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By Ajay Goyal, MD, FACS, New Jersey Bariatric Center
To recognize when it’s time to adjust a gastric band – REALIZE or
Lap Band - you need to understand how gastric band surgery helps
you lose weight. In short, gastric band surgery works by restricting you
from eating large portions of food at a time. The REALIZE and Lap Bands only
work on the amount of food you intake; they do not have sensors to prevent you
from eating high calorie or unhealthy foods such as ice cream or fast foods. It
also does not prevent you from ingesting liquid calories - soda, juices, vitamin
water, etc., which slip through the band’s restriction around the top of
the stomach with ease. Lastly, eating multiple meals per day, or grazing,
will hamper weight loss as the total calorie count per day will go up with multiple
meals. It’s key for gastric band patients – REALIZE or Lap
Band - to aim for three meals per day with 30 minutes spent on each meal.
During the first year after surgery, you will require approximately three
to five REALZIE or Lap Band adjustments to achieve your goal weight. The
band adjustments are done either in your surgeon’s office or under fluoroscopy
(X-ray) at hospital or surgery center. There is no right or wrong way to
perform band adjustments. At the New Jersey Bariatric Center, we routinely perform
band adjustments (more than 99%) in the office. There is no need for local
anesthesia with adjustments, they usually take five to 10 minutes, and are less
painful than getting blood drawn.
On average, the goal is to lose one to two pounds per week after REALIZE or Lap
Band surgery. Band adjustments are performed approximately every four to
six weeks when one is either no longer able to achieve a one to two pound weight
loss per week while eating healthy or feels hungry between meals to the point
that it’s distracting you from normal daily activity. The key is
finding the level of restriction that decreases your food intake without making
you uncomfortable or hungry all the time. It’s important to be patient
with yourself in the beginning, you will be getting use to a new way of eating
and may face the inability to tolerate certain hard foods that you use to eat
prior to surgery.
I hear different gastric band myths from patients all the time. Some of
the most common to consider prior to band adjustment include:
- The tighter the band, the faster the weight loss. When
the band is too tight it often leads to cheating. When
it’s so tight that you’re at the point where
you can’t tolerate solid foods, you will often compensate
by eating high-calorie liquid calories [soda, juices] or
soft foods [ice cream]. In this scenario, you may have
a tighter band, but you can actually gain weight. Another
way to cheat is to graze, eating smaller meals all day long. This
can backfire too by increasing an individual’s calorie
intake. And finally, patients whose bands are too tight
often will “lubricate” it with sauces and creams
to get the food through the opening, once again increasing
the calorie intake and gaining weight, instead of losing
it.
- The more adjustments one gets, the faster the weight
loss. Making to frequent adjustments will
only lead to a very tight band, leaving you unsatisfied,
which often leads to cheating.
- You can lose the same amount of weight per week
as one does with gastric bypass surgery. Gastric
bypass surgery restricts your food intake like gastric
band surgery, however it also involves malabsorption of
food which increases weight loss. Therefore, you
will not lose weight at the same rate as a gastric bypass
patient.
If you feel off track and aren’t happy with your weight
loss, I suggest you participate in a small one to two week
calorie count assignment to help determine why you’re
not losing the weight. The assignment starts by recording
everything you eat daily in order to calculate the total calories
taken in each day. Two sites I recommend to help with
the calculations are www.FitDay.com or
www.thecaloriecounter.com. I find that patients who aren’t
happy with their weight loss, tend to take in more calories
per day then they realize, particularly the liquid calories
which I mentioned earlier that can slip through the band quite
easily, but also eating multiple meals a day and continuing
to eat fast food can put you off course. Charting your
calorie intake will help you determine if you fall in this
category. Remember, to lose weight with the band, you
need to take in no more than 1200 calories per day and perform
cardio exercise at least 30min three times per week to be successful. Some
additional tips to maximizing weight loss include weighing
yourself on a weekly basis, regular monthly appointments with
your bariatric surgeon to evaluate progress and regular calorie
counting to keep you on track.
New Jersey Bariatric Center
The New Jersey Bariatric Center, led by Dr. Ajay Goyal, has
offices in Union and Hoboken, New Jersey. Dr. Goyal’s
approach to patient care has resulted in zero mortality to
date and a complication rate that is lower than the national
average. These surgical results stand out as some of the best
in New Jersey. If you or someone you love is considering bariatric
surgery – gastric bypass, REALIZE band or lap band procedure
- please join us for one of our free educational seminars.
To register, visit us at www.njbaritriccenter.com.
New Jersey Bariatric Center
700 Rahway Avenue
Union, NJ 07083
Phone: (908) 378-1779 (Business hours)
Phone: (201) 461-1915 (Service)
Fax: (908) 688-8861
www.njbariatriccenter.com
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