About Obesity Lapband General Surgery Non-Surgical Your Success

Myths and Misconceptions

The following are some of the misconceptions people have about Laparoscopic Banding.

After I’ve had the band placed I can eat whatever I like.

Absolutely NOT.  Please go to “What to Eat When After Lap Band Surgery” on this site found by clicking on the quicklink “Food Clues” for detailed information about what you can and cannot eat.

I had Lap Band surgery last week and I feel great.  I feel as if I can put anything into my mouth, therefore I should be able to eat whatever I like.

NO YOU CAN’T.  Yes I’m sure you do feel great.  Lap Band surgery is done laparoscopically (through small “keyhole” incisions) so you recover relatively quickly from the actual operation, and physically you do bounce back pretty quickly.  This does NOT mean though, that all systems are normal, and as before your surgery.  They are far from “normal”.  You have committed yourself to a whole new way of being, a new life with a Lap Band.  The band you have just paid your hard-earned funds to have placed surgically must be respected and treated with the utmost care.  The reason you have had the band placed was because other methods of weight loss used in the past did not work.  If you resume your old eating habits the band will not work either.  But worse, you could damage the placement of the band causing it to slip, and thus undo the good work done by your Surgeon, making the whole process an exercise in futility and waste of time, money and effort. The treatment of slippage is usually MORE surgery. So, as above follow the rules of what to eat and what to avoid when by reading the information accessed via the quicklink “Food Clues”.  Also read “The Surgery” in the Lap Band section of this website.  Again, if in doubt, telephone Dr Nicholson’s rooms for assistance.

I feel so empty even though I’m having lots of fluids.

That’s understandable if you are not having solid meals as usual.  This feeling can be negated by having at least one tasty “meal” a day, for example steak and veggie stew or chicken hotpot – VERY IMPORTANT – IT MUST BE VITAMISED TO LIQUID FORM OF COURSE!  This will keep you satisfied for longer.   If needs be you could have up to a cup of this “food” once a day and perhaps a MacLeod’s meal for another.  Both would be high in protein and as such will keep you satisfied.  If you turn to MacLeod’s, make sure you keep your carbohydrates low or hunger will be exaggerated.

I was soooo empty and bored with my fluids I ate solid food.  PANIC STATIONS!

DON’T PANIC.  There is no point, but DO RING DR NICHOLSON’S ROOMS.  The risk you run is that your band will have slipped as the oesophagus tries to “push” (peristalsis is the process that pushes your food through the alimentary canal) food through the newly narrowed opening created by the placement of the Lap Band.  Your first step is to have a glass of soda water to ensure the solid food either goes down or comes up.  Ascertain whether you have any pain or discomfort and then phone Dr Nicholson’s rooms and he will determine whether you have caused any damage and whether any action needs to be taken.  You should give some serious thought though as to why you did the wrong thing so you can take steps to ensure it doesn’t happen again.  After all you took a big step in the right direction when you consented to Lap Banding and you really want to give it the best chance of working successfully.  So talk to Dr Nicholson or his team if you’re frustrated or if you feel you’ll have difficulty complying with the rules of Lap Banding, they’ll be happy to help you.  We can also refer you for further counseling with a Psychologist or a Dietitian.  The most common reason for falling off the wagon is hunger.  If you’re hungry you probably need protein, but remember it must be in fluid form. See “I feel so empty even though I’m having lots of fluids” for ideas on how to get protein in fluid form.  Recurrent and persistent hunger is also caused by drinking sugar-filled fluids.  Taking in sugar-filled drinks will give you an instant, but quick and very short lasting fix.  Very soon after the initial satisfaction you will be even more hungry than you were when you started.  This rebound hunger will cause you to look constantly for calories.   The obvious effect of this is that you’ll begin to put on weight, just the opposite of the desired effect.  So, at the risk of sounding like a broken record, RING DR NICHOLSON’S ROOMS for friendly advice and reassurance. (Read also “Whatever I can suck up through a straw I can have” to find out the effects of sugar treats.)  Putting on weight at this time is NOT a disaster.

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Lap Band surgery is cosmetic surgery.

No it isn’t. Lap Band surgery is performed on morbidly obese people.  The health of a morbidly obese person is at risk because of the strain the extra weight places on the bodily systems. Often morbidly obese people have co-morbidities of obesity that place them at even greater risk health wise.  Such co-morbidities can include asthma, hypertension, depression, diabetes, cardio-vascular disease and others.  These conditions can be life-threatening and weight reduction can either completely resolve them or at the very least improve them.

Whatever I can suck up through a straw I can have.

This is only partly true in two ways.  Firstly, lots of things you can suck up a straw are highly calorific.  So use your common sense.  That Cadbury chocolate topping will certainly go down easily and will fill a hungry spot temporarily, but you’re cheating yourself on two fronts.  You get a quick sugar fix that gives temporary relief but will drop you like a hot potato (sorry about the food analogy) soon after, and make you feel hungrier than ever and desirous of more Cadbury chocolate topping.  This gives rise to the consumption of lots of “empty”, but very weight-gaining calories. Other examples of empty, useless calories are things like milkshakes made on ice-cream, cream and such.  Secondly, once you have reached the point where you can begin to introduce more solid foods, from 5 to 6 weeks post surgery, you really should be leaving the sloppy, liquid food behind.  If you continue to get all your nutrients from soft, squishy, liquid food your band will never learn how to work properly.  Its purpose is to prevent you eating too much solid food.  You can trickle fluids down constantly and therefore will continue to gain weight.  It’s impossible, (provided there is sufficient fluid in the band – and this will only be so after you’ve had a few fills from around 8 -10 weeks post surgery) to eat too much solid food as the band will not let you.  That is the idea.

Now I’ve got a Lap Band, I’ll start to drop the kilos like there’s no tomorrow.

Wrong and right.  To begin with on the sloppy food stage (if you’re not dripping down the high calorie fluids) you’ll probably lose quite a bit of weight.  Once you’ve begun to move back onto a near normal diet you will quite possibly gain weight.  This is because the band is not yet working.   The band will not begin to learn to work, nor will you begin to learn how to make it work, until after your first adjustment (fill – putting fluid into the band to tighten it up).  Sometimes it takes many fills or adjustments to get the band to the optimum pressure to enable you to eat well, and also to be in control of the amount you eat.  It is only then, that you will begin a gradual and consistent loss of weight.  (Read also, The lap band will solve all my problems and Having a Lap Band will solve all my over-eating problems.)  Burning calories by exercising will enhance this loss and provide a better cosmetic outcome.

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I’ll never be able to go out for dinner with friends again.

Of course you will.  There would be no point in undergoing a major surgical procedure to improve the quality of your life if it actually reduced the quality of your life by making you a social outcast.  You will eventually, providing you follow all the rules post surgery, be able to eat an entrée sized meal which will forever more serve as your main meal.  Not only is this very socially acceptable, but it’s also positively polite and genteel.  Naturally, it makes sense to wait until you have adjusted to life with a Lap Band before you venture out to dinner with friends.  When you finally brave it, remember, just because everyone else is having a three course meal, doesn’t mean you have to. The time it takes them to eat their three courses is the time you should take to eat your entrée.

Having a Lap Band will solve all my over-eating problems.

No it won’t.  The Lap Band is not a magic bullet.  It is a weight loss tool, which when used properly will assist you to take control of your eating habits.  Like any tool, it is necessary to learn to use it properly to ensure you get the best result.  The better informed and trained you are in the use of this tool, the better it will work for you.  Some tools are built for left handers, and some for right, hence the band works differently in different people.  Whilst some of your experiences might be similar to others who have a band, it doesn’t necessarily follow that what works for them will work for you and vice versa.  So, no, having a Lap Band won’t solve your over-eating problems, but it will make it harder for you to overeat if you use it properly.  Many of your eating behaviours are the result of a lifetime’s patterning caused by many and varied circumstances, often psychological.  Having a Lap Band enables you to slow down and assess the way you view food and eating.  Because it is necessary to chew every mouthful slowly and well it takes a considerable amount of time to work your way through much less food.  As you’re eating (slowly) you have time to consider whether it is worth the effort (and the angst caused by eating naughty food)  to waste time and calories on something that will give only fleeting satisfaction and no solutions to your problems (eg cheesecake, chocolate cake etc etc).  You also have time to consider how you’ll feel about yourself after you’ve finished eating that piece of cheesecake.  Two bites of cheesecake and two minutes later not much damage has been done, you’ve satisfied your craving for “sweet”, you’ve assuaged your emotional state, you have enjoyed the taste of the cheesecake – then ask yourself, “do I really need the rest?”  Actually, no you don’t.  So why not enjoy the really novel and cathartic experience of throwing it away, or giving it to someone else!  Wow, when you begin to change your eating behaviours in this way it is a liberating experience casting off the shackles of the old you.  Some people will need great emotional and psychological support to enable their Lap Band to be effective and you should be encouraged to seek this.  Doctor Nicholson’s Lap Band package includes two visits to a Psychologist if desired.  Remember, keeping the intake of carbs low helps suppress hunger.

I’ve had my first fill but I’m not losing any weight

As stated previously, it can take a number of fills (many Inamed Bands hold a minimum of 10mls and fills can vary in size from as little as 0.1ml) to adjust your band to the optimum pressure to control your eating.  Your first fill will generally err on the side of caution as this is a new experience for all involved and the Doctor does not know what amount of fluid it will take to pull you up short eating wise.  He does not want to put too much fluid in initially or you will have unpleasant side effects like pain, regurgitation, vomiting and night cough, so it might take a few months to get the level of fluid in the band right to set you on the path to weight loss.  The key is not to get frustrated and disheartened by an initial lack of weight loss.  It is vitally important for you to keep in constant contact with Dr Nicholson until you are happy with your progress.  Do not make the mistake of assuming that because you are not losing weight the band is not working.  It is a learning curve that must be endured and for some the learning process is longer.  Remember this is a lifetime commitment and as such takes effort and persistence to make it work.

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Even though I’ve got a lap band I never feel full

This could be for a number of reasons.  For the first few months after surgery it is quite possible you will feel as constantly hungry as you did before you had surgery (read “I’ve had my first fill but I’m not losing any weight”) because the band is empty and as such does not place any pressure on the stomach to restrict your eating and make you feel full sooner.  So in the early months after surgery this is one reason you might feel hungry.  Another reason hunger can be a factor initially is the nature of your food intake which primarily is fluids thin and then thick.  It can feel like you need endless amounts of fluids to feel full, especially if they lack fibre.  (For hints on increasing fibre in your fluids read “Post Op Pointers” - Diarrhoea” and also our quicklink “Food Clues”.)  Even after beginning the transition to sold foods at 5 to 6 weeks after surgery you can continue to experience hunger.  Don’t be frustrated, this is not abnormal.  Your band is not yet working and will not begin working until you have the correct amount of fluid in it for you personally.  This can take a number of fills to achieve and must be worked at in concert with your Doctor.  (Remembering that the first fill cannot take place until 8 to 10 weeks after surgery.)  If hunger continues to be a problem for you it is advisable to consider the composition of what you’re eating.  It’s often difficult to find ways of getting sufficient protein, especially in the fluid and sloppy phases post surgery.  Protein takes longer for your body to break down to use as a food source and as such lasts longer (“sticks to your ribs” as your Grandmother might have said).  One way of getting more protein is to vitamise a mince stew until it’s very runny, water it down if necessary until you can get it through a straw, and despite not giving you the instant hit carbohydrate based foods (especially processed sugary foods) will give you, this protein based brew will keep the hunger pangs at bay.  Incidentally, the carbohydrate fix, as I’m sure you already know, will let you down much faster.  Part of Dr Nicholson’s Lap Band package includes two visits to a Dietitian so you should really take advantage of the second of these visits after surgery to address the issue of hunger and how to alleviate it as the Dietitian will have some helpful suggestions.  Finally, and most importantly, communicate with Dr Nicholson as often as it takes to get the band to a point where it is preventing you from feeling hungry.  It is up to you.  If you do not communicate your frustration you will never achieve success.

Hunger is only felt by your stomach

No it isn’t!  A lot of the hunger you feel is only in your head (you only think you’re hungry when you might be bored or thirsty) and is the result of a life time’s worth of bad habits.  The Lap Band is sometimes referred to by people as a Head Band for that reason.  Because Lap Banding is the final solution or the last straw for morbidly obese people and is often undertaken in desperation, there is a great deal of pressure put on oneself to have it work instantly and without effort.  Unfortunately this is far from reality.  Making the Lap Band work requires a full understanding of how the mechanism works as well as the belief that if you follow the rules it will eventually work for you, and work well.  Your head can get in the way of this in a very big way.  It will stubbornly attest that “I am doing all the right things and I’m still not losing weight”.  The reality is, that you’re doing or not doing something that is fundamentally interfering with the way the band works, and it is up to you to communicate with you Doctor in order to find out what that is.  Changing eating behaviours is like giving up smoking.  When first you commit to giving up cigarettes you’ll find yourself constantly on the reach for something to do with your hands, and for something to put into your mouth.  Many different  behavioural modification techniques can be employed to cope with this unsettling need.  For example, some people chew gum or take up knitting.  It doesn’t really matter what you do as long as it fills the space vacated by the old habit, and is not equally as destructive as the old habit.  The point of this analogy is that changing eating behaviours via Lap Band placement is just as difficult as giving up addiction to smoking cigarettes and there will be many setbacks for some people.  The Lap Band is your friend and your assistant, indeed a tool, in the endeavour to break a lifetime’s bad habits, and together with the support you will receive from your Doctor and his team, it is a very achievable goal.  So don’t let your Head Band win the battle.  You’ve invested your hard earned dollars, taken considerable risk, not to mention your Doctor has worked hard on your behalf, so communicate with the experts until you are happy you are on the track to weight loss and a lifetime of control.

If I haven’t lost any weight my Doctor will get really mad and tell me I’m a failure

NO HE WON’T! He will want to help you achieve success and if you don’t go and see him even when you have put on weight (especially when you have gained weight), then he can’t help you turn your lack of progress into successful weight loss.  Remember it is in your best interests to maintain regular contact with Doctor Nicholson to get the best from your band.

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The Lap Band works the same way for everyone

Not really.  There will certainly be many similar experiences between Lap Banders such as common problems, side effects of not following the rules, eating out experiences and so on.  The Lap Band experience however, can be as uniquely individual as there are individuals with a Lap Band.  What works for one Lap Bander will not necessarily work for another, just as what causes problems for one Lap Bander will not always cause problems for another.  We all do things differently, and whilst you might get away with eating something that traditionally causes blockages with a band because you’re especially vigilant about taking tiny mouthfuls and chewing each at least thirty times, a fellow bander might be less diligent and a blockage can be the result.   Therefore it is vitally important that you take the advice and information given to you by fellow Lap Banders with a large grain of salt.  It is much better to get the advice from your Doctor.   

Now I’ve lost my weight I’ll have the Lap Band removed

Well you could, but really you should consider this a lifetime contract.  Certainly if you’re entering into a contract of marriage, for example, with the thought, “oh well at least I can get divorced”, it’s highly likely that’s where you’ll end up.  Similarly, if you enter into the Lap Band contract with the thought that you’ll have it removed at some point in the future, then you really don’t understand the complex nature of obesity.  The band is a tool only. It doesn’t address why you’re overeating.  Therefore, if you have the band removed, just like when you have the fluid removed from the band, there will be nothing physical to restrict your eating.  Lap Banding is usually the last resort for morbidly obese people.  They have tried and failed most other weight loss methods many times over, because the reasons for their overeating did not suddenly disappear with the weight, they were still there even when the kilos weren’t.  So even if you don’t have any fluid in the band it is not necessary to have it removed unless it is causing problems, and this is rare.  Removal of the band leads to a rapid regaining of all the weight lost plus “GST”.

The Lap Band will solve all my problems

No it won’t!  Carrying too much weight is often the obvious or outward symptom of a complex underlying problem.  Whilst initial weight gain occurs as a result of comfort eating to get over an emotional upset ranging from something minor to something very serious, the eventual result of continued weight gain, morbid obesity, brings problems of its own compounding the initial problems.  Once the weight (or symptom) becomes the bigger problem, (pardon the pun), then the underlying cause can be completely overlooked.  The focus them becomes losing the weight.  “If I lose weight I’ll be a lot happier.”  Yes, in some respects you will, but those underlying problems will still be there.  The problems morbid obesity can bring are things like social isolation and depression.  For example, you can feel reluctant to participate in physical or social activities with your family and friends because of feelings of embarrassment.  Becoming less and less involved in life will cause you to become more and more depressed.  Once you become depressed it becomes difficult and sometimes almost impossible to deal with anything, especially that very thing that caused you to begin to overeat in the first place.  Reasons people overeat can be anything from seemingly innocuous boredom to much more serious childhood abuse and sadly,  a long list of things in between.  If your concerns are psychological, and often they are with morbidly obese people, you need to take advantage of the lifelines offered you through Dr Nicholson’s Lap Band package which offers you two Psychologist’s consultations.  If you find these sessions beneficial you can opt to continue with further sessions at your own expense.  Unfortunately no one has yet invented a Head Band  so until then it is up to the Lap Band to tackle the problem of morbid obesity.     (Read also Hunger is only felt by your stomach     Having a Lap Band will solve all my over-eating problems.)

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