Lap Band question about homepage article "At Goal, Don't Abuse Your Tool,"

So the other day I was reading the article on the OH home page, “At Goal, Don’t Abuse Your Tool," The article is directed at all WLS patients and how we need to remember to work our tools especially after we reach our goals. There is some great advice in this article, which will work really well for me, like going back to basics, when I get a little too lax. But this article also seems to miss one important feature of the band, which to me is so important that I decided to blog about it this week - our bands continue to be adjustable throughout our lives. In this article the author states “As time goes on things change.  It is easier to get a lot of food in..."  That point gets me to thinking about how those of us who have lap bands, can continue to be adjusted if we are several years out and feeling like we are no longer satisfied with a small amount of good quality, dense food. I’m reminded that we should not underestimate the adjustable nature of our bands; I am grateful I am that I chose my ADJUSTABLE band, and how that was the right decision for me. What do you think?

This is precisely why I chose the band. I had read way too many times stories of successful rny'ers who 2-3 yeasr out were hungry all over again, with pouches stretched and absorption rates changing. I was terrified of that. I think it would feel so low to have everyone build you up for losing the weight only to have them talking behind your back when it came back. I want something that is going too work the same year after year. Thanks for the reminder!

I couldn't agree more!  I too chose the band for that reason.  I love my band, although some days I don't understand my band:)  That's all good though as I am an understanding person I take the good with the bad and usually the bad is when I am trying to eat too fast...duh you'd think I would know by now:)
Oh well...with only 20 or so pounds left I am almost there!!!!!  LOVEN IT!!!!!

I thnk you are missing the point that people with the band who eat to feel full, even when adjusted properly, can stretch their pouch over time. This goal of eating for a full sensation requires more food to create that feeling which implies more calories. It doesn't matter how many fills you get, if you don't measure portions, you can create long term problems for yourself.

The ideal scenario is to eat to dim hunger instead of feeling full. Often, we bandster chase after this feeling of restriction to limit our portions. The band really isn't intended to be the portion police. There are always ways to cheat any surgery.

There was a great article posted on this board that surgeon wrote about how continual stretching of the pouch above the band can make the pouch stretch more easily so that a portion size is larger. The bandster may not notice they are now eating 1 1/4 cups or 1 1/2 cups. Pretty soon, it might be 2 cups. That has nothing to do with adjustability. That has to do with behavior.

I thought the article was spot on. It deals more with complacency and sticking to the key ingredients of long term success-- measuring portion sizes, making healthy eating decisions and incorporating physical activity into your daily life.

Hi Mick,
Thanks for making me stop and think.  Like you, I've been banded a long time (since 2006), and like you I am maintaining a normal weight.  I did read the article you referred to and am planning on discussing it with my surgeon to get his perspective.

I completely agree that there is a risk of trying to eat until we are FULL - and I agree that can become a problem.  I also know people who have tried to keep their bands too tight and eventually chose to have fluid removed.  I am one of those people who feels best when I can comfortably eat things like white meat chicken and fresh fruits and vegetables.   I am also from the school that we should periodically journal,  weigh and measure, and that we should not put more on our plates that we should eat, period, end of story.  I also agree that working the tool is all about behavior.  For more on how  I work my tool,  you can check out this entry on my blog at www.gloriasbandedliving.com/transforming-003-maintaining-004 -getting-the-most-from-my-lap-band%c2%ae-how-i-learned-to-us e-my-tool/

So, as I said, I agree with most of what was in that article, That beind said, I also know that a properly adjusted band really does help with satiety - note that I didn't say fullness, and I know that with a properly adjusted band,  everything I know about how to maintain my normal, healthy weight is so much easier.  Therefore I am gald I chose a tool, that can be adjusted over time, if needed to maintain that satiety.

Gloria, I'm with mick. I'm afraid we CANNOT keep getting the band adjusted forever. After the first year or two, the esophagus loses it's sensations and often no longer tells us when we are "full" We them must SELF-limit to the ideal 1-1.5 cups of food per meal, if we want to avoid band trouble.

After these first years, we are supposed to have improvethrough hard work our eating and choices and  lifestyles enough so that we do not have to rely on the band much. The many many slips, dilations, and eroions that occur as years go by speaks to this. We always want as LITTLE fill as possible to still get help in limiting eating. It's simple - the more fill, the higher the risk of trouble.

the point of the band is not to keep adjusting it every time we find we can eat more. as a matter of fact, it's very wise to get a small UNFILL at goal to decrease the longterm pressure on the stomach. the stomach  was NEVER meant to tolerate tight pressure for long.

If we regain or lose focus, rather than more fill,  We need an attitude and lifestyle adjustment instead. it scares me how few people seem to realize this, and think the band is going to be a major help forever. it was never designed to be that,  no matter what some of the docs make or allow us to believe.

It's also a myth that the band is easily removeable, and I just hate when the band manufacturer states that as a plus. the BYPASS is also reversible, since "it CAN be done" . Band removal is a very difficult and often very lengthy procedure, costing way much more money, surgical time, pain, and recovery than the very simple band placement.  A number of friends have required band removal for various reasons, over the years, and none of the surgeries was less than 5 hours, easy, or anytghing less than very painful for a good while. Some had liver or stomach damage, and worse. I don't want to scare people, but we should be given the truth.

Just my 2 cents as a longtimer.

Sandy r
banded 7 yrs
at normal bmi 6+ yrs

Hey Sandy (and Mick),
Thanlks for some wonderful perspective.  It's great hearing from both of you on this topic!
Warmest Regards,
Gloria

"the esophagus loses it's sensations and often no longer tells us when we are "full""

I guess I am relieved that I do not count on my body to tell me I am full anymore. I thought what you were saying was that the band was going to stop working as an adjustable tool a few years into the process. Luckily I learned early on that "band full" is entirely different than full used to be. In fact my band has almost never worked to control portions. I have had to do that for myself. What it has helped with though is to reduce my actual, real, hunger. I can give myself a small portion and then walk away and not want to eat again for hours. This is excellent advice though for those who do not quite differentiate between real hunger and head hunger. I think sitting down to a ull plate of food for years is partly what got us here, so it makes no sense to continue those habit post op and expect the band to shut you down.

How many people in this thread still have bands, I wonder? 

The sentence about how "bands continue to be adjustable throughout our lives" is a big selling point. Except it's NOT true. So, why are people still opting for bands when they're NOT a lifetime device?  Is it common knowledge now? 

SarahR revised long ago.