Permanent Long Term Weight Loss

[bluegudren 156]

I'm well adjusted. But it took over a year to get here. I do not exercise. I do not weigh my portions. I drink alcohol. I do not regurgitate my food. I am losing 6-8 lbs a month. I'm happy. And I do not beat myself up about what I put in my mouth. Average meal is 1/3 cup 5 times a day I eat Protein mostly. I tolerate salads as well. No bread.

[drgthemd 7]

I couldn't agree more. Being too tight is never good. It only leads to complications, as you well know. I also concur that the endpoint where a Lap-Band patient should stop eating should not be when they are experiencing pain. That is beyond the proper endpoint. It should just be a feeling of fullness, never pain

[drgthemd 7]

It sounds like the band is working well for you and that's great. I think you will find you'll need to add the exercise component to have ongoing success in reaching a normal, healthy weight. Also, occasional drinks and alcohol are fine, it just can't be excessive or it will definitely hinder your weight loss efforts.

[drgthemd 7]

If you totally eliminate exercise, you will lose more muscle than necessary during your weight loss. Exercise should consist of aerobic and resistance (anaerobic) training, such as weight training. The weight training will allow you to retain and not lose excess muscle during your weight loss efforts with the Lap-Band. I hope that information helps

[Bandista 7,466]

I love my band and feel successful although I would still like to lose another twenty or so pounds. Exercise, for me, is imparative because of arthritis, etc. I eat two to three healthy meals a day, avoid sliders, chew very well and experience the food rather than wolfing it down as I did before. My surgeon was of the small frequent fills to get me to the correct restriction (wrong word to use but you know what I mean). I have twice gone in for tiny unfills when I felt the first signs of being too tight. For now it's just right. I drink a lot of liquids and can do that without any discomfort (glugging my water). I don't count calories and I eat when I'm hungry and don't eat when I'm not hungry. It's the first one that can be the most difficult as I was a very restrictive professional dieter going into this process. Now I feel hunger and eat until I feel full. My signal is a sigh. I notice, take inventory and I'm done. Sometimes I count off on my fingers 4-5 hours and note the time at which I might feel hungry again. Alcohol certainly hinders weight loss but I indulge for pain relief and enjoyment.

Reading through this thread it seems like things got off on the wrong foot. Best wishes with your research. My surgeon is great but he does not discuss the banded life and I suspect has no real idea of how to guide patients in the post-op realm. I got that here when it was Lapband Talk. I found the successful banders and followed them. Now the site is mostly other surgeries and that's a bit discouraging sometimes as the revision folks post so much about their negative band experiences. I love my band.

[drgthemd 7]

Bandista, we have patients in our practice with arthritic pain who have been able to adequately control pain with a combination of appropriate arthritic anti-inflammatory medication and swimming as an exercise. As you're aware, alcohol should be minimized.

It is true that the Lap-Band seems to have fallen out of favor with both patients and doctors in the last few years and that, in my opinion, is very unfortunate. In our practice, we have performed thousands of bariatric procedures, i.e. gastric bypass, gastric sleeve and Lap-Bands. In my opinion, the adjustable Lap-Band system is the very best procedure because it is safe, the least invasive, the least expensive and also the most effective for long term, permanent weight loss if the patient is properly educated, has good post-op care and follows the simple guidelines of healthy eating, exercise and eating slowly. Unfortunately, some patients don't comply with the simple rules and many doctors do not want to take the time to properly educate and provide the effective post operative care for patients because it takes significant time and effort to provide good follow up.

We have seen many gastric bypass and gastric sleeve patients who although they lose weight initially, after a few years, they gain all or a good portion of it back again. This is because they can overeat and stretch out the stomach and thereby can consume larger quantities of food. We have placed a Lap-Band in some of those patients as a secondary operation with great success. In summary, in our experience, the Lap-Band is the very best WLS tool for long term, permanent weight loss. With time, I'm sure a lot of the negative press about the Lap-Band will be reversed.

[B-52 7,113]

There was much discussion here not too long ago about how Surgeons are recommending the lap band less and less....

I brought this up to my Dr and the staff and I was told that they too are not performing as many procedures as before.

Not that the lap band is less effective than other procedures, quite the contrary....but that the patient has too much control over the outcome.

The band is adjustable. And with that adjusting comes much compliance and behavior modification from the patient...and peoples perceptions and comfort levels can be very broad. Some people will fight change and have their bands adjusted to where they can keep some of the old ways.

Then there are those who come in to get Fluid taken out because they are going on vacation, or the holidays are coming up...kind of defeats the purpose.

What one person ay say is perfect, the next person will say it's too tight.

I cannot tolerate red meat, rice, breads and flour products, and a few other things. So I have given them up. (Much to the delight of my cardiologist and PCP)

The next person will say I'm too tight, and they feel they should be able to eat anything and everything they want....who's right and who's wrong is not the issue.

I've read posts here where people get food stuck and regurgitate.....They immediately say they're too tight and go and get Fluid taken out.....maybe, just maybe, it was because of what and how they were eating that was the problem, and not the band??

It was because of our bad habits that made us obese, and those habits cannot continue after WLS...but with the band, it can be adjusted so you can hold onto some of those things.

The issue is there are too many variables. Too much adjusting for both the patient and the band to achieve that perfect balance and ultimate success, or not ever finding it, accepting frustration and self failure.. And ultimately, too much for the Dr. and staff to contend with.

Other WLS are more cut and dried....here it is, no adjusting. Everyone's perception is the same. Now you have to learn to live with it, and cannot be adjusted to fit the patients comfort level.

[KateP 359]

@@B-52 I so agree with you!

But, interestingly, in addition to what you say, and not in line with the doctor who started this thread, I am also told by my medical team that one of the biggest issues they face, and one which cannot be controlled, is a build up of scar tissue round the band over the years. This causes tightening.

I am under the aegis of the All-Wales Bariatric Unit which is part of our National Health Service. The surgeon in charge no longer does bands, partly for the reasons you give, but also because he has had to remove too many because of physical issues and scar tissue is one of the main ones.

[drgthemd 7]

In my experience, no matter what kind of WLS a patient has, if they are not willing to be disciplined enough to have some behavior modification, they will not be successful with any WLS. There is no magic pill, but, in my opinion, when you compare bypass, the sleeve and Lap-Band, there's no question the band is the best choice. I can say this with confidence because I've seen the results from all the above three bariatric procedures over a long term. I tell my patients that if they're not willing to make some behavior modification, then they are wasting their time and money with WLS. I have found that once I educate the patient on the pros and cons of all 3 procedures and explain in simple terms the guidelines they need to follow in order to be successful, most of my patients elect to go with the Lap-Band procedure. Once the procedure is performed, we are very diligent and persistent in our follow up care with the patient during the post operative years and this has resulted in the achievement of excellent success for long term permanent weight loss with our patients. There is no reason any patient cannot have total success with the Lap-Band. The real key is education, education, education and follow up, follow up, follow up.

I agree that many doctors are unwilling to do the education and follow up because it takes time and commitment from the doctor. Also I agree that many doctors become frustrated with non-compliant patients and that's another reason they prefer other bariatric procedures where there is not nearly as much post-op follow up care involved. However, I have learned over the years that being persistent with follow up with my patients eventually leads to the goal of behavior modification. Behavior changes are not easy for the bariatric patient, as you all well know. It takes time, effort and patience on the part of the doctor and the patient to achieve it. But, eventually, with persistence, behavior change will occur and patients do have success. Yes, it is true that Lap-Band patients do develop scar tissue, which is a foreign body reaction.The amount of scar tissue that develops varies from patient to patient, sometimes requiring reoperation to remove the scar tissue. However, in our practice, the number of patients needing reoperation to remove scar tissue has been exceedingly rare. I mentioned in a previous post that a number of our patients have had all the Fluid removed from their band once they achieved a normal, healthy weight. Those patients continue to maintain their weight because they have changed their behavior. The ultimate goal of a bariatric practice should be behavior modification with healthy eating and drinking, consistent exercise and eating slowly. In our practice I've seen how we have dramatically improved the quality of life by eliminating comorbities and I'm sure we've also increased dramatically patients' longevity. It is gratifying to see those results. I encourage patients who are struggling with their Lap-Band to be persistent in following the simple guidelines previously outlined because eventually, if they are persistent, despite any failures along the way, they will ultimately achieve success.

[bramos75 6]

I have been banded for 8 months and have lost a total of 106 pounds!! The band is only a tool...we either want to remain unhealthy or allow the band to work with us. People that have not lost weight is not the band's fault it's our fault because we remain in the same mentality. We have to stop trying to blame everyone and just look in the mirror. WE EITHER WANT TO CHANGE OR REMAIN THE SAME! No matter what it begins and ends with us. I have read many excuses on here and it's quite upsetting to hear th as t people are still trying to play the blame game...I have been overweight all my life and at only 4 ft 11 inches carrying 348 pounds was not fun but was my choice so people get over it and create a better life for yourself.

[drgthemd 7]

I commend you for your great success. As you have experienced, the Lap-Band is a great tool for achieving weight loss. On average, our patients lose 8-10 pounds a month and you have lost even more than that. Congratulations. You are obviously compliant with the simple rules of healthy eating, exercise, eating slowly and getting a properly adjusted band. You are absolutely correct that success with the Lap-Band is behavior modification. In addition, it is extremely helpful to have a surgeon who is truly interested in long term results and gives proper education and post-op follow up care to the patient. Good luck to you in your ongoing efforts to achieve and maintain a healthy, normal weight!

[drgthemd 7]

This week's helpful hint for success:

When you shop for processed foods (the foods in cans, bottles, packages), always read the label to be sure you are buying healthy processed foods which contain minimal amounts of saturated fat, trans fat, cholesterol, sugar and salt (sodium). Once you are familiar with healthy types of processed foods, reading the label won't be necessary unless it's something new you've never tried before. If anyone out there is struggling with weight loss, let me try to help.

[Miss Sue 0]

I am brand new to this forum. Got my band on March 9, 2015. I've had two fills of 0.5cc each. My band is a 14cc size. I feel no restriction or fullness of any kind. It's like I never had surgery. I feel like my fills should be a larger amount. I've lost no weight (actually gained a pound). I am following the rules on what to eat but I eat far more often because I am so hungry two hours after a meal! Anyone else feel like this?

[drgthemd 7]

I'm not your doctor and you should seek advice directly from your surgeon. However, I can give some general guidelines. If you have a 14cc band and you've only had 2 fills of .5 cc's each, you are underfilled. You definitely need more Fluid placed in your band. I would make another follow up appointment with your surgeon for an additional adjustment. We do the first adjustment at 6 weeks out and it usually takes 2-4 adjustments to get a patient adjusted properly, in our experience.

Once you are properly adjusted, if you follow the simple rules of healthy eating, avoiding fluids with calories, consistent exercise of at least 3 hours per week, eat slowly and take small bites, chewing your food well, you should lose approximately 2 pounds a week. That has been our experience dealing with many patients over the last decade. Good luck to you and I wish you success with your Lap-Band.

[FluffyTanji 4]

My husband had the lap band in November and he's able to eat anything!....even the day he gets it adjusted he can still eat a full meal...it's as if he's never had it!