Hello, I’m doctor Terry Simpson. One of the things I do in life is put in adjustable laparoscopic bands like Governor Chris Christie had. One of the things that I’m always very concerned about is how we teach people how to use their Lap-band surgery. One of the reports from the news media stated that it makes a person feel full early on. But, that’s not how it works. Some patients report that they feel a little bit fuller sooner. But with this surgery we do not change the size of the stomach. The stomach is the exact same size, as it was prior to placing the Lap-band. Governor Chris Christie himself said after he had the surgery, he felt full after eating about a third of the amount of what he would normally eat. While that’s a good feeling to get, that’s a feeling that happens early on in a person with a Lap-band. It does not continue. Because this surgery doesn’t work that way. This surgery does not work when you eat your food. Sometimes it does. But, most the time it doesn’t. The Lap-band works two hours after you have eaten.
Let me give you an example. If you eat a Lean Cuisine, you can eat it and still have room for more. But two hours later what do you feel? You feel hungry. If you eat a large Thanksgiving dinner, you’re certainly going to feel full when you’re done. Two hours later what do you feel? You don’t feel hungry at all. What’s the difference? In both cases at two hours your stomach would be completely empty of food. There would be no food left. The difference is hormonal. When you have a large amount of food passing through your stomach, especially the upper part of your stomach, a signal goes to your brain saying, “Wow. We’ve eaten a lot. Let’s not send out the hormones that make a person hungry until four or five hours from now.” You eat a small amount of food the nerves at the top of the stomach are not as stimulated as much. The brain reads the message and says, “You know you didn’t eat much. We want to make you hungry in two hours. We want you to survive and you’re not eating enough.” That’s the big difference. Typically, two hours later the reason people get hungry on diets and the reason they fail on diets is they end up snacking, because they are driven by those hunger hormones.
During Lap-band surgery, we place this device around the upper part of the stomach. There is a balloon inside that we can adjust from a port that sits underneath the skin. We add or remove saline solution to make it tighter or looser. It doesn’t regulate the flow of food through the stomach. But it does put regulated pressure around the upper part of the stomach that increases the nerve signals to the brain that tell it how much food has gone by. So if you eat a small amount of food, there are increased signals caused by the increased pressure at top of the stomach that fool the brain into sensing a larger amount of food has gone by. (The brain thinks you’ve eaten a larger amount of food than you really have.) Instead of being hungry two hours later, you are not hungry until three or four hours later.
You can always eat more with the Lap-band. In a way, we find that to be an advantage. One of the advantages of this surgery over many other weight loss procedures is that if you decide to go to Alain Ducasse and have a twelve course meal, you can. It’s not something you do every day. But Lap-band surgery won’t stop you from eating too much. But every day if you choose to eat a small amount of good healthy food, you’re not going to become hungry. You’re not going to have that hunger for hours on end.
So the news media got it wrong, including Dr. Sanjay Gupta and other members of the news media, print and video, where they showed that the Lap-band decreased the flow of food down (into the stomach). It doesn’t do that. If it does do that, it’s a bad problem that can lead to many other problems with this surgery. It doesn’t make you feel full with less. It doesn’t make you satisfied with less. It works to suppress hunger for food later on. We hope Governor Chris Christie got that message. I’m sure he did, because he was in the hands of a very capable, good surgeon, George Fielding, who understands Lap-band surgery, works well with the procedure, and has one himself.