|
News, Updates, and Blogs in Weight Loss How To Get The Best Results From Your Laparoscopic Adjustable Gastric Band This article reviews how to get the best outcome with the gastric band operation. Anyone entertaining the thought of getting a band or who already has one needs to understand some of the fundamental issues in order to achieve optimal results. Aug 29, 2008 The Laparoscopic Adjustable Gastric Band is performed as an outpatient procedure involving placement of the band around the top of the stomach and placing the port beneath the skin. At regular office visits, if necessary, the band can be adjusted by placing a special needle through the anesthetized skin into the port. If fluid is added, the band tightens and if fluid is removed, the band loosens. There are no fixed guidelines as to how much fluid to introduce into the band to achieve a certain weight loss as each patient requires a different amount. The goal of band adjustments is to help patients arrive at the perfrect amount, the "sweet spot" of the band or what is commonly referred to as the "green zone". At this point, the constant gentle pressure that the band exerts on the stomach wall activates the same stretch receptors that get activated when the stomach is full of food after a meal and the brain is "tricked" into giving the patient a sense of fullness. In the green zone, the patient has a comfortable, pleasant feeling of satiety; not thinking about food, not searching for food, and not snacking on food. You may actually go through a meal time and forget to eat. Also small amounts of food will fill the pouch leading to early satiety. Thus, when perfectly adjusted, the patient has appetite suppression and portion control: two very powerful tools in the battle against obesity and for permanent weight control. But these are only tools and the outcome you achieve is related to the effort you put into it.
When the band is too loose, or in the “yellow zone”, then satiety is lost, patients are hungrier, snacking, obsessed with food and require larger amounts of food to feel full. Having a band in the yellow zone is not much better than not having a band. If you are not achieving the weight loss goals with the band, then most likely you are in the yellow zone and you need to come in to the office for an evaluation and possible adjustment. With the first several adjustments, it is common for the green zone to be temporary since as you lose weight, there is less tissue inside the band. It usually takes four to six adjustments to reach the green zone and stay there. Even after the first year, 2-3 adjustments per year may be required to stay in the green zone.
When the band is too tight, or the “red zone”, then eating is painful with a sensation of food getting stuck with relief coming only after vomiting. Other symptoms include heartburn and regurgitation particularly at night and a constant discomfort or pain at the base of the breast bone.
Even when the green zone is reached, weight loss may stagnate. The band will not distinguish between healthy foods (tuna salad) and poor quality foods (chocolate cake) so that discipline is essential. You will have to make nutritious food choices selecting low-carbohydrate high-protein foods, vegetables, multigrain fibers while restricting sweet or starchy foods. High caloric beverages are even worse since liquids pass right through the band and will lead to inadequate weight loss or even weight regain. Consultation with our in-house nutritionist can be beneficial in setting up an ideal meal plan that emphasizes the right foods and drinks as well as proper eating habits.
Separating liquids from solid foods is also important since solid foods will fill up the pouch leading to fullness while liquids pass through and will wash the solid food out the pouch into the stomach downstream. Drinking while you eat can lead to excessive food intake with regain of weight. It is important to separate liquids and solid foods such that you should drink at the beginning of a meal before you eat and take in all the liquids (ie water) first. Once you start eating food, you should drink nothing and avoid drinking for 30 minutes following your meal. This will keep you fuller longer so that you eat less.
Exercise is also important as this will determine the lowest weight you can achieve and help you stay there for the long term. Contrary to popular belief, exercise burns little calories (you cannot eat a slice of cheese cake and then make up for it by jogging one mile). Regular exercise (30 minutes per day of moderate intensity exercise) over months and years will gradually increase your lean body mass which in turn will increase your resting energy expenditure (basal metabolic rate). That way, more of the calories you ingest are burned off permitting you to maintain your weight. If you do not exercise or if you stop exercising, your metabolism falls and, unless you reduce your caloric intake, you start storing the excess calories as fat. |
|