Whenever we undertake something large, be it a job, a relationship…a surgery, we have great expectations. This holds true especially if there has been what could be considered a significant comittment.
So what are reasonable expectations?
With gastric banding I feel reasonable expectations would include:
- weight loss
- significant improvement if not remission in many comorbidities such as: diabetes, high cholesterol, high blood pressure, fatty liver, hormonal imbalances, aching joints, shortness of breath, lack of energy, depression
- nutritional support from a Registered Dietician
- support and motivation from your clinic
- access to support staff in a timely manner
- prompt and appropriate management of any band-related issues
- personalized care
I’m going to cover the first three points in Part I.
Weight Loss. This is usually the primary reason people decide to have gastric banding (or other forms of bariatric surgery) done. If you have been banded, have (or have not) had a few adjustments and are not losing weight there are usually only two reasons:
- Your band is too loose. If your band is too loose than food is crossing too quickly and you are becoming hungry in less than 4 hours and needing to take in extra calories in the form of snacks to control that hunger. If this is the case you need to contact your clinic to set up an appointment for a band adjustment.
- Your band is too tight. This will inevitably lead to the maladaptive eating pattern of consuming ‘slider’ foods because the more solid foods are too difficult to consume. This type of eating nearly always leads to weight plateau or weight gain as these foods tend to be higher in calories plus they cross the band more quickly leaving you hungrier sooner. If this describes you GO FOR A DEFILL. You will not gain weight, in fact you will end up being able to consume a better quality of solid foods, which are higher in protein and you will lose weight.
- You are eating the wrong foods and/or in the wrong amounts. You and I both know that to lose weight the teeter-totter has to be tipped. Calories in have to be less than calories out. Banded or not we also have to eat the ‘right foods’ the majority of the time. This means a combination of protein, healthy carbohydrates, healthy fats. We can’t lose weight if we eat too much and if we eat crap. Food diaries are phenomenal in sleuthing this out. So often we have no idea of the extra calories that sneak their way into our poor unsuspecting stomachs unless we write them down! Try doing a 3 day food diary (and I mean 3 normal days not 3 “I’m gonna be good cuz I’m writing it all down” days) and writing down everything that crosses your lips good and bad. Then have a look and see if you can see extra calories sneaking their way in (a common one: frozen coffee drinks…). If your clinic, like ours, is blessed with an amazing dietician they will analyze your food diary and help you focus on the good and weed out the bad.
- You are not moving enough. Exercise is important I can’t stress this enough. It won’t necessarily MAKE you lose weight (a topic for a future blog!) however it will make you feel AMAZING, improve your health (physical, mental and emotional) in every way and complement your weight loss journey.
Significant Improvement if not Remission in Many Comorbidities. One of the first benefits of gastric banding that I most often see is patients coming in and saying “my diabetes meds are cut in half and I’m almost off my high blood pressure medication”. Few things make me feel better than hearing that. Now I can’t say that you can be guaranteed these results as there are always other factors to consider, but most often people can expect to see these health issues improve in a fairly short period of time post surgery. Usually with the adherence to a pre-op diet the fatty liver starts to improve pre-operatively and this continues post op as the diet improves and weight loss continues. The same holds true for high cholesterol and often hormonal imbalances in women (we have seen +++ healthy babies born as a result of a remission in PCOS and the return to a normal menstrual cycle). Aching joints, shortness of breath, lack of energy and depression…so often these issues go hand in hand. Once the weight starts to decrease joints don’t ache as much, shortness of breath improves, energy levels go up and people feel like moving more. These thing can all lead to an increase in serotonin and the ‘feel good’ hormones, and depression quite often starts to lift. (*This is not to say that depression should not still be closely monitored and followed by your MD).
Nutritional Support from a Registered Dietician. Nobody knows more about nutrition and your band than a GOOD RD. We are blessed at our clinic to have a PHENOMENAL RD and I hope other clinics have the same. A good RD should be there to answer all of your dietary questions related to nutrition and your band. If you have questions regarding WHAT to eat and HOW MUCH to eat….consult your RD. Your RD is not there to give you a ‘diet’ to follow. As you have likely learned in the past, diets fail. You need to learn how to eat well every day with this tool that you now own. A good RD can help you analyze the foods you eat and find tasty, satisfying combinations to keep you satiated, satisfied and healthy.
If you are hanging onto the edge of your seat for the remaining four ‘Great Expectations’ go immediately to ‘Great Expectations…from your Clinic Part II‘…guaranteed to thrill you, chill you and have you begging for more!!!
To be continued…