Once you feel the restriction you will have a great feeling of control over food. People are often frustrated and depressed at their inability to stop eating before they get a good restriction. Be patient. The beauty of the Lap-band is that we can adjust it, and often we can do this in the doctor’s office. You discover it doesn’t take much to fill you up before you put the plate away. For many, this is a new feeling and one that gives you the control over food you never had before. Your biology is now working for you instead of against you.

Small fork stuck into a Brussels sprout showing that Lap-band surgery patients should use small utensils

You should use smaller utensils to eat, cut your food well before you put it in your mouth, and chew well. Shoveling food in and following it with a water chaser will not work with this device, and if you try that, you will be quite unhappy. You will be uncomfortable, sick, nauseated and may vomit. Old habits are hard to break and new habits are hard to learn, but this is one you have to learn. Your food must be cut to the size of your little fingernail before you put it into your mouth. Then you have to chew at least ten times—you do not need to practice Fletcherization.

Variety is the spice of life and of foods. My father eats the salad first, then the meat, then the vegetable or fruit, and finally dessert. He is very regimented— and at age 78 looks great (Mom thinks so, but after 52 years of looking at the guy it is nice to know she finds him interesting). That isn’t the point. The point is that you will not be eating a lot of anything, so have a bit of variety with every small forkful. Many will advocate eating the meat first and then the vegetables.

Speaking of forks—if you are using anything larger than the salad fork, you may feel as if you are not eating enough. Using small utensils has two benefits: the first is that you cannot shove a lot of food in with a smaller fork or spoon. The second is psychological. Your subconscious is programmed to see a spoonful or a forkful as a unit. Now you can have a larger fork and eat more food in less bites, or a smaller fork and eat less food in more bites and feel full with less. So—break out the small stuff. If some snooty person tells you that you are using the wrong fork, tell them to “fork, no!”

Pregnancy after Lap-band surgery – getting in the nutrition

(eat for two, not four)

The beauty of the Lap-band is that if you become pregnant, it can be emptied to allow you to take in more calories. While we prefer patients wait two years after the procedure before becoming pregnant, often times that does not happen. Sometimes, once the restrictive nature of the device is lifted, you eat a lot more than you should, so even though you don’t have the it filled, watch your portions. I am not an obstetrical doctor, but you do not need to gain 90 pounds with your pregnancy—honest.

The advantage of Lap-band surgery is that it can be adjusted.

 

This means you need to keep in touch with your weight loss surgeon. For those who have had Lap-band surgery in other countries, you might have to go back for fills. If you have your procedure done in a foreign country you must make sure someone in the United States will take care of it, and that can be a problem. Weight loss surgeons who have good reputations and are well trained, like my long-named friend, have no problem having us fill them. But be prepared—the first fill we do for another weight loss surgeon is done in the X-ray suite and costs more than ones done in the office. This shows us if the device is in place and allows us to do a fill with precision. If you have a Lap-band that is not approved for use in the United States, it is unlikely that you will find any weight loss surgeon willing to fill that device. That is an unfortunate reality in our litigious society.

Filling the Lap-band is a fairly simple process,but it does involve using some special equipment and needles. Knowing when to fill is the trick, not how to fill, and this is where you need to have a good relationship with your Lap-band surgeon. Sometimes you lose some pounds and then the device becomes a bit lose. That is the advantage of this operation. You can have a quick fill and regain that feeling of satiety with a small meal. When the Lap-band is typically placed around the stomach, it incorporates a bit of fat. As this fat disappears (along with other fat in your body) the device becomes a bit lose, and it is time for another fill. It might not take much to fill, just a bit. Typically, after the first year or two, fills may not be needed. Some patients periodically require a bit of a fill for several years. Keep in touch with your weight loss surgeon—it is important, as they can offer an adjustment and get you back on the road to weight loss.

Do not top off

—applies to gas tanks and laparoscopic banding:

Putting too much fluid in the Lap-band can cause discomfort to you. Too much pressure on the stomach can cause a perforation, so most weight loss surgeons will be a bit conservative. There is no pain with this procedure, but if there is pain after a fill, you need to call your weight loss surgeon immediately. While the adjustment will make you feel tight, and cause some heartburn, if you should wake up the next morning with pain, CALL. Your surgeon will probably need to remove some fluid.