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After RNY gastric bypass surgery, generally one loses weight quickly then after time, weight loss slows and then you bottom out and enter the "maintenance" phase. The goal in the "Maintenance" phase is to maintain the weight loss that you achieved thus far. A weight gain of 7 pounds in one week seems too drastic. During the weight loss phase it is important to consume an adequate amount of Protein. The daily protein requirement is a combination of the amount of protein obtained from supplements (Protein shakes, protein bars) combined with the amount of protein from meals. In the beginning of the process, one lives off of protein shakes to meet this requirement because the meal volume is extremely low. But as time goes on, one can begin to transition off from these protein supplements if one concentrates on high protein meals. These protein supplements contain calories. So when you say that you are increasing your calories to 800 per day are you counting the calories in the protein supplements that you are taking? So one strategy to continue weight loss is add up your daily intake of protein; concentrate on consuming high protein meals; reduce your protein supplements (and the calories they contain). That approach may help you kick-start your continued weight loss. I put together a short article on my experience in the "Maintenance" phase that you may find to be useful. It is available at this link: http://www.breadandbutterscience.com/Surgery2.pdf

Worries about money, the economy, income levels, and finances are behind many women’s stress eating and overeating these days. In a recent group coaching call, every participant’s dominant concern boiled down to money worries of one form or another. Even if your own financial situation is secure, the worries, stress, and difficulties of others surround us in a big way. Feeling out of control, anxious, worried, or unhappy are all triggers for emotional eating, Here are some tips to keep stress about the economy from affecting your actual bottom line. Emotional Eating Tip 1: Acknowledge the Stress and Your Feelings As tempting as it is to avoid reality, it’s important to acknowledge the stress and the way you are feeling. That doesn’t mean that you are going to dwell on it or feel that way forever, but if you don’t let yourself deal with your feelings directly, you won’t be very effective at responding to them. One of my clients had been avoiding getting clear on how her financial situation has been impacted by the stock market. She was worried and fearful and was trying to cope by “not thinking about it.” Instead of feeling better, she found herself facing mounting dread and guilt for not doing what she knew she needed to do to clarify her situation. She also found herself snacking more–especially in the evening–and putting on weight. As this happened, she began to feel more out of control. Luckily, she saw herself entering a vicious cycle. Trying to avoid her feelings led to emotional eating, guilt, and weight gain (and didn’t help with the worry and stress anyway–in fact it added to it). It wasn’t until she acknowledged how stressed, worried, and fearful she was that she could start to develop a plan to take care of herself. A coaching client was noticing that economic changes were leading to changes in her clients’ buying habits. She panicked when a popular program wasn’t so popular anymore. Instead of spiraling into fear (and stress eating), acknowledging how she was feeling allowed her move into effective problem solving. Tip: If you have money worries or fears or stress, give yourself some time to let yourself really think about and address your feelings. This is not the same as “fixing” the situation. Give yourself time to journal, talk with a supportive friend, or think about how you feel. Emotional Eating Tip 2: Take Comfort If the economy is causing you stress, you could definitely benefit from comfort. Comfort eating reaches an all-time high when we are stressed and aren’t feeling entirely sure of (or in control of) the solution to our problems. In order to take control of comfort eating, it’s important to have comfort strategies you can use instead of turning to overeating. How are you compassionate to yourself during stressful or uncertain times? How can you take good care of yourself? Start making a list of things that feel good that you can turn to when you don’t. Emotional Eating Tip Three: Control What You Can Lots of people are feeling a loss of control these days and that’s leading to more emotional eating and overeating. The economy impacts all of us. If you are feeling less in control, it is important to identify what you can do to begin to feel more in control–because that’s where you want to be. As you begin to think about this, don’t only think about the big issues and worries. When life starts to feel out of control, one of the most powerful things we can do is to take charge of the things (big and small) that we can control. Ironically, when life feels out of control, it’s sometimes tempting to throw up our hands and quit entirely. Don’t. What can you control? What can you take pride in today? Pack a healthy lunch. Walk for twenty minutes after work. Do something kind for yourself this evening. If you are looking for order or predictability, clean out a drawer or your closet. Clear off your desk. Take one proactive action. It will help. ## Dr. Melissa McCreery is a Psychologist, Coach, and Emotional Eating and Overwhelm Eliminator for smart busy women and the creator of the Emotional Eating Toolbox™ Bonus Series for Women After Weight Loss Surgery. Are you struggling with emotional eating, overeating, and balancing work and life? Claim your easy-to-use audio series: "Five Simple Steps to Move Beyond Overwhelm with food and Life" at http://TooMuchOnHerPlate.com.

Hello extended family, I want to know is it okay to feel the way I'm feeling? Lately, I've been stressed out with school because I'm in finals week. I'm also extremely stress out at work because I'm expecting state audit soon at my facility. ( I'm a nurse manager working at a nursing home) To top it off, I'm moving at the end of this month, which is conflicting with my study time. What I'm trying to get at is that I'm under a lot of stress and I'm a big emotional eater. The other problem is that I have no restriction in my band (2.5cc). I could eat anything and large portions of it. Before finals week I felt no restriction but I was really trying not to gain any weight. I was fluctuating between at 2 to 3 lbs. I stop weighing myself because it was driving me nuts. So now that I'm not weighing myself, I have no restriction, and I'm under a lot of stress. I feel like maybe I'm giving off a "I DON'T CARE" attitude. I'm really afaid of gaining the weight I loss already. Call me crazy, but I think I could even notice some weight gain in my face. I'm feeling really depressed about it. I paid a lot of money out of my own pocket with no one's help to have this surgery. I want to prove to myself that I could do this. Anyway, I just wanted to vent my issue. Thanks Family. :eek:

First off, congratulations on your weight loss. I think it is common for some individuals who undergo weight loss surgery to gain some of the weight back. And normally when a woman has a child, it is common to have a little weight gain. So a weight gain of 10 pounds does not seem excessive. To maintain your weight loss, it is back to basics of Protein intake, food volume, Vitamins and exercise. I have also heard that the stomach heals after about 1 1/2 years and begins to absorb 100% of the calories from food instead of 70%. I do not know this for a fact. I am 1 1/2 years from RNY surgery, so I should see this effect around now. If this is true, then it will mean that I may have to cut my caloric intake.

Currently I am taking meds for all three. I have taken some meds that did cause a huge amount of weight gain, but I stopped them as soon as I realized that. So far, I have stayed at my weight for the past few months, if I have gained it's because of eating bad stuff. I don't want to stop taking any of my meds because I have been stable and out of the hospital for more than two years. I have had a few bouts with depression, mostly due to stress. My self esteem is shot because of my weight, I hardly leave the house because of it. But other wise I am ok. Thanks for responding. susi

I had the Mirena IUD done. It will last 5 years. No problems so far. I don't have a period no weight gain for me. Everything seems to be good. I have had it for 3 months now.

Today I had my weekly weigh-in and I have gained 0.2 lbs. This has been my first gain since surgery in Jan. I have lost 81 lbs and I should not be so upset about this. 81 lbs is huge! So, why does this hurt so bad. A lot of questions are running through my head. What did I do wrong? Have I hit my limit; never loose again? I know it seems silly, but I could really use some encouragement right about now.Weight Gain Panic Today I had my weekly weigh-in and I have gained 0.2 lbs. This has been my first gain since surgery in Jan. I have lost 81 lbs and I should not be so upset about this. 81 lbs is huge! So, why does this hurt so bad. A lot of questions are running through my head. What did I do wrong? Have I hit my limit; never loose again? I know it seems silly, but I could really use some encouragement right about now.

I'm having left leg outer thigh numbness,its been coming on for a year .then it started like pins poking pain and burning. I had a EMG at neroligist. Its called MERALGIA PARESTHETICA. Google it. It's a pinched or trapped nerve. Femerol nerve. The nerve that let's you feel on the side of thigh. Its caused from tight clothing, or belt .Also from weight gain. It usually is only on one leg. My dr said after I loose weight it will start to heal. It itches also. And I get burning pain. The pain came on after 6 months of numbness. My surgery gastrectomy was March 4th. I'm down 13 lbs. Started at 210 now 197 5ft and 1/2 inch. I hope this pain stops soon. I'm on gabapentin and norco pain meds it hurts bad. Google it.

The last two days both my knees have been aching. I had a one day episode of this about a week ago. Previously I had sore knees from the weight but that got much better after I lost only 20 pounds. I've had a bulging disc in my back since 1993 which has caused me a ton of pain over the years and prevented me from doing things....contributed to some of my weight gain. Now my back is great! No pain at all! No more pain meds, yay! I'm suspecting that my knees ache because I stand on them differently since my belly and my bum are so much smaller. Like my center of gravity has changed so the pressure points in my knees are in a different place. What do you guys think? Feasible? Or am I nuts?......maybe I don't want you to answer that one? LOL!

I am getting sleeved on Jan 17. I started this whole process back in August and I have probably gained 10 pounds since then. My eating has been out of control. I know this may sound strange but I think I am going through some kind of grieving process for the food that I won't be able to have after the surgery. Has this happened to anyone else? Well, now that I have gotten all the hoops out of the way I hope that I can buckle down and at least lose that extra 10.

My name is Carlie. I am 27 years old and I have struggled with weight my entire life. I live in Tucson, Arizona. I love to travel, volunteer, dance, workout, run, exercise, hike, rock climb, play the violin, go to movies, listen to music and spend time with my family. I was banded two weeks ago. I am trying to change old patterns. I love eating anything unhealthy (donuts, Cookies, candy, ice cream etc.), but up until now have maintained a decent weight. Recently, since December I have gained 70 pounds, which is the most I have ever weighed equalling 192. My weight gain was extremely rapid. I have a scary family medical family history. I am excited to have the band, but I feel I am not following all the rules. I don't think I am doing everything I am supposed to. Please help. Sincerely, Carlie:eek:

I have consistently been of the belief that some form of counseling should be considered by all of us while losing the weight, either to figure out what triggered teh weight gain to begin with, or to help us deal with the weight loss and "new us" as it happens. There WILL be emotions revolving around this, whether hormonal or not. Some of us have never been thin. Others haven't been thin in a long time. Still others will be dealing with attention we never had before or haven't had in a long time. And others may start getting attention from the opposite sex while our spouses act like we're a bump on a log. There are a lot of things that will stir around massive weight loss, and I personally feel it is imperative that some form of therapy be involved. I think a lot of people go into this thinking that our problems will all go away as the pounds melt off. As some here have already mentioned, the weight gains we had were indicative of a much deeper issue. Those issues are still there for many of us, simply covered up by a lot of eating and fat. It's like burying a body... it may be out of sight for a time, but once dug up, the "evidence" is still there. I recommend a good self-help book if you can't afford a therapist; or check your church, if you are a member, to see if they offer something. You might even find a therapy organization that has a sliding scale, or Overeater's Anonymous which may be free (sorry, not sure). Anything that helps you uncover the root of your issues will do wonders -- it doesn't have to be a professional. Good luck, MrsFlipFlops. I feel where you're coming from, I really do.

Here here Weho,,,,,,,,,,,,,great post and great way to think. I am only a month out and have adapted the same attitude...I am no longer increasing my weight gain and I feel great , eventually Ill get to where I should be and until then will enjoy every minute of this sleeve

So next week I have my final appointment with the dietitian, and I'm excited about it. But I'm also worried that once it's all done and everything is submitted to insurance, they won't approve me. I've gained a pound or two since all of this started, and luckily I've finally lost a pound, and I'm hoping I can keep it off by the appointment next week. But is it true that Aetna doesn't accept someone because of weight gain during this time? I'm freaking out.

I didn't have to survive bandster hell because my doctor doesn't believe in it. Two weeks post op and I was back on regular foods with the caveat to eat slowly, pay attention to the foods that were giving me problems and then avoid them. He was clear that until I had some restriction in my band I would most likely be able to eat as much as I used to. His advice..."if you're hungry, then eat" but he stressed making good choices and eating healthy meals. I didn't have the weight gain after surgery that many have and actually continued losing right up until I had restriction. You may be worrying needlessly, but just in case, look through your band literature or go online if you weren't given any. My band literature (Realize band) states the conditions where a fill is needed and it has nothing to do with weight loss. My says a fill is needed if the patient is hungry and still able to eat to excess. The band, when at the right restriction, will not let you eat to excess without serious consequences (sliming, PBing, regurgitating, pain)...assuming you are eating healthy meals. For some reason, the junk goes down without problem so avoid it. Then highlight this information and take it into your appointment. If you're hungry and eating to excess...and your doctor still refuses a fill...find a new doc. Just my .02. .

Wow, so much has changed since I originally started the thread "no help for the wicked." It was 3 months before I was banded, and I was really struggling with my asthma. I mean, really struggling. Death looked like a real possibility. I really thought that by now I would have lost if not all my excess weight, I would have lost a big whack of it. I was sure that I would be a size 16 by now, not still 22/24. But that is not in the cards for me. I still struggle with this. But I suppose I should have clued into the "sudden weight gain" since no one else seems to experience that particular "joy." I've since learned that it's one of the hallmarks of Cushing's, and I've had to come to terms with learning that my journy is not the typical journy. Someone on a recent thread was commenting on how pissed they were because someone told them that by having WLS they were not doing it "right" that they were not doing it the old fashioned way. That somehow having the band was cheating and so any loss woul be less valuable. I personally think that WLS is the easy way, because it makes it makes it possible for so many people to actually lose weight and keep it off for possibly the first time in their entire lives. I have absolutely no problem with this being the easy way, becaus I have no need for people to suffer. I see little value in adding suffering and grief to life. It's hard enough without looking for extra hardness to add.

Wow, so much has changed since I originally started the thread "no help for the wicked." It was 3 months before I was banded, and I was really struggling with my asthma. I mean, really struggling. Death looked like a real possibility. I really thought that by now I would have lost if not all my excess weight, I would have lost a big whack of it. I was sure that I would be a size 16 by now, not still 22/24. But that is not in the cards for me. I still struggle with this. But I suppose I should have clued into the "sudden weight gain" since no one else seems to experience that particular "joy." I've since learned that it's one of the hallmarks of Cushing's, and I've had to come to terms with learning that my journy is not the typical journy. Someone on a recent thread was commenting on how pissed they were because someone told them that by having WLS they were not doing it "right" that they were not doing it the old fashioned way. That somehow having the band was cheating and so any loss woul be less valuable. I personally think that WLS is the easy way, because it makes it makes it possible for so many people to actually lose weight and keep it off for possibly the first time in their entire lives. I have absolutely no problem with this being the easy way, becaus I have no need for people to suffer. I see little value in adding suffering and grief to life. It's hard enough without looking for extra hardness to add.

Very informative article. By Maureen Callahan Science is finding that these foods and drinks can help you shed pounds more easily and quickly Staying at a healthy weight during your fiftysomething years is a balancing act between calories consumed and burned. Chances are you already know that you need fewer calories as you age. So it’s trickier to prevent weight gain without making some efforts. Exercise is one good strategy, especially aerobic activities, like brisk walking, swimming, dancing and biking. But it also pays to take advantage of any and all foods that can burn fat, curb appetite and tweak your metabolism into overdrive. Here’s a look at five foods that do just that. 1. Dried Beans Foods rich in water-soluble Fiber, like kidney beans, chickpeas and black beans, not only help you feel full at meals but they may even target your stubborn spare tire. In a 2011 study, researchers noticed that for every 10 grams of soluble fiber eaten over the course of a day there was a corresponding 3.7 percent decrease in abdominal fat over a five-year period. “There is mounting evidence that eating more soluble fiber and increasing exercise reduces visceral or belly fat, although we still don’t know how it works,” said Dr. Kristen Hairston, assistant professor of internal medicine at Wake Forest Baptist Medical Center in North Carolina and lead author of the study. “Although the fiber-obesity relationship has been extensively studied, the relationship between fiber and specific fat deposits has not. Our study is valuable because it provides specific information on how dietary fiber, especially soluble fiber, may affect weight accumulation through abdominal fat deposits.” For more details on various types of fiber and weight loss, check out this article from WebMD. (MORE: The Fiftysomething Diet: Should You Be Juicing?) 2. Salmon One of the biggest food helpers on the path to weight loss is Protein -- preferably lean protein, which is better for the heart and overall health. The simple explanation is that a good dose takes longer to digest than carbohydrates, keeping you satisfied and therefore making you less likely to overeat between meals. It doesn’t hurt that the body burns more calories digesting Proteins than it does carbs. But the intriguing thing about fish as your protein source -- salmon, in particular -- is that preliminary reports suggest salmon plays a role in modulating insulin levels or insulin sensitivity. The key word here is preliminary. Still, two reports bear mentioning. In one 2009 study, scientists fed three groups of volunteers low-calorie diets: no seafood (the control group), lean white fish or salmon. Everyone lost weight, but the salmon eaters had lower fasting insulin levels, which is far better for overall health. Weight loss is one partial explanation, researchers say, but the compounds in salmon (perhaps Omega 3 fats like EPA and DHA) might also contribute to modulating insulin. In an unrelated 2011 study with animals, Canadian researchers found that a group fed salmon protein had significantly lower weight gains than groups eating other varieties of fish. What’s happening here is still part mystery, yet it could be a win-win. Choosing salmon as your lean protein source might not only help you lose weight, but also help prevent the insulin resistance that can lead to type 2 diabetes in later years. Wild salmon is leaner than farmed. It contains plenty of protein minus unhealthy fats. Three ounces of cooked wild salmon contains 155 calories, 22 grams of protein and just 7 grams of fat, most of it the heart-healthy omega 3 variety. (MORE: Boomer Bellies: Can Middle-Age Spread Be Avoided?) 3. Nuts Most dieters shy away from nuts due to their high fat content, but research suggests almonds, peanuts and other nuts offer special weight loss benefits. It all started with a 2001 landmark study from Harvard that found that participants following a Mediterranean-style diet that included nuts and peanuts lost greater amounts of weight and stuck with the diet longer than those on a different low-fat diet. (Harvard researchers now call the Mediterranean plan the best diet for losing weight.) Then a 2003 study in the International Journal of Obesity discovered that an almond-eating group of overweight volunteers (eating 85 grams per day or about 3 ounces) lost 62 percent more weight and 56 percent more body fat than a nut-free diet group eating the exact same number of calories but no nuts. Research also confirms that women who eat nuts have lower body mass indexes, or BMI, than women who eat little or no nuts. Speculation is that the fat and protein in nuts helps keep dieters full longer. Whatever the reason, all researchers say the key watchword is moderation -- say, a couple of small handfuls of nuts a day. Count on a handful being about one ounce of nuts: 157 pine nuts, 49 pistachios, 24 almonds, 20 walnut halves, 20 pecans, 20 hazelnuts, 18 cashews or 12 macadamia nuts. Keep in mind, you can nullify all health benefits if nuts are covered with chocolate, sugar or salt. 4. Green Tea We’ve mentioned before that green tea contains antioxidants (called polyphenols) that may fight cancer and lower cholesterol levels. But studies suggest it might be time to add fat burner -- or maybe we should say belly buster -- to the list of health benefits. Scientists seem to be zeroing in on a specific group of polyphenol compounds called catechins as the surprising force behind weight loss. A 2009 study from the Journal of Nutrition showed that a group of 132 overweight and obese adults doing moderate exercise for 180 minutes per week and drinking either a caffeinated beverage with green tea catechins or a control beverage with no catechins, had remarkably different weight-loss scenarios. At the end of 12 weeks, the exercisers drinking green tea with 625 milligrams of catechins lost more weight and more belly fat and had lower triglyceride levels than dieters drinking the catechin-free beverage. It’s unclear how green tea promotes weight loss, but researchers suspect it may have something to do with revving up fat burning in the hours after a meal. A small 2013 Brazilian study confirms these findings. Researchers there found that overweight and obese women drinking green tea and following a program of resistance training lost more body fat, lowered their waist circumference and showed more significant increases in their resting metabolic rate than women who drank a placebo or green tea but didn't exercise. Bottom line: To net the fat-burning efforts of green tea it appears you need to pair your tea sipping with exercise. (MORE: One Man's Diet: How I Lost Nearly 50 Pounds) 5. Water Call it the forgotten weight loss aid, but studies continue to confirm that good old zero-calorie H2O is one of the cheapest and most effective weight-loss aids on the planet. Will it work on a fiftysomething body? Definitely. A 12-week 2010 Virginia Tech Study divided a group of overweight adults age 55-75 into two groups. All participants ate the same amount of calories, but half the group was asked to drink two cups of water before each meal; the other half drank no water. "We found that over the course of 12 weeks, dieters who drank water before meals, three times per day, lost about 5 pounds more than dieters who did not increase their water intake,” said Brenda Davy, an associate professor in the College of Agriculture and Life Sciences at Virginia Tech, senior author on the study. Davy says the exact mechanism responsible for weight loss is uncertain. She speculates it could be as simple as the fact that water fills up the stomach and makes you feel like eating less. In an earlier study, she and colleagues noticed that middle-aged and older adults who drank two cups of water before a meal ended up eating about 75-90 fewer calories. Another plus of choosing water as your beverage of choice before meals: There’s less room for calorie-rich options like soda, sugary cocktails or fruit juice. Link to story: http://www.huffingtonpost.com/2013/03/28/how-to-lose-weight_n_2965765.html?view=print&comm_ref=false

also, you will want to use a heating pad on your shoulder. It helps with the shoulder pain and take ibprofin.. it also helps with the swelling. I don't have those health problems. However, if you had an IV drip, they are putting extra fluids in you which means you will have a weight gain. That is normal anytime you have IV fluids put into your body. Good luck with your band!!!

LindaS being on vacation, eating & drinking right, physical activity - sounds great - hard to do when you are away from home. you are scratching your head trying to figure out what happened not loosing any weight must be/hopefully is due to Water retention. 6 lbs sounds like a lot, maybe tomorrow the weight gain will be gone as quickly as it came

It is interesting that you ask this, because its the first thing my parents asked me once I told them about my "relapse" I guess you would call it... Over the 3 years that I was banded I developed a list of "danger foods", things I had once loved but learned that because of my band I could no longer eat, it mainly consisted of carbs (Pasta, french fries ect) but also ice creams and high fat Soups (baked potatoe soup for example). I learned to enjoy more fruits and veggies, partly because they were healthier but mostly because I could eat them without getting food stuck. I have to admit that once I origionally had the fluid taken out of my band I fell into the "I can eat anything" mindset. Pasta's, milkshakes, mongolian BBQ took over my diet for the first while my band was empty and by the time I leveled out my eating and started avoiding my "danger foods" again alot of the damage had already been done. My mindset about food has definatly changed over the years, through the lapband and also because I was only 17 when I had my surgery so alot came with maturity. I made poor choices when I was first loosened but I knew that I was making them, I was just making up for lost time I guess you would say. I made myself fall off the weightloss track and now I'm just trying to get back on it. Though, I did also find that even once I stopped eating those "danger foods" and started dieting and exercising again I still didn't loose any weight because the band really did help with portion control for me. I hope this helped answer your question, I'm sure I'm not the best lapband success story given my current weight gain but I am always willing to answer any questions you may have.

Awesome advice! I am a firm believer that staying busy with good stuff, helps. I knit, walk, play a game with my kids and keep a book and puzzle going at all times. It helped a lot. I also journal, plan meals, and watch every bite that goes in. But remember that Water, etc., fluctuates a lot, so don't get down by day to day weight gains.

Hi, my name is Linda and I'm really new to this my start date is May 2014. I have been rather heavy most my life but never this heavy at 213 lbs. I have many health issues and on so many medications that increase the weight gain also that I need some help getting this weight off and keeping it off. I have been reading the many forums on here for a week now, every day I have read something new that will help me in my Quest to be thin, or at a decent weight. Some say your not over weight enough to have this done, but when you have to buy 1x and 2 x tops there is a weight issue. I started out at the PCP at 215 he said at 5'5 I have a bmi at 37. I have had my meeting with the surge in and he is wonderful! Been to see nut and a support group just yesterday. I've had my exercise eval done and will have a EDG done on Tuesday the 10 June. My ins calls for 6 visits with PCP and I have to have medical problems, which it have many. What do I want to get out of this? I want to get down and play with my 9 wonderful grandchildren, work in the yard, do my own house work and to look healthy and live longer. Is there any one around my age that has had this done, I'm at 57. Would love to hear from you or anyone on how you made it through the surgery and recovery. I've had so much information from drs nut already that it's a bit over whelming. My fiancé was not on with this, and I don't know if he is or isn't now. He tells me it's to drastic to go through just to lose a little weight... Ha 75 lbs is not a little weight, and I want to keep it off also. Were to be married Jan 31 2015, I believe it will be put on hold just because I don't know when surgery is or what faze I will be in at the time. Also haven't told my kids, just know my daughter will have her say in this. My son well he's easy going and what makes me happy makes him happy. Wow looking back I've written a book so I will stop here and thank you all for writing on this forum for people like me to read.

I pulled that article for you Gummiebear. It's a good read. Think You Need a Fill? THINK AGAIN By Nikki Johnson Do you remember that feeling you had when you first had your band placed? For a while, everything was great. You didn't experience hunger, you felt satisfied with a small portion of good food, you had more energy, and you were thrilled with your initial weight loss progress. If you are like most people, your experience changed over time, Some of those feelings of hunger returned, and you stopped losing weight. You knew you needed something, so you went to your surgeon's office and asked for a "fill" right? If so, you might be surprised to learn that it is your thinking about your band, and not the band itself, that needs adjusting. The LAP-BAND Bad Word Paul O'Brien, MD, FRACS, is a skillful, compassionate surgeon and a foremost expert on the LAP-BAND System. he was involved in its design in the early 1990's and placed the first band in Australia in 1994. Since then, he has treated thousands of patients and is recognized worldwide for his expertise. When his patients utter that worst of four-letter words, "fill," in his office, they are asked to throw a dollar in the Red Cross donation bucket--a reminder that, according to Dr. O'Brien, thinking about a "fill" is just wrong thinking. How can a concept that we hear about so constantly be so very wrong? Dr. O'Brien's answer is simple: "Any adjustment to the band is something that only takes place in the context of clinical consultation--part of a relationship of trust, honesty and communication between patient and surgeon--that is much more key to the success of the patient than the precise number of milliliters of Fluid in the band. This concept of partnership is the central theme of Dr. O'Brien's new book, The Lap-Band Solution--A Partnership of Weight Loss. Patty's Note: Available on Amazon.com ISBN#9780522854121 Like many people, you might assume that weight gain or a sustained plateau means an incorrectly adjusted band; in fact, you may be right. But you may be surprised to learn that weight gain sometimes results from a band that is too tight. This is part of the reason why the "fill" concept is so misleading. If your surgeon determines that you are not losing weight as you should, then discovering why that is happening is crucial. Sometimes adding fluid to the band will only make matters worse. Life in the "GREEN ZONE" Most people who have the LAP-BAND operation will have an amazing feeling of disinterest in food for the first week after surgery, before any adjustments are even made to the fluid in the band. According to Dr. O'Brien, that lack of interest in food is referred to as satiety. A related but different feeling is satiation, or the feeling you get as you are eating, precisely at the point that you don't need any more food to eat but you do not have an uncomfortable feeling of fullness. These two feelings--satiety and satiation--are what the properly adjusted band helps you achieve, allowing you to maintain your new healthier eating habits. Your careful observation and truthful sharing of your feelings and eating behaviors, combined with the expert care and training of your surgeon and his or her staff, can make the very individual determination of whether your band is properly adjusted much more accurate. In order to help create the most effective partnership between themselves and their patients, Dr. O'Brien and his colleagues at the Australian Centre for Obesity Research and Education have developed a concept they refer to as the "Green Zone". When patients are in the green zone, they experience satiety, satiation after properly-sized small meals, and satisfactory weight loss or maintenance. However, there are also yellow and red zones, both of which indicate that the band is not optimally adjusted. If your band is too loose, you will not have the benefits the band's hunger-controlling mechanism. If your band is too tight, you will have trouble eating properly and may actually gain weight because the foods you can eat more comfortable, that tend to be liquid and calorie-rich, like ice cream and chocolate, do not provide the proper nutrition. Learning to recognize when you have the feelings and eating behaviors that signal a problem can help you give your surgeon the information he or she needs to help you keep the band optimally adjusted. Thinking Adjustment Once you have eliminated the concpet of "fills" from you Lap-Band vocabulary, you will be able to let go of much of the conventional thinking connected to it. Perhaps you have heard talk about the "ideal" amount of fluid in the Lap-Band. While it may be helpful to have some idea of how much fluid is in your band, Dr. O'Brien says there is no magic number. No perfect amount of fluid will provide the best results for everyone. He says, rather, that "whatever volume of fluid is needed to achieve the [feeling of non-hunger] is the correct volume." When you notice that you are feeling hungry or are not losing weight, your body is telling you it is time to revisit your partner in weight loss -- your surgeon. your success absolutely depends on this relationship. So rather than thinking "adjustments," adjust your thinking, and, in partnership with your surgeon, find a lifetime of health! For more information about all of the themes discussed in this article, please see Dr. O'Brien's book, The Lap-Band Solution--A Partnership for Weight Loss, which is available fro Amazon.com. We also invite you to visit LAP-BAND® System Forum - Home for more information and supportive resources.

For me the weight gain was a mix of medical and emotional. The medical prompted the emotional which prompted bad eating habits and it was a downhill effect from there. I just recently put all the peices of the puzzle together. I think KNOWING what caused my weight gain helps alot tho.