From change in taste to the connection between stress and weight - here are five nerdy facts about a weight gain.
1. Increased weight can can change how you taste food. Latest study performed by Kathryn Medler, PhD, associate professor of biological studies at the University of Buffalo showed that obesity may change how our tongues react to different foods. Tests showed that severely obese mice had decreased ability to detect sweets compared to their slimmer counterparts. The plumper mice had fewer cells that reacted to sweets and those that were present reacted weaker than normal. It is unclear how decreased sensitivity to sweetness can impact the increase in weight. Dr. Medler gives one possible answer – the overweight may crave sweets, but because of the lower sensitivity, it may take a larger portion to feel satisfied.
2. Traumatic events and depression has been linked to obesity and weight problems. One of the recent studies shows positive relationship between PTSD in women and increased body weight. Women with one to three symptoms of PTSD were 15% more likely to be overweight or obese than women who never experienced trauma. Women with four or more PTSD symptoms were 25% more prone to increased body weight. Weight problem is not only caused by emotional eating but also by a hormonal imbalance that causes increase in the abdominal obesity. Primary care physicians caring for patients affected by PTSD should stay vigilant to the signs of weight gain in their patients.
3. Researchers found a surprising relationship between the antibiotic consumption and weight gain. The studies show that the antibiotics affect the bacteria living in a digestive tract, and by lowering gut’s bacterial diversity, can cause a weight gain. According to the article published by Newsweek, the diversity of cultures in the digestive tract may be adversely affected by a direct use of antibiotics or consumption of animals that were treated with antibiotics – which means most of the meat in a grocery store. It remains unknown how exactly the decrease in bacteria can cause the weight gain, but apparently in conducted experiments the resulting increase was statistically significant. It is also unknown whether changes in the gut are permanent or temporary – whether the bacteria colonies can rebuild themselves after damaging impact of the antibiotic.
4. Elevated levels of Cortisol – hormone released in the initial reaction to stress – can increase appetite and aid to transform fat cells into visceral fat. This may in turn make patients more prone to diabetes and hyperlipidemia. Another way that the Cortisol can jeopardize dieting efforts is by suppressing the insulin and leaving whole a lot of glucose in a bloodstream. Cells starved for glucose send signal resulting in hunger pangs. The unused glucose is later stored as body fat. This the mechanism can cause overeating and significant weight gain during prolonged stress. In addition, Cortisol was shown to bind to the areas in brain responsible for cravings increasing the appetite which in the end can make the weight gain even worse.
5. Even without diabetes or high blood pressure, BMI above 30 can be detrimental to overall health. Researchers from Toronto’s Mount Sinai Hospital found that patients with BMI greater than 30 are at 24% higher risk of heart attack than those with lower BMI levels. In other words, there is no such thing as healthy obesity; even without metabolic diseases, the weight alone may increase chances of cardiovascular issues.
Ladies, do not threat! We are all going though this, and more often than not we give in to the cravings brought by PMS. Many times we tell our patients that rather than fight the battle we will most likely lose, better to give in but in a controlled manner. We understand that if you crave chocolate so bad you want to bathe in it, trying to fight the urge with full abstinence may not be the best strategy - unless you have a strong history of success in this kind of throw downs then more power to you!
For those of us who fail miserably on the battlefields of PMS cravings, we decided to get you some lap-band-friendly recipes. Even though in some cases, moving toward healthy desserts may turn out to be a slippery slope, feeling miserable and deprived is not a DayOne Health way of shedding pounds. Desperate times call for desperate measures ladies. Here is a list of five lap-bander friendly recipes that will make your head spin and PMS be gone. If you would like to see more recipes you can visit our lap-bander friendly recipe page or get more recipes from the www.hungrygirl.com (Great site by the way!).
- Loca for Mocha - a fantastic weight-loss friendly frozen coffee
1 packet hot cocoa mix with 20 - 25 calories (like Swiss Miss Diet or Nestlé Fat Free)
1 tsp. plain fat-free nondairy powdered creamer
1 tsp. mini semi-sweet chocolate chips
1/4 tsp. instant coffee granules
1 no-calorie sweetener packet (like Splenda or Truvia)
1/2 cup light coffee ice cream
1/4 cup light vanilla soymilk
1 cup crushed ice or 5 - 8 ice cubes
In a tall glass, combine hot cocoa mix, creamer, chocolate chips, coffee granules, and sweetener.
185 calories, and PMS gone bye bye. Enjoy!
- Slice of Life – Chocolate cake madness with 217 calories per slice
1 sugar-free chocolate pudding snack with 60 calories or less (like the kind by Jell-O)
1/3 cup chocolate frosting
2 tbsp. light chocolate syrup
2 tbsp. mini semi-sweet chocolate chips
Two 25-calorie packets hot cocoa mix (like Swiss Miss Diet or Nestlé Fat Free)
Half an 18.25-oz. box (about 1 3/4 cups) moist-style devil's food cake mix
1 tsp. granulated sugar
1 tsp. baking powder
1/8 tsp. salt
1/2 cup fat-free liquid egg substitute (like Egg Beaters Original)
Preheat oven to 350 degrees. Spray a 9" round cake pan with nonstick spray and set aside.
In a medium-large bowl, combine topping ingredients. Mix thoroughly. Cover and refrigerate until thickened and cake is ready to be frosted.
To make the cake, place chocolate chips and the contents of both cocoa packets in a tall glass. Add 1/2 cup very hot water and stir to dissolve. Add 3/4 cup very cold water and set aside.
In a large bowl, combine cake mix, sugar, baking powder, and salt. Stir well. Add chocolate-cocoa mixture and egg substitute. Whisk until completely blended.
Pour batter into the cake pan. Bake in the oven until a knife inserted into the center comes out mostly clean, about 30 minutes. Set aside to cool completely.
Once cake has completely cooled, transfer to a plate. Evenly spread the topping over the top of the cake.
Refrigerate until topping has set, at least 15 minutes.
Evenly cut cake into 8 slices 217 calories each. Serve and enjoy! (Refrigerate leftovers.)
MAKES 8 SERVINGS – share the love!
- Bite It! – A divine chocolate mousse
1 pack Nabisco 100 Cal Oreo Thin Crisps
2 Mousse Temptations by Jell-O snack cups, any chocolate flavor
1 Jell-O Sugar Free Chocolate Pudding Snack
1/2 cup Fat Free Reddi-wip
Roughly crush cookies and set half aside. Evenly distribute the other half between two small glasses or dessert bowls.
Spoon a container of mousse into each glass/bowl. Top each layer of mousse with half of the pudding. Squirt 1/4 cup Reddi-wip on top of each pudding layer. Sprinkle remaining crushed cookies on top of the two desserts, evenly distributing the cookies between the desserts.
Observe their beauty, maybe take a picture for Facebook, and DIG IN!
MAKES 2 SERVINGS each 150 calories worth of goodness!
- I ShouldCocoa
One 25-calorie packet hot cocoa mix (like Swiss Miss Diet or Nestle Fat Free)
2 tsp. fat-free non-dairy powdered creamer (like the kind by Coffee-mate)
2 tsp. unsweetened cocoa powder
2 tsp. mini semi-sweet chocolate chips
20 mini marshmallows (about 1/4 cup)
2 low-fat honey graham crackers (half a sheet), crushed
Place cocoa mix, powdered creamer, cocoa powder, and chocolate chips in a large mug. Add 1 cup very hot water, and stir until ingredients are fully dissolved, melted, and combined. Top with marshmallows.
Using a kitchen torch, toast the marshmallow layer for 5 - 10 seconds, until slightly melted and cooked to your liking. (Some like their 'mallows golden, some like 'em blackened!) Allow to cool slightly, and then top with crushed graham crackers.
MAKES 1 SERVING and 178 calories!
- Oreo Invasion
4 packs 100 Calorie Packs Oreo Thin Crisps
3 cups light vanilla soymilk
1/2 a small (4-serving) pkg. JELL-O Sugar Free Fat Free Cook & Serve pudding mix; Vanilla
1 envelope unflavored Knox Gelatin
2 cups thawed Cool Whip Free
2 tbsp. sugar-free chocolate syrup
Stir pudding mix into soymilk in a medium-large saucepan. Stirring constantly, bring to a full boil. In a large mixing bowl, combine soymilk mixture with gelatin and whisk continuously for at least 5 minutes (until gelatin is completely dissolved). Place dish in the fridge for about 45 - 60 minutes, until chilled and partially set. Meanwhile, take 1 and 1/2 packs of the cookies and process in a blender or food processor until reduced to fine crumbs (or place them in a sealable plastic bag and crush through the bag with a rolling pin; less clean up!). Place crumbs in a 9" pie dish, and use your hands to spread crumbs along the bottom to cover. Take remaining 1/2 pack of cookies along with 3rd pack and break into pieces; set aside. Once mixture in fridge is ready, stir in 1 and 1/2 cups of the Cool Whip (a wire whisk works wonders) until thoroughly mixed. Next gently stir cookie pieces into the mix. Carefully pour mixture into pie dish and spread evenly on top of crumbs. Return to fridge until set (3 hours or overnight). Once ready to serve, break 4th pack of cookies into small pieces. Spread 1/2 cup Cool Whip over pie and sprinkle cookie pieces on top. Drizzle with chocolate syrup and prepare to get cookies 'n cream crazy!
Serves 8 with 115 calories a pop!
1) Low-Fat means healthier
Low-fat does really mean that what you are about to consume is low in fat content. Nevertheless, in most cases it is also very likely to be higher in sugar. You may think you are eating healthy and getting a head start on your diet, while you are actually getting more calories than you planned. Always check the food label to get the whole picture of what is in your food. Sometimes it’s better to go with the regular version of the product.
2) A vegetarian diet will help me lose weight
That holds true only if you keep your calorie intake on the prescribed level of 1,200 calories a day. If your diet will remain high in calories and snacking, a vegetarian diet will not get you the expected results. In addition, if you are not use to eating fiber-rich foods in the beginning you will most likely feel miserable and deprived. Finally, if you are a carnivore at heart, you may find the diet unsustainable or go on a binge after you are done with your vegetarian kick.
3) You can eat as much protein as you want
Living solely on protein is not a good idea to start with because soon you will deprive your body of all other nutrients necessary to stay healthy. Protein is truly very good for you, but only if it’s lean protein. Not all protein-containing food is the same – foods differ in type and amount of fats they contain and sugar levels. When in doubt, consult the nutrition label to determine if what you are eating is really good for you both in a nutritious and caloric sense of the word.
4) Skipping meals will help you lose weight
Skipping meals is a very bad idea. Skipping meals may actually make you gain weight for two reasons. First, you will be more likely to go on binging sprees if you go hungry for longer periods of time, or try to radically change your eating schedule. Second, by starving yourself you may induce your body to go into a so called “starvation mode” which will cause your body to store the calories it would normally burn.
5) If you exercise you can eat what you want and still lose weight
No matter if you exercise or not, the number of calories you eat has to be lower than the number of calories you burn in order to lose weight. You can argue here, that it is obvious that if you exercise you will burn more calories, but you have to take under consideration two facts that are not in your favor. First, when start exercising you will naturally be hungrier. Second, we usually do overestimate how many calories we burn when exercising. With that in mind, unless you are in an honest relationship with My FitnessPal, you can get yourself into a lot of trouble with the idea of eating what you like because you exercise.
6) Working out the body parts you want to slim down, will burn fat in these areas
Everyone has fallen for this one, one time or another. You decided you want your stomach perfect for the summer, planned out your daily dose of crunches, and even followed though for two weeks. What happened next was that you actually got better with your crunches; nevertheless, your stomach stayed exactly as it was or maybe even worse. What happened was that while doing your crunches you didn’t actually burn the fat on your stomach, you burned some calories and maybe some fat, but not where you expected. In that sense, if you want to lose weight it might be more beneficial to do cardio exercises to burn more calories and tone your whole body.
7) Hot Yoga will make you burn more calories
You can easily leave your sweat suits, garbage bag, and exercise in high temperature behind. None of these things will make you lose more weight than doing the same exact exercise in regular temperature. The only result is that you dehydrate yourself, which will definitely not improve your weight loss. When it pertains to exercise, sweating more does not mean better results or that workout is more effective. Keep exercise light but repeat it every day and you will see improvement much sooner than slow cooking yourself once a week with other yoga aficionados.
8) A cleansing diet will upstart my weight loss
Cleansing may give you results in the beginning, but for many reasons it will be a Pyrrhic victory. First simple reason is that “cleansing” makes you miserable, so it is very unlikely you will actually enjoy your success. Second, it is not sustainable. As soon as your body gets any extra calories it will go into starvation mode and either cause you to regain the weight or will heat you with a double force of a yoyo effect. We strongly discourage from upstarting your weight loss this way because even if you manage to “cleanse yourself” it is more likely you will prime yourself for massive weight regain than long-term weight loss.
9) Carbohydrates make you fat
You need to remember that all carbohydrates don’t have the same effect on your body. It’s not the carbohydrates that are making you fat but the calories. Don’t forget also that carbohydrates are a necessary part of your diet, so cutting them out is not a good idea. You should definitely eat them in moderation, and make sure that you minimize the amount of processed carbohydrates. Processed means that they are stripped of the fiber that would normally make you feel full faster. Because most of the carbs in processed foods are processed as well, make sure that you incorporate in your diet fiber-rich foods.
10) Fad diets can give you permanent weight loss
If you tried to lose weight with fad diets and still haven’t, you already debunked this myth yourself. The problem is that fad diets seem like something that would work – it’s radically different from your routine, it’s preoccupying, you see results almost instantaneously, you are hungry and/or feeling deprived. Probably the most attractive thing is that these diets have limited time, so no matter how miserable you feel you know deep down you feel that “14 more days and I will finally eat whatever I want.” All of these factors may make us feel like we are doing a great job; in reality, we are doing ourselves a great disservice by destabilizing our metabolism and setting ourselves up for failure. The truth is, the change does not have to be radical, but steady and permanent.
There are risks inherent in any surgical procedure, but LAP-BAND risks are minimal compared to the risks involved in gastric bypass surgery.
While gastric bypass is the most common weight loss surgery, it is also the most dangerous. For those of you who are not ready for a drastic solution like a gastric bypass, LAP-BAND can be a better surgical weight-loss option.
LAP-BAND surgery is an outpatient procedure that is just as effective as gastric bypass, but without the risk involved invasive cutting and stapling of the stomach or intestines.
Furthermore, unlike gastric bypass, LAP-BAND can also be adjusted without additional surgery, or removed if necessary. Nevertheless, although LAP-BAND is currently the safest weight-loss surgery available, there are risks involved in any surgical procedure. At DayOne Health, we take all necessary precautions to minimize risk to the extent possible.
Possible Side Effects of LAP-BAND Surgery
Post-surgery complications of LAP-BAND surgery include digestive issues such as nausea, vomiting, gastroesophageal reflux, productive burping (regurgitation of food that has not passed the upper pouch), diarrhea, constipation, bloating, and difficulty swallowing.
While these issues may look worrisome, don’t fret! Since these digestive problems are very rare and are usually caused by the type and/or amount of food ingested as well as insufficient chewing. In other words, these issues can be easily prevented by consulting with our bariatric dietition about your eating habits after surgery.
Choosing DayOne Health for your LAP-BAND procedure means that you will have a caring and knowledgable dietitian to guide you along your LAP-BAND journey and provide you with the information necessary to avoid LAP-BAND complications and make the most out of your weight-loss surgery.
In rare cases, if the symptoms are not going away or you have difficulties following the dietary requirements, we advise to temporarily empty the band. LAP-BAND deflation usually does the trick and quickly relieves all symptoms. However, moving forward we will definitely work with you to adjust not only the optimal level of fluid in your LAP-BAND, but also to tailor your diet to your individual needs.
LAP-BAND Placement Issues
Sometimes, there may also be issues with the LAP-BAND placement, or the angle at which the band lays on the stomach. The band is made from resilient bio-materials, so mechanical malfunctions of the band do not occur. Nevertheless, the band may slip from its intended position requiring adjustment or in serious cases removal. It is very rare, but unfortunately happens. For instance, at DayOne Health since 2001 we’ve seen only 10 cases of LAP-BAND slippage.
There are two main causes of the band slippage. One is overeating and constant overstretching of the upper part of the stomach. When the pouch becomes overstretched it significantly increases pressure on the band and may cause it slide down a bit. The band slippage can be easily prevented by a timely follow and following dietary recommendations.
The second possible cause of the slippage is frequent vomiting. Normally there is no danger in vomiting. However, in the event of frequent vomiting due to the band being too tight there is some risk of LAP-BAND slippage.
This is also why we cousel patents to contact our physicians if they feel too much restriction after a LAP-BAND adjustment. If you feel that food is not going down properly and/or you have a hard time keeping it down, call us immediately to have your LAP-BAND readjusted. Reacting quickly to avoid frequent vomiting is the best prevention for the band slippage.
In rare cases, it is possible for the esophagus to dilate after surgery. This risk can be reduced by complying with the bariatric dietary recommendations and proper, timely adjustments by an experienced bariatric surgeon at DayOne Health. Esophageal dilation can usually be corrected with band deflation. It is also possible for the stomach opening at the site of the band to become obstructed, often due to improper food intake or in some cases band slippage.
Other complications include infection at the incision site, ulceration, abdominal pain, dehydration, and asthma. As with any surgery, there is a slight risk of serious problems including thrombosis, liver damage, lung damage, spleen damage, perforation of the stomach, and extremely rare cases death.
For patients who are considered good candidates for the LAP-BAND, health risks associated with excess weight may be considered a greater concern than the risks of surgery. Our experienced surgical team at DayOne Health has a track record of providing consistently excellent results, and has published patient outcomes exceeding FDA trials.
To learn more about the benefits and risks of LAP-BAND, the safest weight loss procedure available, schedule a one-on-one consultation with our surgical team today.
Lap-band surgery has been performed in Europe for over 10 years before being approved for use in theU.S.in 2001. Until now, it is estimated that over 300,000 gastric band surgeries were performed worldwide. Over a decade of experience in the U.S. alone has shown that lap-band is an effective tool in fighting excess weight and that it has been more successful than traditional methods in achieving long-term weight loss.
According to the study performed with the use of database developed as a part of the accreditation program instituted by the AmericanCollege of Surgeons Bariatric Surgery Center Network (ACS-BSCN), out of 28,616 patients only 6% developed complications following the lap-band surgery. Majority of the complications constituted pouch enlargement (stretching of the stomach) and the band slippage, and were addressed with the band repositioning.
Another study performed by Dr. Franco Favretti and Gianni Segato looked at 1,791 patients who underwent the lap-band procedure within the period on 12 years. The analysis showed the total complication rate of 5% out of which band slippage and pouch stretching constituted 3.9% of the cases. The erosion cases constituted 0.9% of the sample. No cases of mortality were recorded. The study by Paul E. O'Brien and John B. Dixon showed mortality of 1 out of 2,000 patients. This rate is approximately 10% lower than the mortality rate indicated for the gastric bypass surgery.
Belgian study published in 2011 indicated complication rates for lap-band to be significantly higher – especially for instances of band erosion – than any other study. The researchers were claiming that the approximately 40% of patients experienced serious complications (39% band erosions) and another 22% suffered minor complications such as pouch enlargement. Nevertheless, study analyzed patients who underwent the surgery between the 1994 and 1997, and followed only half of the original sample. In other words, out of the whole sample of 151 patients, the researchers followed up only on 84 patients. In addition, bands and urgical methods observed in the study were substantially different from the bands currently used.
In over a decade of experience at DayOne Health, we observed the complication rate no higher than 4%. The most common complications we've seen at our practice are a stretched pouch and a band slippage. At DayOne Health, we have not seen yet any band erosions.
Lap-Band Weight Loss
According to the study done by Dr. Favretti and Dr. Segato the average weight loss achieved by patients was 58lbs or 38.5 ± 27.9% loss in excess weight. Other studies report 40% excess weight lost within the first year followed with additional 10% to 20% in the second. The study by O'Brien and Dixonindicates weight loss of 56% of excess weight in three years after the procedure. In comparison, the average weight loss for the same time period for gastric bypass was 59%. In other words, lap-band is as effective in achieving long-term weight loss as gastric bypass. As a side note, the surgeons who performed over 100 lap-band surgeries achieved better weight loss results than the less experienced ones.
Lap-band weight loss results and closely connected with the frequency and length of a follow up care. The study performed by Jonathan A. Myers, M.D., Sharfi Sarker, M.D., and Vafa Shayani, M.D. showed that patients with higher BMI (>60) took longer to achieve the same weight loss results than lower BMI patients and required longer follow up period
. In the study performed by Evan Valle, Minh B. Luu, Khristi Autajay, Amanda B. Francescatti, Louis F. Fogg, Jonathan A. Myers, that there is a strong positive relationship between a higher number of lap-band adjustments and percent of excess weight lost. The study also indicated that patients operated and followed up on at the surgical facility achieved greater weight loss results from patients at the hospital
. The difference was ascribed to the fact that patients seen at the surgery center had easier access to the frequent follow up
Make exercise part of your makeover. If you are already deciding to undergo a weight loss surgery, you are in for a big lifestyle change. Why not push it a little further and pick up some good exercise routines?
Exercise does not have to mean sweat and tears, but the unfortunate part about exercise is that you have to stick to it to get the results. Instead, we lose motivation and stop before the scale even twitches. Like with every habit, this one will also take time to work into a daily routine. Because it's so hard to get on track, the best approach is to start slow and adjust workout to your progress as you go. Here are some routines that will stretch your muscles and get you started.
Start slowly. There is no need to overstress yourself. Treadmill and stationary bike could be your best friends and help you incorporate some exercise without putting big strain on your body. For a good start, you can do a light walk for 20 minutes every day. You don’t need any incline or to walk fast. Also don't walk longer or much faster than comfortable - don't fall into the trap of the first day zeal. Walk for 20 minutes and give it a rest. Use the same strategy with a bike. You don’t have to set high resistance or pedal fast. Take your time and enjoy the exercise. First day will always make you feel like you can do everything or more than your overall fitness actually permits. Remember, the objective is to build up your stamina and the only way to do it is to make small consistent adjustments in your training. Overdoing it on a first day will just make you sore and too tired to go do it again.
If the weather permits, it’s a great idea to start walking outside. If you live in a city, walk around a block or go to store to get some groceries. If you live in the suburbs go for a walk in your neighborhood or drive to the park. Staying outside and breathing fresh air will make you feel better. Your first walking session doesn’t have to be long and you don’t have to walk fast. Remember, any extra step you take contributes to your well-being and stamina. Sometimes the change is too small to see it in a first few days, but trust us – your overall health improves with every extra step.
Exercise while sitting
For heavier patients longer walks can be more straining and a lot of gym equipment can't accommodate higher BMI’s. You may find that the seats are not big enough or are too narrow and uncomfortable. In this case, you can start your own exercising routine while sitting in your living room.
Get a chair that will keep your legs at a right angle and let you maintain the straight posture. These fiver exercises will let you stretch and help relax while exercising.
- Get two paper plates and put them under your feet. Push on the right leg to slide it forward and activate your hamstrings. Pull the right foot back, and repeat the exercise on the left side. Repeat each side 15 times.
- Sit straight with both feet on the floor at 90 degrees angle. Straighten a right leg and hold it for a second with a flexed foot. Lower it back on the floor and do the same with the left foot. Do 15 repeats on each leg.
- Raise your arms in front of you at straight angle. Fold them away from your body. Now while sitting straight twist 90 degrees to the right side while keeping folded arms perpendicularly to the rest of your body. Bring your arms back to the middle. Do the same on to the left. Repeat twisting to each side 15 times.
- Raise your arms even with your shoulders on your sides. Move your arms in circular motions clockwise 10 times and then do the same counter clockwise. Do five repeats.
- Raise your arms like in the previous exercise, but bend them at elbows so that you are touching shoulders. Move your elbows in circular motions clockwise and counterclockwise 10 times each. Repeat the set 5 times.
It’s always hard to start, and even harder to keep to your regimen. However, when you are struggling remember that all of this work will contribute to your lap-band results. Building a good balance between exercise and diet gives the best weight loss results.
Gastric bypass remains the most popular and the most common of weight loss surgeries. Nevertheless, unfortunately for patients the gastric bypass is oftentimes the only option that patients look into when researching their weight loss surgery options. What many patients don’t realize is that gastric bypass is the most invasive and most dangerous of all available weight loss surgery options. In addition, gastric bypass irreversibly reroutes your digestive tract and changes the way your body processes food for the rest of your life. When deciding to undergo the weight loss surgery, patients should look closely into all available options and make an informed choice with help of their physician.
What is gastric bypass?
Gastric bypass is both a malabsorptive and restrictive weight loss surgery. The procedure entails bypassing a major part of the stomach and a part of the intestine responsible for large portion of nutritient absorption. The new smaller stomach is then connected to the further part of the intestine. As a result of cutting off a large portion of the stomach, patient’s remaining stomach can hold a much smaller amount of food than prior to the surgery. During the procedure, bariatric surgeon excises approximately 90% of the stomach leaving patient with approximately a four ounce stomach capacity. Limited stomach capacity allows patients to limit their portions without feeling deprived.
The malabsorptive side of the procedure is caused by the resection of the intestine. Bypassing the first section of the small intestine, the post-gastric bypass digestive tract absorbs less of high concentrated sweets, fats, iron, calcium and vitamins B12, A, D, E, and K. As a result, even if patient does not fully adhere to the new dietary requirements he or she still loses weight. The downside is that following gastric bypass patients must take multivitamin and dietary supplements to compensate for the decreased absorption. In addition, the common side effect is a so called dumping syndrome – indigestion and severe diarrhea after eating concentrated sweets.
The duodenal switch, like gastric bypass, is both a restrictive and malabsorptive weight loss surgery. The surgery is very similar to the gastric bypass in rerouting of the small intestine. However, duodenal switch entails removal of the 75-85% of the stomach and connecting the portion of the duodenum (first segment of the small intestine) resected from the stomach to the last six feet of the small intestine. In other words, the duodenum becomes attached to the lowest part of the small intestine bypassing the majority of the absorptive process and creating a type of a loop. Because the surgery involves cutting and rerouting of the digestive tract it is considered a higher risk surgery that is comparable to the gastric bypass.
In terms of results, it is reported that patients undergoing duodenal switch lose about 70-80% of excess weight. Patients lose most of the weight within the first year. Gastric bypass patients were reported to do slightly better than those who underwent duodenal switch. However, due to the fact that duodenum remains connected to the lower part of the intestine, duodenal switch patients don’t experience dumping syndrome that is a common side effect among gastric bypass patients.
Other weight loss surgery alternatives
Currently the most popular alternatives to the gastric bypass and duodenal switch are gastric sleeve and adjustable gastric band. Both procedures are solely restrictive and do not involve decreased nutrient absorption. This means that patients who undergo either of the procedures lose weight by working their portion size. Both procedures aim at substantially decreasing size of the stomach with results in patients feeling full faster and digesting food slower. Purely restrictive weight loss surgeries provide weight loss that is slightly slower than in case of malabsorptive surgeries. Weight loss following gastric sleeve or adjustable gastric band is less “violent” but is accompanied by fewer side effects. In addition, the side effects that occur are considerably less serious than those posed by the gastric bypass and duodenal switch. Finally, research shows that on average after two years the cumulative weight loss for patients undergoing different weight loss surgeries evens out.
As mentioned above, gastric sleeve surgery is a restrictive procedure. The surgery comprises of surgeon removing a substantial part of patient’s stomach leaving about six ounces volume “sleeve” shaped stomach. The surgery does not involve rerouting of the intestines like in gastric bypass, hence it’s considered less invasive. Nevertheless, when deciding for the gastric sleeve a patient has to be aware of the risk of leakage from the stitched side of the stomach. Because the surgery does not involve a malabsorptive component, patients do not have to take dietary supplements or experience dumping syndrom. The surgery is not reversible, but once operated stomach can easily stretch if a patient does not adhere to the recommended diet.
Adjustable Gastric Band – LAP-BAND®
Lap-band is currently the only weight loss procedure that is fully reversible and adjustable. The lap-band procedure involves bariatric surgeon placing an inflatable band around the upper part of the stomach. The procedure aims at creating a smaller size pouch that becomes a patient’s new smaller stomach while leaving the rest of the stomach intact – the final result reminding an hourglass. The band is connected with a port that is placed under the muscle in the left side of the abdomen. Finally, it band can be filled and unfilled with a fluid to change the band’s restriction around the stomach. Because the procedure does not involve any alterations to your digestive tract, the complications involved with the band are not as serious as those connected with other weight surgeries. The most common side effects are due to the inadequate restriction (the band is either too tight or too loose). Nevertheless, adjustability of the band allows flexibility that other weight loss procedures don’t. At any point in time you can deflate or remove* the band leaving your digestive tract intact.
If you would like to learn more about lap-band surgery contact our Chicago clinic at 312-219-9259 or contact our patient advocte.
*The band removal is associated with an additional surgery and is not generally advised. The band is meant to be a permanent solution unless decided otherwise by your bariatric surgeon.
The question how heavy you have to be to be a candidate for the lap-band is likely the most often asked question by our consultation candidates. While the FDA states that lap-band is recommended for patients with BMI of 30 and higher, the final answer whether you qualify will depend on your physician and/or requirements on your insurance policy.
FDA’s weight minimum for LAP-BAND surgery
When first approved by FDA in 2001, the LAP-BAND was recommended for patients with BMI of 35 with two or more weight-associated conditions or BMI of 40 and higher. This weight recommendation remained in place for a decade. Nevertheless, in 2011 FDA lowered the BMI requirement to 30 BMI with one or more co-morbidities and 35 BMI with no co-morbidities. The requirement was lowered after it was established that the lap-band surgery can be used as prevention to developing conditions associated with obesity. While the FDA requirements usually serve as a guideline, a weight-loss physician always determines whether a patient is a good lap-band candidate on case-by-case basis.
Bariatric surgeon weight requirements
When a patient visits for a consultation he or she will most likely be automatically recognized as a candidate for the lap-band surgery if his or her BMI is above 30. Nevertheless, in some cases weight-loss surgeon may decide that the weight-loss surgery may be a good option for patients with BMI as low as 28. The surgeon makes the decision on basis of the overall assessment of patient’s health. In other words, if a patient has weight associated conditions surgeon may recommend the surgery even though the patient does not meet the FDA’s weight recommendations.
That is especially true for patients whose weight concentrates in their midsection. The fat concentrated around the waistline may be an indicator of high visceral fat that is considered to be far more dangerous than the subcutaneous fat (under your skin). The visceral fat is a fat that surrounds your internal organs such as heart, stomach, liver, and intestines which, if high, it may put you at significantly higher risk of developing conditions such as hyperlipidemia (high cholesterol), diabetes, hypertension, and heart disease. Because prevention is the best way to treat some of the more serious health conditions, your surgeon may recommend the surgery even if your BMI has not reached 30.
Insurance weight requirements
While FDA and a surgeon have their recommendations in regards to a lap-band candidate, the insurance companies have their own requirements which deviate from the other two. Most of the insurance policies require patients to have a BMI of at least 35 and have at least two weight-associated conditions (co-morbidities). The conditions that are currently recognized by health insurance are:
- sleep apnea
In order for the co-morbidity to be recognized by your insurer, you have to indicate treatment with medication and that the condition is not responding to the treatment. In terms of sleep apnea, a patient has to undergo a sleep study to confirm the condition.
Patients who surpass BMI of 40, usually don’t need to indicate any weight associated conditions or treatment to have their weight-loss surgery covered. The exception to that rule are health benefits provided via unions which sometimes may require a patient to be over 45 BMI to qualify for the procedure. To learn what are your weight requirements for the lap-band you will need to contact an insurance person at the clinic to verify your coverage.
If you would like to learn more about the lap-band surgery and determined if you are a candidate, you can contact our patient advocate at 312-548-1483 or schedule your one-on-one consultation with a bariatric surgeon.
When looking at weight loss surgery options, you probably noticed that in the world of adjustable gastric banding there are currently two bands offered in theU.S. While both bands are very similar in terms of complication rates such as slippage, erosion, or leakage, the two differ in certain aspects that every patient should know before getting the weight-loss surgery.
Realize Adjustable Gastric Band
Realize Adjustable Gastric Band is a restrictive device
produced by Ethicon Endo-Surgery, Inc. In its early years, the band has been known in Europe under a name Swedish Adjustable Gastric Band (SAGB). The band was introduced in clinical trials in theU.S.in 2003.
The FDA approved use of the Realize Band in 2007, and since then the band has been available to patients. In its history, Realize Band had a recall in 2010 due to the increased instances of port leakage. Since its introduction in 1986, the Realize band has been performed on 100,000 patients. Currently used band is a second generation of the Realized bands released to the market.
Lap-Band AP System
Lap-Band System was first introduced in clinical trials in theU.S.in 1995, and approved by the FDA in 2001. Since then, the band has been placed in approximately 650,000 patients worldwide, becoming the most widely used adjustable gastric band in the U.S.Over the years, Allergan worked on improving the original band model, effectively releasing three different models of the device. There has been no recalls on Allergan bands as of today.
Currently, Allergan offers two sizes of the device differing in maximum fluid capacity – 10 and 14cc’s. The decision which band size to use is mostly up to your surgeon and depends on the size of your stomach. DayOne Health surgeons largely prefer to use the small band which they believe gives better restriction to a majority of patients.
Structural differences between the bands
The two devices have a few structural differences that are of importance not only to weight loss surgeons, but also to patients. First and foremost the difference to think about is the structure of the restrictive area of the band.
The inflatable part of the band in Realize is a uniform balloon that surrounds the stomach, whereas in Lap-Band AP System this part consists of a series of inflatable “pillows.” The Realize band producer claims that the balloon without the separators adjusts better to the shape of the stomach and is more comfortable to patients. In contrast, some believe that lack of divisions causes balloon-to-balloon contact that may cause complications later. Neither of the claims however was confirmed by long-term studies.
Our DayOne Health experience shows that patients with the Realize band don’t get as good of a restriction as patients with the Lap-Band System. The surgeons believe that the open balloon causes the restriction to not spread uniformly around the stomach and, as a result, doesn’t provide the expected weight loss results.
Both bands consist of tubing leading from the port area to the band. In the Realize band the tubing is a little further from the site of injection during the adjustment. Some claim that this factor decreases the chance of tubing leakage. The claim finds no confirmation in long-term studies. The complication rate for both bands remains the same – including tubing and port leakage.
The main difference between the ports is their relative height. The Realize band port is significantly flatter than the Lap-Band AP. While this feature made a difference before – patients who lost a lot of weight sometimes experienced port protrusion – now with a changed technique of placing the Lap-Band System, there is no issue with the port visibility even with a substantial weight loss.
Nevertheless, the new surgical technique that places the port below, instead of on the top of the muscle, can be only be used for the Lap-Band System not for the Realize Band. What this means is that even though the Realize Band is thinner, it still has a higher chance to protrude than the Lap-Band System.
The reason why the technique can’t be used for the Realize Band is a special mechanism in the Realize port that is intended to clasp on the muscle when the port is placed. The Lap-Band System port is stitched to the tissue allowing the hiding of the port.
Another difference is that the Lap-Band AP System port has a significantly smaller injection site than the Realize port. It could potentially make a difference in terms of ease of finding the injection site for less experienced physicians. This may result in more discomfort during adjustment and potentially longer time to locate the port. Fortunately, in a large majority of cases surgeon’s experience adjusts for the difficulties connected with the size of the port.
If you would like to hear more about the differences between the Realize and Lap-Band Ap System you can contact our patient advocate at 312-548-1483 or schedule a one-on-one consultation with a surgeon to see which band would be a better option.
How does the lap-band promote weight loss, you ask? Well, the lap-band is designed to restrict the amount of food your stomach can hold, allowing you to feel full and satisfied with eating smaller portions. The success of the procedure depends on how motivated you are to change your eating behaviors, promoting a great deal of weight loss.
The lap-band is an adjustable band placed around the top of the stomach during a laparoscopic outpatient surgery that is designed to confine food intake. A port is positioned under the skin of the abdomen and tubing to the lap-band allows the surgeon to adjust the fit of the band based off personal preference and comfort.
Things to keep in mind about lap-band surgery:
Every small step is a step. Don’t wait until after surgery to start a different dietary plan. The more prepared you are, the more effective your post-lap-band routine will be. It is important to stick with your liquid diet before and after the surgery. At DayOne Health, we help guide you through the process with helpful tips on beneficial steps before and after surgery.
Commitment is key. Before and after lap-band surgery it is important to be enthusiastic and motivated. At DayOne Health, we believe that one of the most crucial parts of the weight loss journey is being surrounded by support systems. Patients who do well on their diets prior to surgery continue to have an open mind, staying motivated will help you achieve your weight loss goals.
Stay Active. Nobody is perfect and cheating does happen, don’t beat yourself up. Keeping a routine and doing simple exercises will help keep you focused on your goals. While the weather is still nice, take a break from your hectic day by going on a nice relaxing walk to unwind.
The lap-band is the first step to a new, healthier you. Keeping positive and motivated after surgery will kick start an improved your lifestyle.
If you would like to hear more about DayOne Health or talk to a real lap-band patient call our Chicago clinic at 312-255-1900. It’s never too late to start your weight loss program, set up your first consultation with a bariatric surgeon today.