WLS NITTY GRITTY

The NITTY GRITTY of WEIGHT LOSS SURGERY

Nobody can predict the course or outcome of your weight loss surgery, but I’m going to try anyway, starting with a simile that most of us can understand.

WLS is like a marriage, with your band as your lifetime partner. At times you’ll thank your lucky stars you found each other. At other times you’ll wish you’d never met, never mind married. You’ll never walk alone again, but you alone will be captain of your ship. You will lose weight and gain a new lifestyle, but some of your losses and gains will be bittersweet. You’ll wonder what on earth you got yourself into, as well as why on earth you didn’t do this a long time ago.

Most of all, you’ll scratch your head and say, “Why didn’t anyone tell me how much work this would take?”

I’m not telling you all this to scare you. A little fear is fine if it makes you a compliant patient, but I don’t want fear to rule you. I just want to remind you that like every other human endeavor, the WLS journey has ups and downs. I believe that my band surgery saved my life and I’ve never regretted my decision to do it, but I can’t claim that every moment of my journey has been sunny and carefree. If you don’t want to hear about the tough stuff, that’s fine. You have my permission to move on to another article (preferably one by me). But if you want to hear about some of the things I wish I’d known at the start of my journey, read on. Knowing these things in advance wouldn’t have changed my WLS decision, but it sure would have helped me stick it out more easily when my weight goal seemed a million miles away.

1. The band is not magic. There is nothing in it that – hey, presto! - will make you lose weight. Changing your eating behavior and lifestyle, plus dozens of other factors that vary from one person to the next, will make you lose weight.

2. Your band won’t do all of the work. If you don’t (metaphorically) grab hold of it and use it as a tool, it will be about as useful as a cordless drill without a battery.

3. For most people, the band doesn’t start working right away. As a new post-op, surgical swelling and/or a small “primer” fill may or may not kill your appetite (desire to eat) and physical hunger (physical need to eat), but most bandsters need several fills to get the weight loss going, and more fills after that to keep it going.

4. If you don’t eat carefully, will you will suffer temporary, extremely uncomfortable side effects that can, if ignored, turn into permanent, expensive, and unhappy complications.

5. Once you achieve an optimal fill and restriction level (which will last for 30 seconds, 30 minutes, 30 hours, but probably not for 30 years), your restriction is very likely going to vary, for reasons too numerous to explain here. In this area you must remember that the human body is alive and always changing, whereas the adjustable gastric band is inert and changes only with the addition or subtraction of fluid. One day you can hardly eat, the next day you can eat anything and everything, and the day after that, you can eat just the right amount (remember Goldilocks and the Three Bears?).

6. Restriction may also vary according to the time of day (or time of month, if you’re of the female persuasion). Morning “tightness” is very common, and it may limit your morning food choices. That is not, however, a good excuse for skipping breakfast and thereby depriving your body of the fuel it needs, and doing so can set you up for a monster binge when hunger suddenly hits you at 11:38 a.m. So you will have to be willing to stay flexible, try new foods, and practice patience (which is something I have to practice every day in every way anyway).

7. You will have to deal with restriction even when you wish you had none at all, when you’re at a party or on vacation or sitting down to Thanksgiving Dinner at Mom’s overloaded dining table. At times you will want to go on eating because the food tastes so good, but you’ll have to stop because you physically can’t eat more, and because eating more would cause uncomfortable and undesirable side effects (to say nothing of weight loss plateaus or regain). That experience of food “deprivation” has been very frustrating for me. Not every day, not at every meal, but often enough to remind me again and again that my upper GI tract is no longer the free and easy party girl it once was. That reminder is often a good thing, but sometimes it makes me want to put my fingers in my ears and chant, “I can’t hear you, Stomach!”

8. This next piece of WLS Nitty Gritty is such a big, important one that I left it for last so that it will (I hope) stay burned into your brain a good, long time. NO WEIGHT LOSS SURGERY OF ANY DESCRIPTION WILL KILL THE EATING DEMONS IN YOUR HEAD. Vanquishing, subduing or managing those demons is something you’ll have to do yourself, possibly with the help of a counselor or support group, with daily practice for the rest of your life. But that’s OK, because you are worth all that effort.