight, I am in the 5%

ditto on that, same goes with rare side effects. But my pounding headaches/migranes have been

almost absent after 2 weeks on it.

Good to hear about the diabetes thing, since I am not diabetic either.

I am also one of the chosen few who when my thyroid was high I could gain weight. Most people lose when that happens.

I think I might be in that small population too, although I dont know what the heck is going on with my thryoid, my TSH and T4 levels have been wacko all over the place the past 2 years even though I am on synthroid. I seem to have hyper-hypo phases......I swear to god I have hashimotos but I have had my antibodies tested twice and they were neg....I also likely have a pituitary tumor that is causing some hormone dysfunction....but I just cant wait for them to come up with a diagnosis and just watch myself BLOW up to over 400lbs....that is why I really want the band....b/c I do believe they will eventually find something....and if they do...all of us will be happy that I chose the band....its a really tough descision...and I guess I hadnt mentioned it on here before b/c you guys might think it is a weird reason for seeking a band....but if they are willing to band me (which costs a lot more than running tests to dx me) I have to go along with it......

I dont know, what would you do...just sit and wait for an abnormal test while you battle with hungry every day and watch the scale continue to go up....or do something if you were offered it...???

[Cocoabean 430]

Cocoabean,

ditto on that, same goes with rare side effects. But my pounding headaches/migranes have been

almost absent after 2 weeks on it.

Good to hear about the diabetes thing, since I am not diabetic either.

I think I might be in that small population too, although I dont know what the heck is going on with my thryoid, my TSH and T4 levels have been wacko all over the place the past 2 years even though I am on synthroid. I seem to have hyper-hypo phases......I swear to god I have hashimotos but I have had my antibodies tested twice and they were neg....I also likely have a pituitary tumor that is causing some hormone dysfunction....but I just cant wait for them to come up with a diagnosis and just watch myself BLOW up to over 400lbs....that is why I really want the band....b/c I do believe they will eventually find something....and if they do...all of us will be happy that I chose the band....its a really tough descision...and I guess I hadnt mentioned it on here before b/c you guys might think it is a weird reason for seeking a band....but if they are willing to band me (which costs a lot more than running tests to dx me) I have to go along with it......

I dont know, what would you do...just sit and wait for an abnormal test while you battle with hungry every day and watch the scale continue to go up....or do something if you were offered it...???

Hi There again.

I'll let Betsy speak to the malabsorption amount in RNY. All I really know is, it is a fact that there is more in RNY than there is for LAP-BAND as we absorb everything we eat :smile2:

You ask what I would do? I would keep pursuing a diagnosis, that is for certain. I'd also pursue the band.

This is my opinion only, of course--I have no medical training. The reason I'd choose the band over the other WLS procedures is that you are unsure of your thyroid condition. I would not want to permanently disable parts of my digestive tract. RNY -is- reversible, just not as easily as is a band. Also, RNY affects some other hormones, not sure if I'd really want that if I were already having endocrine problems.

My thinking is that if you do get a band, whey you are hypo, you'll not really lose weight, you might even gain. When hyper, the band will help you with Portion Control and you'll lose, probably pretty quickly. Especially if you work the band properly.

This is based on my hyper phase experience. I was HUNGRY. So I ate.

Question for you, are the surgeons willing to do the band with the thyroid issues going on?

Have you tried Armour thyroid? I've read that some people do much better converting it than the synthetic variety.

Best wishes in your decision!