This is always the question- but it is best answered before you come to the office. How do you do it? You perform a few simple science experiments.
Lap-band weight loss surgery patients must measure their portion sizes. Measure your food out for different meals– four ounces (by volume) of meat/fish/poultry – and six ounces of vegetables. Plate this meal out– eat it slowly, and note how long it takes before you start to feel hungry again.
Measure your food a number of times– the more you do it, the more accurate information we have, and the better you can help us determine if you need an adjustment. The key is how long before you feel hungry again.
So before you come to the office do the experiment. Once you have eaten, see how long it takes before you are feeling hungry again. Note it. If it is several hours (4 or more) – you won’t need an adjustment. If you start feeling hungry in a couple of hours (2), then we need to adjust it.
By Weight or by Volume?
Over the years the “experts” have recommended either using a scale to measure your food (by weight) or a measuring cup (by volume). They go back and forth on which method to use. We’ve found that most people don’t want to carry a scale into a restaurant (but some do it). It’s much easier to carry a four ounce disposable cup that fits easily into purse or pocket. When you’re done with it you just throw it away. When you measure for your six ounce vegetable serving, you just do a cup-and-a-half. Some foods are denser and so the cup will not be as accurate – you’ll get more than 4 ounces by weight. Conversely, less dense foods might cause the portion size to be too small. You’ll quickly and easily become a master at measurement. We show you exactly how. You will learn the densities of foods over time and adjusting accordingly becomes second nature.
It is NEVER- NEVER – a matter of how much you can eat at a single sitting. The Lap-band is not a tool designed to STOP you from eating. Nor is it designed to tell you when you are “full.” The Lap-band does NOT restrict how much you can eat. Food goes through the it in about a minute. In patients who are successful – we can watch, on x-ray, and see that food goes past the device very quickly. A person with a Lap-band can eat however much they want. This is one of the two choices you have – first choice is what you eat, and the second choice is how much you eat.
If that is the case, what did I need the Lap-band for? It doesn’t stop you from eating—that is still, and always will be, your job. The Lap-band makes it so if you CHOOSE to eat less, you won’t be hungry for four hours, and your body will be able to utilize fat more efficiently. Two things you cannot do on your own.
The Lap-band is NOT restrictive – and when patients come in saying they don’t feel “restriction,” we know that they have been getting some severe misinformation somewhere else.
With the Lap-band what if I feel hungry after I eat?
That isn’t hunger. Hunger is what you feel after a couple of hours. The sense of needing to eat more, and the ability to eat more, is unrelated to what the Lap-band does. It’s job is to suppress your appetite. Think of it this way—before the Lap-band if you ate a small meal – like Lean Cuisine – in two hours you would be hungry. With it, if you eat that amount of food, and it is properly adjusted, you will not be hungry. The Lap-band will NOT stop you from eating more – it will stop you from being hungry a couple of hours after you eat. Those first two hours are a matter of you eating less.
I notice that if I eat my meal slowly, I feel “full” after just a small amount of food. Is that the Lap-band? Not really – eating slowly is important and will allow you to feel “full.” If you eat your meal too fast with the Lap-band bad things can happen. You could get a it to slip, or erode into the stomach, or cause your esophagus to enlarge, and you will be hungry. So – eat your portion slowly. Taking your time eating slowly will both keep you out of trouble, and allow your brain to send the signal that you are “full.”
How the Lap-band works:
Food passes by the Lap-band – when it does, there is a signal sent to the brain that you have eaten food. With the device the brain thinks you have consumed more food than you actually have. This is the part of the brain that controls appetite – which means it will delay sending out the hormones that signal you to eat (appetite stimulating hormones like ghrelin). It will also make it easier for you to use your fat stores (another set of hormones). If the brain thinks you are starving it will send out hormones to get you to eat more—which happens if your Lap-band is loose.
So if your Lap-band needs tightening – then your brain will send out hormones in two hours after food—that you are hungry. It will also make it more difficult to utilize your fat stores.