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I'm really confused. How does this thing work?



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Ever since I decided to start this process in earnest I have been reading non-stop about it. I've read articles and visited every message board I can find. I don't think anyone REALLY knows how/why this thing works! I've actually read articles written by doctors that say stuff like "by some mechanism we don't fully understand..." Etc. etc.

I've read that it causes restriction: OK, but what does that mean exactly? That I can't eat white meat chicken and raw vegetables? But those are the HEALTHY things I thought. Why would I do something that causes me to not eat healthy things? Oh, they say, it only causes you not to eat them when you are too tight. OK, so what happens when you are NOT too tight? Oh, then you can eat whatever you want, you have to use your willpower then.

WTF? Why would I do this to my body (and pocketbook) when it just boils down to using my willpower in the end? Is it just an expensive and risky way to force myself to go on a month-long liquid fast? It would be cheaper and safer to go to a fat farm where they don't let you eat for a few weeks or go on the Optifast diet.

I've seen people say that the restriction means that food stays in your pouch longer and makes you full longer. Then I see someone say that their doctor told them that it only stays for one minute. ??? And if it only stays for a minute anyway then why can't we drink with meals? I've read it's because it will wash the food out of the pouch and through the band faster and we will get hungry faster. So if it only stays a minute anyway why can't we drink after a minute and not wait 30 minutes?

When you get "stuck" it means that something is too large to go through the opening the band creates right? But in order to feel full the food has to stay in the pouch for a while so that means it HAS to be too big to get through the opening at first right? That's why milkshakes and pudding go right on down.

Does digestion start in the pouch? Does food get reduced in the pouch enough to go through the band or does gravity just cause it to slowly trickle down and if it's too big then you either have to vomit or have your band unfilled?

What happens when you vomit? Does stuff from the bottom stomach get pushed back up through the band? Or just the stuff in the upper pouch? I know when I vomit now it feels like stuff is coming from my feet to come back up. What about after the band?

I'm so confused right now. I know these are really questions for the doctor but I don't go for another 2 weeks and that's just to the nutritionist. I figured people who had the procedure might know how it actually works but honestly, it seems like I get different information from each person. And yes I realize it goes in a human body and it's just a tool. But really, how does it work? I know exactly how my screwdriver works and it's just a tool and I'm a human using it. I'm beginning to think it IS magic and therefore works differently for each person depending on their level of pixie dust.

I just need to step away from the Internet and chill out.

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I just need to step away from the Internet and chill out.

This is exactly what you need to do. You actually quoted someone's post about what they claimed their doctor told them (the food only stays in one minute). That is absolutely false. They probably misheard their doc or only partially heard (maybe that liquid only stayed in one minute?). You need to focus on reliable sources. Just because someone wrote it on the internet does not make it so. The medical studies show that this works primarily by keeping food in the upper portion of the stomach (where the nerves that tell you that you are full are located) for a longer period of time. It isn't a miracle, it does require willpower but it gives you that extra help when most of us who are fat are weak. I know people who have had the procedure who have done really well, some who have done OK and one for whom it completely failed. Like anything, you get what you put into it.

I assure you, if pixie dust was involved, my insurance company would have refused to pay for it! :)

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I guess it's semantics - he is saying it is about suppressing the appetite - which is how I was told it works, too. It fills up the "pouch" with a small amount of food - but since the receptors for the feeling of being full are in the top of the stomach, the fullness above the band convinces your brain that your whole stomach is full. The food also passes out very slowly (if you are well adjusted), making you feel full longer. I think the doctor's reluctance to use the word restriction comes from the fact you can eat 1200 calories worth of liquid in a sitting without any issue (that's a pint of Haggen Daz, in case you were wondering) which will not let you lose weight. So I think your confusion comes from different people using the same language to mean different things...

Either way, stepping back from the computer until you talk with a respected surgeon is still a good idea!

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Reading over the entire article you cited - I think this is the key passage as to why the band works...

"Think of it another way -- the hypothalamus does not have eyes -- it doesn't know how much you ate, it doesn't know if there is a lot of food around and you are not eating it, or if there is a band on your stomach. The hypothalamus reacts very simply to the stimulation provided by the upper part of your stomach. Stretch that thermostat, it thinks you are eating a lot -- do that consistently over time, and it behaves as if you are eating a lot all the time and will allow your body to release fat stores and not cause your body to go into a metabolic slow-down. Conversely -- if you go on a diet, without the band --and that part of the stomach is not stretched, your hypothalamus thinks you are in a famine -- it doesn't know that there is a lot of food around you."

We've all had that experience - the stopping/slowing down of weight loss even when you are being so, so good on a diet. And it happens because our cursed hypothalmus has decided there is a famine and hangs on to those fat stores! Then we get discouraged and give up on our diets because "they don't work."

It also explains why I keep losing on the extreme calorie restriction that the early post-op period forces on us. When I normally do this extreme a "crash" diet I stop losing after about a week and I haven't seen that slow down yet - and maybe I won't according to this information. Interesting article!

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I'm not sure it's so much semantics as a general misunderstanding of how it actually works. He's not talking about liquids when he says this:

You can always -- always, always, always, -- eat more food, because, contrary to what we believed for a long time-- food passes by the band within a minute and then into your stomach. But the key to successful patients is not how much they can eat, but how little they can eat to suppress hunger.

So, could that mean that hunger is suppressed by stretching those upper stomach fibers even if it's for just a minute after you get done eating? I do think it makes sense when he says that by stretching those fibers it causes the hypothalamus to release fat stores. I can see how that might work. Which would explain why some people who diet hit a plateau and never get out of it. They never stretch those fibers so fat is not released. That's what happens to me. I just didn't realize that hitting those fibers for such a short time might cause long-lasting hunger suppression. And by what a lot of people (here and everywhere else they discuss lap band) say, they believe that the food stays in the pouch for a long time, like hours, too.

I just need to know how this works before I put it into my body. I refuse to go into this with just a hope and a prayer. If my questions are bothersome feel free to ignore me. But if anyone can help with true understanding that would be great.

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Yes you are confused you just confused me lol. Have you been to a seminar or have you just been internet searching? I suggest you go to a seminar where you can ask questions. Everyone's experience is different, you ask enough people and you will end up totally confused and a bunch of the info you listed is just wrong!!

BTW willpower is needed no matter what Diet, or WLS you have. Nothing will force you to make good choices.

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Okay I am not a doctor nor do I play one on TV. What I can tell you from my own experience is I believe I am at restriction. It has taken 6 months, lots of fills (now at 10.6). The band has been tightened to the point where the opening between the small stomach (pouch) ands large stomach is smaller than it was when the band was just "placed around the stomach". When it was installed it was just sitting there not doing anything. This explains why after surgery people say "How come I can eat as much as I did presurgery?". Because there is absolutely not difference in your physiology until you have several fills.

At restriction I get a satiation on less food then presurgery. By less food I mean 3 oz solid Protein, half cup veggies, 5+ grapes etc. Some people get upset that they are not full on a couple bites. 3 oz of Protein should be more than a couple bites! Depending on what I'm eating I may or may not feel full when I stop eating (I measure my food and stop when it's gone). After a few minutes I get a sensation of being full. I feel satisfied for 4 1/2 hours. Some people would say the Vegas nerve is being pressed on by either the food or the band which causes this full sensation. I don't know why but I do know it's happening so do I need to know why to accept that it works?

It could boil down to a leap of faith. Since the band works differently in different people it will be very difficult for you to get hard and fast rules/results. It's not like having a hip replacement where the broken body part is replaced. Also so much of band success is mental that the physical aspect is only part of the equation. The band does help me to turn down food if I see it. There are times that I get head hunger because I'm board, lonely. I have conversations with myself "We have carrots that's a healthy snack." "Yes but do we feel hungry enough for a snack? " "Uhhh, well not really". It's giving me the will power to not eat food that before I would have eaten (since hey it was healthy right?) but that I really did'nt need. And if you don't physically need it those calories go in the deficiet column.

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Have you been to a seminar or have you just been internet searching? I suggest you go to a seminar where you can ask questions.

Yes, I went to a seminar but I didn't know anything then. They talked about "restriction" and said you would feel full on less food. I hadn't done all this reading at that time and didn't know what to ask.

BTW willpower is needed no matter what Diet, or WLS you have. Nothing will force you to make good choices.

Then why not just use willpower and not get the band?

I feel satisfied for 4 1/2 hours. Some people would say the Vegas nerve is being pressed on by either the food or the band which causes this full sensation. I don't know why but I do know it's happening so do I need to know why to accept that it works?

Sorry, but yeah I do.

It could boil down to a leap of faith.

That's not a leap I'm willing to take.

The more I read the more this is sounding like snake oil. I'm not going to spend thousands of dollars on something that is only going to provide a placebo effect to make me feel full longer and give me all kinds of bad side effects as well. The fact that many many people say they cannot eat meat and raw veggies is enough to give me considerable pause. I thought those were the things we are supposed to eat to be healthy. And when someone says they have no restriction and can eat anything they say they don't simply because of will power. Maybe I should save my money and just get hypnotized.

I don't know. This is very early in my process. I haven't had my 1st real appt. yet. I'm sure going to bombard them at that 1st appt. and it will only be the nutritionist so I'm not sure how much she can actually tell me about how it works. She should be able to though I would think.

I'm just hoping this is not something that is going to be real popular for a while then, after people have had it for 10 years plus down the road we will be seeing those lawyer commercials saying "Has someone you love been harmed or killed by the Lap Band? Call us and we will get you money."

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Hey there!

I think your questions are perfectly acceptable and wise to ask. I've had my band since 2007, and although I have lost a good deal of weight, over time some of the issues you are wondering about have been a problem for me. For instance, sometimes it IS hard to eat Proteins and vegetables and sometimes it isn't. The body (this is my experience) changes all the time-so sometimes if you try to eat the same, exact thing you ate a few weeks ago just fine - you'll puke it up. And a whole lot of us have trouble eating in the morning, so be prepared to drink Protein shakes, etc. That goes for your periods too (possibly, and yes, for me it's an issue). So, when these tight episodes happen, we have one of two choices: 1-take your lumps and go to liquids until you feel better, or 2-drink milkshakes until you feel better. It's VERY HARD not to drink the milkshakes, it's true.

I don't know how many minutes food stays in my pouch, and the very specific and scientific data eludes me in general. I don't regret the surgery, and I was a self-pay too, but it is not an easy adventure. If you are worried about the amount of willpower it takes with this system you may need to look into the laproscopic gastric bypass, maybe? My mother got that, and she is doing great. But, over time you can work yourself back into being overweight if you are determined to do so. So nothing is an ultimate cure, but good habits do develop during the process that you can depend upon when needed.

I wish there was some fairy dust...

Best of luck in whatever you choose, and love yourself always, regardless. Be fabulous at any weight.

Melanie ;)

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It sounds like nothing will convince you to get the band, but it's not for everyone. Thats ok.

Will power plays a big part in this. My will power never lasted that long on regular ordinary diets. I had never lost more than 30 pounds by myself and I always gained it back. Now a year and a half after banding I am down 87 pounds and havent gained any back. It may sound like snake oil to you, but its a wonderful, awesome gift to me.

Best wishes

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I think it's good for you to be asking these questions. IMHO too many people go into this surgery not understanding that a lot of people don't feel restriction from the beginning, the band won't make you make healthy good choices and you may be restricted in what foods your band can tolerate. If you choose to have surgery then you need to understand what the band will and won't do.

That said, I can tell you that I did feel restriction from the start (I have had 1 fill in 5 months) and there aren't any foods my band won't tolerate (including bread and pasta) so I have to make good choices about both the foods I eat and the quantities. Yes, I could have lost some weight without the band but I have never in my life been able to lose 70 lbs so for me the band is definitely worth it. I don't know all the specifics of how it works (like you, I have seen a ton of conflicting info) but I DO know that it does work FOR ME. The band doesn't work for everyone and if you aren't willing to do your part then it isn't the right surgery for you.

Good Luck!

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Rainydayz...maybe, just maybe lapband isn't for you. You can poke holes in it all you want but the proof of the pudding is in the eating. You're not willing to rake the risk...that's fine. Perhaps one of the other WLS is for you...or perhaps none at all. Perhaps you could give willpower another try.

For me, I love my band somedays and others it frustrates me. I can't argue with the success I've had.

Perhaps go to a seminar, do a consultation, find a surgeon you can trust.

Personally I think it belittles what we've all done and the effort we've put into our banded weightloss to call it snake oil...just my 2£. Feel free to give me change back.

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