A gastric band is simply a tool – albeit a very effective one – for achieving sustained weight loss. To get the best from it you need to follow some simple guidelines – Success Rules. To get the best out of your band you need to do your best in all of them – not just a few.
An absolutely key behaviour for success with the band is to keep a food and activity diary. I know this sounds tedious beyond belief, but it really works and there are a lot of studies to show how effective it is.
Nowadays most people use electronic devices of various kinds and so band patients often tell me they have an App to track their calories and an electronic record of what they are eating and drinking every day. In my experience this almost never works. Why not?
When you put information into your phone, it’s stored somewhere you can’t see it and in this case, “out of sight, out of mind” is absolutely true. You will just forget about it. I have often asked patients to show me their electronic food diaries in clinic and they almost invariably have just one or two days entered and nothing more.
So my advice is to buy a small notebook and keep it with you and visible. If you have a handbag or briefcase, make the book a bright colour so that every time you open your bag, the “band book” shows itself and reminds you to actively record what you are doing. If you want to be successful with the band, you need to have it in mind and it has to be a priority.
Now here’s the key – you MUST write down whatever you have been eating or drinking within 15-minutes of eating or drinking. Don’t leave it until the end of the day because if you do, you will tend to forget what it was you actually ate and drank. More particularly, you will tend to under-record your consumption (we all tend to do this!).
At the end of the week, use the record you have created to help with your weight loss. See where calories are creeping in through snacking or where you failed to get your exercise in as you had hoped. Then write down a plan for the coming week so as to avoid the pitfalls of the week before. These should be simple, clear and achievable goals. Remember “if you fail to plan you plan to fail”.
Body weight can vary significantly throughout the day – anywhere between 1-5lbs is quite normal. It’s primarily due to changes in body water (urinating, respiration) and bowel movements, though alcohol consumption and hormonal changes can also have an effect. But it means that a single reading can be quite misleading: you may be doing better or worse than numbers suggest. Some patients tell me they weigh themselves 3 or 4 times a day – not a good idea. If your weight is less than you thought, you might be tempted to relax and have that snack you were denying yourself. If you are heavier than you had hoped, you may get discouraged and feel as though you might as well give up. Yet in both cases the variation in weight may be due entirely to changes in body water. So whilst it’s essential to keep track of your weight, it’s also very important not to become a slave to the scales.
So the guidelines are:
So much of our eating behaviour is habitual. We look at the clock and think “It’s lunchtime, what shall I have”. But if you’re not actually hungry you don’t need anything.
So this rule is simple:
IF YOU ARE NOT HUNGRY – DON’T EAT
The band works by sending a signal to the brain to tell you when you are no longer hungry. By chewing slowly you will give the satiety mechanism time to act. On the other hand, if you eat too quickly you will have pain and you may well regurgitate your food. If you make a habit of this, you’ll end up with problems such as slippage or pouch enlargement.
In order to harness the full effect of this mechanism:
Not only should you only eat if you are hungry, when you do eat you should stop as soon as you are no longer hungry. To recognise this point takes a bit of practice, but you need to ‘listen’ to what your band is telling you. It’s a kind of conversation. And yes – sometimes – you just have to say “NO”.
The other thing to remember is that if you are sitting at a dinner table (and you should NEVER eat in front of the TV), don’t sit for any longer than 20-minutes. Just get up and walk away – do something else.
Recognise that so much of our eating is habitual – it’s just a learned behaviour. And you can unlearn it.
We all know that being physically active is absolutely vital if you are to be successful with the band. The key word here is – consistency. You have to aim to do something on most days of the week and for at least 30-minutes.
Impulse snacking between meals is the sworn enemy of weight loss efforts everywhere. Self-monitoring with your food and activity diary will help you keep track of the snacks you have. If you do get hungry, it’s better to have a piece of fruit or a small bowl of cereal than calorie-rich cakes, biscuits and crisps.
By the way, this doesn’t mean you can’t enjoy occasional treats such as a piece of chocolate. But it can’t be every day if you are serious about losing weight.
our new life with the band requires a different approach to the foods you choose to eat. Since the volume of food you are eating has dramatically reduced, you should concentrate instead on the quality.
So, you know the drill: avoid foods high in fat, sugar and anything that’s lacking vitamins and minerals. Choose a balanced diet comprised of lean meats, fish, wholegrains, legumes, fresh fruits and vegetables. It’s a good idea to focus on proteins first, because good quality protein will make you feel fuller for longer.
This is not about the weather or the Green Party. It’s about your immediate (home and work) environment. And the mantra is:
If it’s there you’ll eat it and if it’s not you can’t.
So when you do the shopping, make you choose healthier options which are consistent with your weight loss aims. Make a list before you head to the shops and don’t stray from this healthier food list. It is also not a good idea to do your food shopping when you are hungry.
Don’t buy biscuits, cakes, chocolate, crisps and all the usual suspects because if they are in the house (or in your desk at work) you will eat them!
Patients often tell me they buy them for other members of the family, but this is still a bad idea. If you are intending to avoid junk, why would you want to give it to your children or partner?
The last Success Rule is to set realistic goals. Making big gestures is all very well, but you’ll almost certainly fail to sustain them, leading to disappointment and failure. The better approach is to look for what is sometimes called “the aggregation of marginal gains”. In other words make small changes over time and they will add up to quite big changes.
So, for example, if you enjoy crisps don’t say you’ll give them up entirely to begin with. If you eat 2 packets a day, start by eating one and then have them every other day, or just at weekends.
The same with your exercise plan. Don’t start by promising to go to the gym for two hours every day – it won’t happen. Begin with walking every day for 10-15 minutes and extend this gradually over a number of weeks. Then, if you wish, join a gym and add this to your walking programme. You get the idea. This way you will make changes that are sustainable – and this is precisely what you need to be successful with your band.