There are several characteristics that we have identified from those patients who are successful with their lapband. Sometimes what we find out from them surprises us, and changes the way we think about the lapband. But we spend a lot of time with our successful patients, and learn from them as to what we can do to help others.
One lovely patient of mine said that if I told her this one more time she would choke me. But this is what our patients who lose their excess weight tell me. “The lapband doesn’t do the work,” Bill told me, “I’m doing the work. The band just makes it possible.”
As a weight loss surgeon, all I do is install the right tool. It is up to you to use it properly.
Bill has had his lapband for five years. When he came to me he weighed over 300 pounds at five foot six inches, and was not a happy man. He now weighs 160 pounds, but he will tell you that he works at this every day. He eats healthy food, he measures his food, and when he needs to get an adjustment, he comes in. Recently Bill had a bit of pouch dilation so we had to remove fluid for a few weeks and rehabilitate his band (he had been eating a bit too fast over the last months and started to notice heart burn.). During the band rehabilitation Bill gained 2 pounds.
X-rays of successful patients
Take a piece of food, like meat, and put some x-ray material on it (kinda ruins the taste) and have a successful patient eat it. How fast do you think it goes from above the band to below the band? Pretty quickly- usually less than a minute, but for most about 30 seconds.
We used to think that food stayed above the band and slowly dripped down – like coffee through Mr. Coffee filters. But it doesn’t. Food, in successful patients- goes through quickly.
What about patients who are not successful and talk to us about wanting the band tighter and more “restricted.” Their food stays above the band longer. They have more episodes of “productive burps” more trouble with meats and vegetables. But if you ask the unsuccessful patient they will tell you, “I know my band, and this is how I lost weight before.” It probably wasn’t- but now they think the answer is to make the band tighter and tighter.
Drinking and eating
Successful patients eat and drink at the same time. We use to think this wasn’t a good idea, and some lapband patients from those days don’t eat and drink at the same time- and tell us it makes a difference.
Did you know that 77% of our successful patients exercise. Lots do weight training, some cardio, but they work out and do it a lot and enjoy it. A very small per cent did that before the band. Exercise isn’t how they stay thin- but if you ask them, “When I exercise, I don’t want to waste calories on something stupid and give up all I did.”
Unsuccessful patients tell us they didn’t exercise last month (the month before they came to the office).
They don’t “eyeball it,” they measure it. And in fact, they often don’t trust their own eyes because when they don’t measure for a few days and then test themselves they are shocked at how much they start to eat. Jacquie weighed 260 pounds when she started with us. One year later she weighed 130 pounds. What was her secret — she measured everything, “Everything I ate I put in those little cups.” Oh, after a year she got her first fill (her band was a bit lose).
Unsuccessful patients tell us “I eat less than I ever did, and I just don’t understand.” Do they measure? No- they eyeball. Test this right now – get a measuring cup out and cut up the meat you would think is your portion for dinner.
Successful patients know that they eat less for the first year or 18 months, then they increase the amount. Unsuccessful patients increase the amount.
Never hungry, never full
“I just live by never being hungry, but I never want to get full either,” said one of our lapband patients. She ate every four hours, but never much, and she had gone from weighing 220 to 125 in one year.
Patients who are not successful tell us that they “can eat more than I should.” The answer is, they always could eat more – the band does not physically prevent them. But when you eat to feeling “full” you will eat more than you should. When you know how much you need to eat to avoid getting hungry, and not go over that, the answer is weight loss.
Everyone has setbacks. But successful patients get up, come back in, and get adjusted. Sometimes it is their head, sometimes it is there band.
Unsuccessful patients blame everything but themselves: be it drugs they are taking, a lack of exercise, or stress. The successful patient learns from the mistakes they made, know their trigger and figure it out. We had one patient get upset because she was on prednisone, had thyroid issues, had orthopedic issues, and just thought we were not nice because we didn’t accept that as an excuse (we would have the first time, maybe the second time, but a year of excuses to not lose weight with the band).
Successful patients will tell you that they eat differently now than before surgery. Unsuccessful patients tell us that their diet can’t change because they are picky eaters, and their diets have not changed. In spite of signing the consent form, which on page 2 says they are willing to change lifestyle- these patients don’t change the most fundamental issue- what they eat, and where they eat it. Bad food, and too much of it, is bad food.
Successful patients see us about 6-11 times the first year, and 4-6 the second. Unsuccessful patients see us either much less – or a few see us more.
Want to change?
Consider this- there is nothing that is difficult if you are willing to change. Let the lapband be the tool. Our 90 day challenge is meant for those who either need to re-focus, get rid of things, and then begin again. Never stay down- always come back.