Having a band around your stomach is intended to limit how much food you can consume. However, with that kind of restriction, you need to make sure the food you eat is nutritious enough. It might be quite difficult to get adequate protein, vitamins, and minerals. Surprisingly, it might sometimes be challenging to get enough water. The support of a qualified dietician is crucial throughout the process because failure to consume the proper foods in the right proportions might result in a number of issues.
After the treatment, any bariatric program will probably include some kind of nutritional counseling, but it's crucial that this person—or this group of people—be included in the initial screening phase. Prospective patients need to know in advance what they may anticipate to consume and what dietary adjustments they will need to make.
Having a band demands you to eat differently, and many patients find adjusting their eating habits to be the most difficult part of the procedure. For the band patient, it's not just a matter of eating the "right stuff." Your results will be, to put it mildly, dismal if you are unwilling or unable to change the way you eat. There is no alternative for appropriate training from a knowledgeable band member, followed by appreciative comments when these modifications are really made.
The dietician is primarily responsible for carrying out this demanding role of training, testing, and encouraging the patient. Patients with Type 2 diabetes are especially in need of professional advice because their blood sugar levels and associated medication needs can and typically do vary even more quickly than their weight.
Last but not least, the nutritionist must be involved in determining when and how much the tightness of the band should be adjusted. It's crucial to have the dietitian's opinion. Most of the time, a skilled professional can see through the patient's protests and assist the patient.
acknowledge that their unwillingness to alter their eating habits may be the cause of their troubles rather than the band's tightness. The dietician must be a combination of nutritionist, coach, drill sergeant, and psychologist for the band patient. But most importantly, the nutritionist needs to be active, particularly in the first year when those new eating patterns are developing.
Sue's Tale
Pre-op Sue, 312 pounds (left).
Sue, right, four years after surgery, 185
holding ancient jeans that weigh pounds
tightly.
I was 53 years old, 312 pounds, and 5 feet, 8 inches tall, and I had a miserable quality of life. In fact, I was fairly certain that I wouldn't live for very long. It was made worse by the fact that I taught preschool and believed the principal had bias against obese individuals. In addition, I experienced knee and hip discomfort, sleep apnea, and was using a Cpap machine.
I experimented with the typical diets, such as Weight Watchers® and Jenny Craig®. I did a ton of research on surgery after those failed. The bypass would be covered by my insurance, but not the band. But I was genuinely frightened by the gastric bypass death rates. I believed I wouldn't have enough time to save the money for the surgery in the States before becoming handicapped or passing away, and the cost difference at the time was significantly greater. I underwent the procedure in Mexico.
After that, I experienced severe buyer's remorse. I had a good time in Mexico, and after a while I was expected to check into a hotel. They kept me overnight nonetheless because I still had some esophageal edema. I was sent home after they let me go, but the swelling hadn't decreased enough, and I was rapidly dehydrating. I even stopped producing saliva after a few days. It was warm. I'm from California. I was perspiring. I couldn't sleep since my own spit wouldn't stay down, so I had to carry a cup about to spit into. The doctor in Mexico suggested I return when I called him, but I didn't want to. I didn't believe I would be able to return to Mexico. At that point, I wasn't even urinating anymore.
In order to get me admitted to their ER, the Mexican doctor located a nearby American physician. I was on IVs for four days in the hospital. They looked to see whether the band had slipped, but I was unharmed. No matter where I acquired the band from, I believe that would have happened. For almost a year, I was without a fill. I wasn't in need of one. And I shed a ton of weight. I'm currently 185.
When I finally needed a fill, I located a U.S. doctor and started with a very minimal dose. Driving to the other side of the border doesn't really excite me. Being a police officer, my spouse is very cautious. Simply put, going back would be too painful.
I no longer feel hungry. To eat, I have to remind myself. I must have some lunch at noon in order to limit how much I eat for dinner. I can still feel my stomach grumbling and the need to consume anything that isn't moving.
Some foods, like pizza crust or bread, are off limits to me. I go to my closet, though, and ask myself, "Is the toast worth being where I was?" if I start to feel deprived. No way. I can recall that I used to lie on the bed and
To zip and button the pants I'm holding in the "after" picture, I had to tuck my tummy in.
Other things exist. After 9-11, I took a flight to visit my daughter on the East Coast, but I had no room. I had trouble fitting into the airplane seat. Torture was used. I set the tray table down when I boarded the plane two years later to see her once more. Legs could be crossed. I felt like I was in heaven. Now that I visit amusement parks, I ride the rides. I used to be forced to stand and observe. Some rides are too frightful for me to ride, but I can if I want to. I visited Colorado last summer and scaled Pikes Peak. Additionally, I visited New Mexico and scaled some ruins. Compared to when I was in my late forties, I can do more things now.
I think I need plastic surgery when I look in the mirror. But that's not what I'm doing. Although my arms are so slack, who cares? Although I'd like to, I'm not sure if the roll around my stomach will go away. Nobody notices it. I don't move around in swimming suits or shorts. I don't think it matters now that I'm retired.
The only thing I now regret is that I didn't take action years ago. So much of my life was lost. It should have been more readily accessible in the US, in my opinion. And I like that the band may be worn on either side. My anatomy hasn't changed, so I could go back, but I wouldn't want to now.
A workout regimen
Some people may find that obtaining a personal trainer or joining a health club is exactly what they need to start an exercise regimen and stick with it. But if it were the only factor in weight loss success, you wouldn't be reading this book. The fact that many personal trainers have limited training and experience with obesity and the physical restrictions that go along with it may in part explain why exercise regimens alone have failed to effectively treat obesity. People who are morbidly obese typically struggle to perform the types of workouts that a regular personal trainer demands. The psychological effects of "going to the gym," where it frequently seems that everyone else is there trying to get "buff," while you are just trying to survive, are another factor that might cause failure. Unsurprisingly, some obese people decide they are just not going back because of the shame element. "Is it my imagination, or is everyone really here just to watch me struggle?"
Exercise is essential to your success, despite the discomfort and the embarrassment. Exercise speeds your metabolism and eliminates fat reserves that would otherwise withstand dieting. Someone with experience in both the physiology of exercise and the unique requirements of obese patients is required for a thorough program. Given the potential physical restrictions that obesity may impose, it is crucial to create a workout plan that is both safe and effective in raising your metabolic rate. An expert exercise physiologist or physical therapist would be better suited to fill this position because it differs greatly from that of a personal trainer. Additionally, neither daily nor even weekly education is necessary. This kind of exercise specialist can provide patients instructions for creating an exercise plan that progressively changes with just sporadic visits.
An interview with the exercise physiologist or physical therapist, which will assist define their function as part of the program, should be a part of the preoperative evaluation process. This consists of an official examination of the patient's physical state and abilities, as well as an assessment of the
the patient's capacity for activity before surgery. There are suggestions on what forms of exercise are suitable and secure.
As part of the general physical evaluation, a full range of body measures, including those for the chest, waist, hips, arms, legs, and neck, should be taken. These measurements are one of the most crucial motivational and feedback mechanisms in the entire program, despite the fact that some patients find them embarrassing. Patients may see exactly how many inches they have dropped around their waist, hips, thighs, and every other place measured by repeating these measurements every three months. It brings joy and motivation to everyone, frequently much more so than the number of pounds gone. I've seen several patients eager to show everyone how successful they are proudly carrying their measurements about like a "straight A report card." They are even more motivated to increase their workout regimen in light of their documented success to achieve even better results when they are measured again.
Adapting Your Thoughts
We appear to place considerable importance on "the will to win" and the power of that desire, and seem to judge individual achievement in our culture by our ability to be self-sufficient, self-motivated, and able to "pull ourselves up by the boot straps." We are led to believe that a strong mind, capable of managing behavior in every circumstance, is what separates failure from success. On the other hand, we draw the conclusion that someone who would permit their weight to spiral out of control is dim-witted, undisciplined, or simply lazy. These presumptions and conclusions are obviously incorrect.
Anyone with experience in bariatric surgery will tell you that the psychological effects of obesity are possibly the most significant and perhaps the most difficult to treat. The stigma associated with obesity on a social and psychological level contributes significantly to the difficulty. I've even witnessed professionals who anticipate a negative response from the patient and start by making excuses for the request for a psychological evaluation even before the patient has had a chance to voice any objections. The mere suggestion that a psychological assessment is necessary before undergoing bariatric surgery can elicit a defensive response, such as "I'm not crazy!" or "I certainly don't think I need a shrink!" Along those same lines.
Our reluctance to submit to an examination of our thoughts and behaviors is frequently motivated by fear. Nothing is more private or intimate than our thoughts, particularly when they pertain to how we view ourselves. Naturally, when someone probes into our thoughts and perceptions, we feel exposed, exposed, and uncomfortable. But in order to successfully alter a lifetime of damaging behavior, we must first alter our thought patterns. Before we can swap out self-defeating, negative beliefs for positive ones that can cause changes in our behavior, we must first identify such thoughts. This calls for expert assistance.
A clinical psychologist or psychiatrist with training in the science should provide an initial examination as part of a complete weight management program.
of human conduct. This assessment can take the form of a written test, an in-person interview, or ideally both. The purpose of this evaluation is to ascertain the patient's readiness for change and ability to participate in the program. It is always preferable to know this before having any surgery done because occasionally this evaluation will reveal unique personality features that make the patient destined to struggle with changing behavior. In addition, as discussed in Chapter 6, insurance plans frequently demand that patients undergo psychiatric testing prior to weight-loss surgery.
A comprehensive program's psychological components, however, stretch far beyond the initial assessment. They cover an extensive range of behavioral modification techniques, not all of which are offered by the psychologist. The components of a psychological support system might be as straightforward as a regular newsletter that offers clear guidance and encouraging testimonies or as formal as a series of behavior change sessions led by a licensed psychologist. Actually, every team member is essential in helping patients as they fight to recover control over their life. Regular office visits with the surgeon, exercise physiologist, and dietitian should involve encouragement of the patient's changing behaviors. The psychological examination can assist the team by providing them with information crucial to assisting the patient in succeeding, as Steven Greer, Ph.D. indicated in Chapter 6 under What We Look for in Psychological Testing of AGB Patients.
How to Change Your Thinking in Five Steps
psychologist G. Dick Miller
The process of altering your thinking involves five steps. To become an observer of yourself is the first step. Simply writing down what is on your mind for a week or so is a wonderful method to accomplish this. Don't condemn it. Just capture your internal monologue. The key is personal honesty; do an honest inventory of your current views. What exactly is going on within your head? You shouldn't berate yourself. Just glance at it.
The next stage is to determine whether or not your thinking is illogical. Finding the incorrect thinking is the tricky part. Everyone has experienced difficulty with this at some point. It takes sense to examine your views, nevertheless. To determine whether your opinions are rational, you can compare your way of thinking to these five straightforward guidelines. Are they literal in nature? Does it benefit my physical well-being? Are my current thoughts in line with my short- and long-term objectives? Does it avoid major disputes with others? Does it support my desired feelings? These five questions are further discussed in "The Tests for Rational Beliefs" in Chapter 8.
The third phase is to develop a new, rational style of thinking. Here is when you have to question your current perspective. It's time to confront ideas that you have been telling yourself, such as that two cookies won't affect your diet. Do two cookies really matter? A "no" response is illogical. Naturally, they do. Two cookies do make a difference in your daily consumption since they alter your blood sugar, which can cause emotional and physical ups and downs as well as give you the okay to eat more (since you know, I already blew it), and they can also cause other issues.
Practice is the fourth action. Begin convincing yourself what makes sense. Replace the previous reasonable statement with the new one you have created. Therefore, whenever you think that two cookies won't make a difference, think instead that two cookies will. You may also say that you'd want to wake up the following morning proud of yourself for acting in your own best interests.
The fifth step is developing the ability to put up with discomfort. Your brain will produce convictions like "This is weird," "It doesn't feel right," "I feel awkward," "I wonder if someone else thinks I'm stupid," and similar ones whenever you do something new, which is known as "cognitive dissonance." In actuality, cognitive dissonance happens whenever you learn something new, be it a new golf swing or a recipe to prepare. I'd even venture to argue that if you don't experience any discomfort when trying something new, you're not changing anything that needs to be changed. Learning to tolerate is the difficult part.
Give yourself some time to get used to the change you're bringing into your life. It can be energizing to know that you will go through this. Being uncomfortable may even become something you look forward to since it means you're moving forward.
Five-Step Checklist for Change
Watch your thinking and work on being honest with yourself.
Compare your reasoning to the logical thinking rules.
Challenge your views and develop a fresh, logical way of thinking.
Put the new ideas into practice.
Recognize and accept discomfort.
Your path to success consists of these five steps for change. They can also turn into a habit that you can utilize to maintain your band-assisted weight loss.
A Comprehensive Program's Summary
While it is possible to lose a significant amount of weight with simply your willpower, it is not very common. Unfortunately, the issue and the treatment are anything from straightforward for the majority of people who battle obesity. Therefore, it takes more than simply a diet, an exercise routine, surgery, or even cultivating a positive outlook to successfully lose weight and keep it off. In actuality, it calls for more than just those elements to operate together in a well-coordinated program. What makes anything "more" is the patient's commitment and labor of love. No matter what anyone says you, even with a team of professionals at your side, it isn't simple. However, the benefits may be plentiful. A year or two following surgery, when questioned about the program, many patients respond, "It's the best thing I have ever done for myself."
The next stage is frequently the most difficult when you have discovered a thorough curriculum. It takes a lot of guts to call your doctor and ask for an appointment when your problem is fat. However, it is up to you to take that initial step since, as is usually said, "Every great journey begins with the first step."