I don't understand!!!

[DrWatkins 5]

All weight loss comes from calorie deficit (burning more calories than you consume). Burning more and consuming less is what causes weight loss.

The band will not force you to burn calories. The band helps with the consuming less part. It helps with this in three major ways:

1. Reduced appetite - some surgeons argue that the band is an appetite reduction operation. It has been shown to reduce appetite hormones. Patients say they don't feel hungry - they don't feel like they are on a diet. The band reduces true physical hunger. Some of us struggle with emotional hunger, phantom hunger which is not cured by the band but reducing physical hunger is very helpful at combatting head hunger. Emotional hunger comes from deep rooted emotional pain causing negative emotion that is unfortunately temporarily cured by food.

2. Fullness on small portions - the amount of stomach above the band is small. You will feel full on a much smaller portion of food if the band is properly adjusted. The fullness feeling is not a "pat your lower belly" kind of fullness. Band fullness is a very high sensation - in the chest - the feeling that the last bite of food is somewhere near the base of the tongue and another crumb will not be physically allowed.

3. The impossible nature of overeating - let's say you feel full and not hungry but you decide that you will overeat anyway. A properly adjusted band simply will not allow this. A point will be reached where the system will reject anything more. The esophagus (swallowing tube) is a transport organ; not a storage organ. The esophagus has two buttons: down and up. It will try down first. If that doesn't work, it switches to up and you get to see the food again.

We've been banding for eight years and we see three groups of patients in our practice:

Group 1 - gold medal superstar patients who lose easily and steadily after band surgery and send us Christmas cards that will bring tears to your eyes.

Group 2 - patients who acheive the same ultimate results as Group 1 but it takes longer with more office visits and more education and slower weight loss but we still get there. The race car crosses the finish line but it's on fire and badly damaged.

Group 3 - patients that will be three years out from band surgery and only down 20 or 30 pounds. The three biggest reasons patients are in this group are: 1.) unsolved emotional eating 2.) zero calorie burning 3.) Quit, give up, stop coming to the practice for band adjustments, education, etc

One of the best books I've seen on emotional eating is: "Shrink Yourself" by Dr. Gould. Many patients have told me this helps. The secret to curing emotional eating is to identify the root cause of this negative emotional pain and work through it. This is the most difficult aspect of successful weight loss.

The best calorie burning is the one you'll do (walking, WiiFit, Appalachian clogging, etc, whatever). Simple things like taking the stairs and parking as far away from a store entrance as possible really add up to burn calories and jumpstart weight loss.

Hope that helps

brad

[btrieger 21]

You are doing brilliantly. I am sure you will be a great success on the band too. I wish you every success with it!

Thank you!

If I can do it, any man can. There is definitely nothing special about me.

[Marine mom 3]

I am male and my doctor told me men do better on the band. Why should that be? Because they often don't have to prepare food for others?

Maybe. That part does suck sometimes. I know that in general, men seem to have an easier time losing weight than women, so maybe he is borrowing from that statistic.

[Awkward customer 5]

One of the best books I've seen on emotional eating is: "Shrink Yourself" by Dr. Gould. Many patients have told me this helps. The secret to curing emotional eating is to identify the root cause of this negative emotional pain and work through it. This is the most difficult aspect of successful weight loss.

Hi, Dr Watkins. I wonder if there is a book specifically about how to lose weight with a gastric band. Can anyone recommend any book?

[Humming Bird 275]

The band will not force you to burn calories. The band helps with the consuming less part. It helps with this in three major ways:

1. Reduced appetite - some surgeons argue that the band is an appetite reduction operation. It has been shown to reduce appetite hormones. Patients say they don't feel hungry - they don't feel like they are on a diet. The band reduces true physical hunger. Some of us struggle with emotional hunger, phantom hunger which is not cured by the band but reducing physical hunger is very helpful at combatting head hunger. Emotional hunger comes from deep rooted emotional pain causing negative emotion that is unfortunately temporarily cured by food.

2. Fullness on small portions - the amount of stomach above the band is small. You will feel full on a much smaller portion of food if the band is properly adjusted. The fullness feeling is not a "pat your lower belly" kind of fullness. Band fullness is a very high sensation - in the chest - the feeling that the last bite of food is somewhere near the base of the tongue and another crumb will not be physically allowed.

3. The impossible nature of overeating - let's say you feel full and not hungry but you decide that you will overeat anyway. A properly adjusted band simply will not allow this. A point will be reached where the system will reject anything more. The esophagus (swallowing tube) is a transport organ; not a storage organ. The esophagus has two buttons: down and up. It will try down first. If that doesn't work, it switches to up and you get to see the food again.

brad

Thanks for the post Doc.

These are the 3 things that have made the band a "magic wand" for me personally.

[btrieger 21]

All weight loss comes from calorie deficit (burning more calories than you consume). Burning more and consuming less is what causes weight loss.

Woohoo!! Thank you Doctor!

In the 6 plus months I have been on this site, this is the first time I have seen a doctor take the time to answer questions.

I'm impressed.

[DrWatkins 5]

The best band advice is from your surgeon's practice.

The best general book I've seen on band weight loss is by Jessie Ahroni, PhD. She is a very successful band patient and a brilliant person and many band patients read her book and really find it helpful.

brad

[Awkward customer 5]

Let me clarify. I have previously done well on the Weightwatchers diet, but have this time round found it hard to get into. I asked the hospital whether I should follow the Weightwatchers diet after banding. They said no - I could cancel my WW membership, as no specific slimming club memberships were required. The band would help me on its own. Actually I am not sure this was good advice.

The weightwatchers principle starts you off eating quite a lot and reduces your allowance as you lose weight, with the result the weight still comes off. I think the general principle is 70 calories is one WW point and 4 grams of saturated fat are one WW point. So if you have something with 140 calories and 8 grams of SF, then that would be 4 points. I would start off on about 39 points and then gradually be allowed less as I lost weight.

But I am not sure when I start eating real food that I would be able to eat the 39 points - that is actually quite a lot o food.

Should I target calories? or calories and SF (as with WW)? or what? Or just forget calories and SF and let the band control my portion size?

[Awkward customer 5]

The best band advice is from your surgeon's practice.

The best general book I've seen on band weight loss is by Jessie Ahroni, PhD. She is a very successful band patient and a brilliant person and many band patients read her book and really find it helpful.

brad

Thanks. I'll try that book.

[DrWatkins 5]

The best approach would be to make sure your band is properly adjusted where you are full on a small meal for 4-6 hours. If you can eat a lot of volume or you are starving within a couple of hours after a meal, have the band tightened and make it do more work. Also, make sure you are eating good healthy Protein. Mushy foods will zip through the band and are not a good judge for band tightness. The best way to judge band tightness is a "test meal" of a good moist protein portion - 6ounces, 20gms (fish, chicken, beef, etc) and some steamed veggies. You should be able to eat that in less than 30 minutes and stay full on it for a long time.

Perfect band tightness

Perfect food choices

Perfect calorie burning

Perfect weight loss

hope that helps

brad

[DrWatkins 5]

Men tend to lose weight faster because of relatively higher muscle mass due to testosterone being the predominant hormone.

We always check testosterone levels in all our male patients because sometimes it is low and it will impair their weight loss until we get their levels normal with replacement hormone therapy.

Recently, we've been checking testosterone levels in women as well because female levels are supposed to be around 20-80 as opposed to the male levels of 300-800 (the actual normal range differs among labs). I have seen several female patients who struggled with weight loss, we found that they had testosterone levels below 20 and once we replaced their levels to normal female levels, they started losing weight.

If a female patient asks their doctor to check their testosterone levels they will think you're crazy but we've seen this to be very important in some patients.

Testosterone levels are a major influence on muscle mass and our muscle mass is a major part of our basal metabolic rate ("metabolism"). Low testosterone levels or low muscle mass from inactivity can impair successful weight loss in men and women.

hope that helps

brad

[Chapamar 0]

Thank you for the great information.

[tarajim 20]

As another one of the men on this site, I can confirm that committed men lose fast. I am averaging 3.2 lbs a week since going to the seminar in October. I was banded in Late November. I have lost 62 lbs in 4 months.

Committment takes diet, exercise and thought. I tracked everything for the first three months, but stopped and am maintaining my loss. I feel I know the rules now and don't track because the rules are ingrained in my day to day thinking.

I travel a lot for work, and eat out often. I also drink alcohol sometimes when out with business associates. I work out 6 days a week for at least 45 minutes. I eat a lot of Protein, and at least 5 days a week rely on Protein shakes in the morning.

I eat beef, chicken, fish and shrimp. I eat salads, vegetables and some carbs (one time a day at most).

That is what it takes.

I have PB's 3 times and slimed twice. I learned my lesson there to slow down and chew.

I have had 2 fills.

I do not think I am exceptional, just an average band patient, but I am committed.

I am a scale addict too. Oh well.

Good luck to you. If you want to lose and keep it off, this may be your best chance.

TJ

[Humming Bird 275]

I am a 45 yr old female. After my overies were removed 10 years ago they did test all my hormones. All my hormone levels were almost nonexistant including testosterone levels. They put me on testosterone , messed with dosages, and it gave me severe acne, so I opted out. This may have contributed to my rapid weight gain in those 10 years (along with other things)

I took estrogen for 5 years. Now I take none.

I guess I should get some hormone testing done, but with no health insurance I avoid any added medical costs.

[Awkward customer 5]

The question of whether you can lose 4lbs a week - I know a large man can maintain that pace for months on Weightwatchers - depends on how big you are. Let's use the Harris Benedict Equation (Harris Benedict Equation)

A man like me of 340 lbs, 6 foot, 40 years old, little exercise would require 3392 calories to maintain his weight. By reducing that to 1392 calories a day, he would lose 4 lbs a week (as 1 lb =3500 calories).

Clearly that pace of weight loss could not be sustained by everyone. Using the same formula:

A woman (like my sister) of 224 lbs, 5 foot 7 inches, 39 years old, little exercise would require 2102 calories to maintain her weight. Even a 1000 calorie a day diet would only save her 7700 calories a week, equivalent to 2 lb. It would not be possible for such a woman to lose 4lbs a week for a long period.

To experiment with these figures:

work out your BMR (basal metabolic rate) using BMR Calculator, and then multiply by your activity factor (Harris Benedict Equation). That gives you the daily calorie intake needed to maintain weight. Anything below that will lose weight, but 3500 calories are required to be lost to lose one lb.