FAQ GASTRIC BAND
I have just had surgery, what do i do now with my diet?
For a detailed explanation, please refer to the videos explanations on the gastric band presentation page,
There is a handout explaining the dietary changes under the handouts page
I am feeling hungry with the band. I thought I would not feel hungry again. What do I do?
The goal of the gastric band and all surgeries is to help reduce hunger levels and help you feel satisfied on less food for a longer time. The gastric band will not eradicate the hunger, rather help to control it. So there are a few different reasons hunger may be an issue early after surgery and long term.. So lets work through these.
EARLY POST GASTRIC BAND SURGERY:
- As the swelling settles post surgery, you will find that your hunger will increase before your first adjustment (fluid placed into the gastric band system). As the swelling reduces, less pressure is applied to the receptor sites where the band is placed. This results in a weaker message being sent to the brain to feel less hungry. Also fluids flush through easily and do not apply much pressure onto the receptor sites. The only solution is to place more fluid into the gastric band system to help place more pressure onto the receptor sites to tell the brain to feel les hungry for a longer time.
LONG TERM POST GASTRIC BAND SURGERY:
- Sufficient amount of fluids is required into the gastric band system. As you lose most of your weight in the early weeks/months post surgery, this results in the Gastric Band feeling loser. Therefore your hunger is not under control. The solution here is to return to the clinic for another adjustment. It can take 4-6 adjustments to get the correct amount of fluid in the band to control your appetite and portions.
- On an ongoing basis, the fluids can leak out of the system, which will make the gastric band feel looser. So it is essential to maintain contact with the doctors at your clinic to ensure an appropriate amount of fluid is in the band. There is nothing wrong with your band if fluids leaks slowly over the years. This is normal.
- To ensure you are working with the band, your food choices are important, infact crucial to help control your hunger also. Liquids based meals flush through the gastric band and have little effect on your appetite. Conversely, solid food that requires a lot of chewing, as they pass through the gastric band, this texture will apply pressure on the receptor sites and make you feel satisfied on less food for a longer time. research has shown 20 30ml portions of food chewed well, will help make you feel very satisfied after a meal, if your gastric band is in the green zone (enough fluid to control your appetite and hunger)
Doesn't the Gastric band create a small stomach of 1/2 cup capacity?
Absolutely not!!! This is the biggest miss representation of the gastric band.
The Gastric Band is not a “silver bullet” that will magically make you lose weight. The role the Gastric Band plays in your weight management is that of a tool. It helps you achieve two things:
(1) to help you feel satisfied for a longer period of time on a smaller amount of food, and
(2) forces you to take smaller mouthfuls and eat slowly.
It is imperative that you understand that the Gastric Band will not stop you on a finite amount of food, this is your job. To clarify this further, let’s understand how the Gastric Band works. Visualise the Gastric Band as a funnel and nothing more. The Gastric Band is placed very close to the base of the oesophagus. Placement and inflation of the Gastric Band creates a narrowing where the food you eat needs to pass through.
The area above the Gastric Band, I describe as the “holding bay”, which you have heard me mention a few times by now. The capacity of this holding bay is very small, approximately 1 tablespoon. Not a small plate, cup or handful of food that is often mistakenly believed. To explain the process of the Gastric Band, refer to the diagram of the funnel concept below.
Step (1) You chew a small portion of food in your mouth, no more than one teaspoon. Refer to my chewing exercise.
Step (2) The mushed up food enters the “holding bay”, where it can take up to 1 minute to pass through the narrowed area (where the band sits). Food is transported from the mouth into the stomach via a process called peristalsis. This involves a squeezing and contracting process. Hence adequate time must be allowed for the whole mouthful of food to be pushed through the narrowed area (where the band sits), before you swallow your next mouthful.
Step (3) Your brain is tricked to feel satisfied on a smaller amount of food. Within the stomach lining there are nerve endings. When pressure is applied on the nerve endings, a message is sent to the brain, tricking the brain to believe that the stomach is full of food. The brain then terminates the feelings of hunger. Your brain can be tricked to not feel hungry via two processes. The Gastric Band applying pressure on the nerve endings continues to trick the brain and turn off the hunger signals on an ongoing basis, plus the additional pressure applied by the types food eaten.
Firstly, for adequate control of your hunger overall, it is important to inflate the inner balloon of the Gastric Band Firstly, for adequate control of your hunger overall, it is important to inflate the inner balloon of the Gastric Band. Secondly, your hunger is also controlled at the meal time. As the food squeezes through the restricted area (where the band sits), this extra pressure and stimulation applied by the food onto the nerve endings also help to make you feel fuller on less food at the meal time by tricking the brain also. It will become easier to stop on a toddler portion of food, because you won’t be feeling hungry in fact quite the opposite, satisfied on a smaller amount of food.
The Gastric Band will help provide and maintain a level of satiety where your interest in food is greatly reduced. It then becomes easier for you to eat less food on an ongoing basis and feel comfortable and content.
Can I drink and eat the same time during my meal?
It has been a long belief that you should not drink and eat solid food at the same time, as this would flush the food from the small stomach through the Gastric Band into the larger stomach. You would then feel hungrier earlier and consume more calories.
As a result of the most recent research conducted through the Centre of Obesity Research and Education, the functioning of the Gastric Band is better understood. In view of this, the timing of the liquids is more important. If you wait sufficient time for all the food to exit the “holding bay” and move through the Gastric Band (restricted area) into the larger stomach, then there is room to take a sip of water or calorie free liquid between mouthfuls of food.
In practice many individuals struggle with waiting adequate time between each mouthful. So ultimately the final decision is n your hands, as to your preferred choice of whether you keep your liquids separate to your meal times. Either way, it would be a great habit to have a glass of water 5-10minutes before each meal and then start drinking again as soon as you feel comfortable after the meal has been completed.
Healthy foods is getting stuck all the time and it hurts, what do I need to do?
There are 10 key reasons why food may be getting stuck. Firstly ensure you understand the band works as a 30ml funnel and not as A Small stomach that is being filled up. Lets works through 10 reasons below.
- TOO BIG OF A MOUTHFUL: ensure you take maximum 1tsp food maximum per mouthful
- FOOD WAS NOT CHEWED WELL ENOUGH: place the food onto your tongue first, the saliva will build up to soften the food. Then begin to chew, taste chew and once the food is ground down to resemble a mince meat texture, the food is ready to swallowed.
- SWALLOWED EACH MOUTHFUL TOO QUICKLY: You must allow 1 minute between each food swallowed to allow time for the food to be pushed through the gastric band into the stomach.
- THE BAND IS THE TIGHTEST IN THE MORNING: It is normal to wake up and not feel hungry for breakfast. It is ok to delay your first meal a few hours before you begin to eat. Do not try to eat any solid food in the morning. The gastric band is too tight in the morning due to fluid changes in the body. All solid food will get blocked.
- STRESS MAKES THE BAND FEEL TIGHTER: It is important to note that is you are having quite a stressful day, you may find your gastric band feeling tighter in the action of the foods you would normally be able to chew and eat pain free, become a little difficult. There is no need to take the fluid out of the band. Instead change the texture of your food. Move from solid dry food, to wetter easier foods such as casserole, chunky soups and shakes. This wetter texture is easier to pass through the gastric band and avoid creating more frequent blocks. When the stress settles, return straight back to normal solid food.
- FOOD BLOCKAGES: If some food gets stuck before the band and it passes through within a few minutes, there is nothing you need to do to address the situation. However it took a lot longer and you feel uncomfortable, then you would assume some swelling would have occurred and the band will feel a little tighter than normal. So what you can do is revert back to wet easy foods for the remaining part of the day to allow any swelling to settle. The following day, return back to normal eating habits.
- EATING FOODS THAT ARE GENERALLY HARD TO EAT: There are certain foods that could be difficult to eat with the gastric band no matter how well the food is chewed. These foods could include, dry/left over meat, doughy bread, fibrous food such as the tough skin on fruit or stringy vegetables. Everyone’s journey with the band is different and you will work out the foods for you that you will need to avoid long term.
- FLUID CHANGES: If the band is too tight to start with (such as being in the red zone), then fluid changes associated with one’s menstraul cycle or occasions when excess fluid is retained due to other medical reasons, this can make the band feel too tight. Once again the texture needs to be reverted back to wet and easy for a short period of time until the fluid retention is resolved.
- GASTRIC BAND IS TOO TIGHT: If the gastric band is too tight that is too much fluid is in the gastric band, then you must return to the clinic to have some fluid removed
- MEDICAL ASSESSMENT OF GASTIC BAND PLACEMENT: The medical team could possibly suggest a barium swallow to assess the gastric band placement to ensure medically everything is still stable
How do I know there is enough fluid in my Gastric Band?
For a details explanation, please refer to the videos on the gastric page presentation page.
My weight loss has stopped, what can I do reach my goals weight?
Lets firstly question if your weight loss has actually plateaud. The scales may not be moving, but if you find your clothes are feeling looser, then you are not on a plateau. A true plateau is when you are not losing weight on the scales and your clothes are not feeling loser. Also if neither of the two aspects change for atleast 2-4 weeks, then yes it is a true plateau, of not losing weight. If it is a true plaeau any of the following will help continue your weight loss
Since having Gastric Band Surgery, I am now craving sweet foods, when I never used to. Why is that?
This can occur when the Gastric Band is too tight (in the red zone) and an individual is unable to eat an ideal balance of protein and some quality carbohydrate foods. The body then screams for some energy and sweet foods such as lollies, cakes and biscuits provide an easy to consume source of carbohydrate. It is well understood that these types of processed foods are not ideal for weight loss, when too many are consumed. The solution here is to ensure the gastric Band is not too tight and sufficient quality of healthy food can be consumed.
Why is it so easy to eat junk food and not salad?
This is a very interesting question. There is a process we need to work through to help you verify what is happening in your situation. In principle when a food melts in your mouth and does not require much chewing at all, these foods can be described as slider foods, that is they slide through the band very easily. The goal is obviously to eat normal healthy food and avoid these foods getting stuck before the band, to ensure this occurs, the following steps will guide you:
- Please clarify the understanding of how the Gastric band works, as a 30ml funnel rather than a small stomach. This will ensure that the chewing style would consist of 1tsp food, chewed well and waiting 1 minute between each mouthful is swallowed
- Do not eat solid food as the first meal of the day, as the Gastric Band is typically tightest in the morning.
- Salads and all potions of food should be consumed in small amounts of 1 teaspoon per mouthful
- Spinach leaves or butter lettuce can often be the easiest types of lettuce to be consumed as they break down more readily
- Ensure the band is not too tight and in the red zone, all solid food will difficult to eat
- If the Gastric band is too tight, stress and holding extra fluid can make the gastric band feel tighter and make the healthier food more difficult to eat
Do I need a multi vitamin per day?
With the Gastric Band, it is reasonably easy to consume adequate amounts of nutrition. However a multi vitamin would be a great idea.
In Australia there are two key brands:
The key differences are:
- Fit for me is a once day tablet
- BNmulti is twice a day
- Both companies have chewable and capsule options
To ensure you achieve your maximum nutrition, the convenience and taste of fit for me, would be ideal for you. Both supplements can only be purchased online using the links above
Why can I eat a bag of chips at night, I never thought I could eat so much?
It is important to understand the structure of the band, where a flow through of food is permitted. Also chips would be described as a slider food, meaning that it dissolves easily in the mouth which would slide through/move through the gastric band very easily. This is the reason for the ability to be able to graze and eat a large volume of food such as a packet of chips. To help manage the volumes, the topic of managing non-hungry eating, click here to view, would help provide some guidance to manage the volumes of food.
How is the Gastric Band adjusted?
Adjustments are carried out in the doctors office. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes. The goal of the band adjustments is to apply more pressure onto the receptor sites. You can see with the image below that the space where the food passes through is reduced, encouraging the importance of consuming 1 tsp food per mouthful, chewed well and waiting 1min between each swallow.
To achieve the required appetite control, it can take between 4 to 6 adjustments. The frequency in the early stages post surgery is because weight loss makes the gastric band feel looser also, so the adjustments are important to manage the hunger. Once the weight loss slows down, the frequency of adjustments will reduce. Ono an ongoing basis, you may only need 1-2 adjustments per year to maintain appetite control. Each individual’s journey will vary though.
Are there any restriction in my daily activities to be careful regarding the port site?
There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise.* The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let your doctor know as soon as possible.
Once I lose my weight, is the Gastric Band removed?
No. It is important to keep the gastric band well adjusted to help manage the hunger. If the band is removed or the fluid is removed, then the hunger will return.