Bariatric & Metabolic Surgery

Lifestyle Band Failure

Lifestyle Band Failure

Guidelines for Good Nutrition and Physical Activity

Brief Nutritional Guidelines

The traditional Mediterranean diet is a healthy diet based on vegetables and cereals, salads, legumes (peas, beans, lentils etc), bread, pasta, fruits and nuts.  It has been shown to promote long-term weight loss and reduce inflammation.  It is therefore an excellent approach for the overweight individual with a gastric band.  The main features are listed below:

  • Choose plant-based foods, such as fruits and vegetables, whole grains, beans, lentils, chickpeas and nuts
  • Choose cereals such as wheat, barley, oats, millet, corn and rice, which are found in cereal flakes, pasta, bread, couscous and crackers.
  • Replace butter with healthy fats such as olive oil and canola oil
  • Limit your intake of highly processed fast foods and ready meals, which may be high in salt and saturated fat
  • Use herbs and spices instead of salt to flavour foods
  • Limit red meat to no more than a few times a month
  • Moderate your intake of dairy products
  • Eat fish and poultry at least twice a week (especially salmon, herring, mackerel etc)
  • Consider using portion-controlled, low-calorie ready meals (including high-protein shakes) – most supermarkets have a range of nutritionally balanced options.

Of course, you should be eating only small portions of these foods and it’s important to eat very slowly (see Success Rules section).

Here is a short video on the health benefits of a Mediterranean diet:

Physical activity

There is a wealth of scientific evidence to show that regular exercise reduces the risk of heart disease, diabetes, cancer and other chronic diseases.  It also improves mood and mental functioning and is associated with lower rates of depression and dementia.  Importantly, studies also confirm that regular physical activity after weight loss surgery is associated with greater weight loss.  So if you have had a band it’s essential!

Experience suggests that those who are trying to lose weight tend to focus far more on diet than they do on exercise.  This is a big mistake.  Participating in regular physical activity is every bit as important as controlling calorie intake.  In fact, although you may still lose weight, if you don’t take regular exercise you will find it all but impossible to maintain.  Unsurprisingly, an inactive lifestyle is a major cause of failure among those trying to lose weight, whether by lifestyle changes or after weight loss surgery.   So if you are not already physically active, now is the time to get started!

There are two ways to get more physical activity into your schedule:

  1. Activities of daily living (ADL)
  2. Specific exercise programmes
Activities of Daily Living (ADL)

Before talking about specific exercises, it’s important to mention ADL.  Many people find it difficult to set aside a specific time for exercise each day – something always gets in the way.  A meeting crops up, you have to get the school run done, you have to work late or you might be travelling.  It seems as though there is always something lying in wait to sabotage your plans for a more active lifestyle.   Surveys show that up to 67% of those with gym memberships never use them!  This is where concentrating on ADL can be helpful.  So for example:

  • Get off the bus or tube one-stop early and walk the rest
  • Walk the children to school – or at least part of the way
  • Try a short walk during your lunch break – you’ll feel better and brighter in the afternoon
  • Try to walk around the airport/station whilst waiting for your flight/train/bus (better than sitting in a cafe with a coffee and a muffin)
  • Park the car on the far side of the supermarket car-park and walk the rest
  • If you are able-bodied, never, NEVER use the lift!

You get the general theme.  The question to ask yourself is how could you introduce just a bit more activity into your daily life, without causing disruption?  If you can, it means that even if you don’t get to that spinning class or gym session, you’ll at least have done something every day.  So take a few minutes to think about what you might be able to do – and make a plan to do it.  Planning is very important.  There isn’t the slightest point in spending time thinking about what you can do and then just leaving it.  You have to DO IT!  This is why we always say:

“If you fail to plan, you plan to fail”

Specific exercise programmes

In addition to ADL, you need to set aside some time for regular physical activity. Recent surveys suggest that activity patterns among adults in the UK are woefully inadequate. In fact it’s the decline in physical activity – especially ADL – which is the primary underlying cause of the current epidemic of obesity.


If you are currently sedentary, start with a daily walk and then build this up until you are walking for a minimum of 30 minutes every day.  If you find it helps you can use a pedometer or one of the myriad of electronic devices that will measure steps and total distance travelled etc.

Gym work

When you have been walking for a while, you can move on to more vigorous exercises – swimming, cycling, treadmill jogging, stair-walker, cross-trainer etc.   This will probably require joining a gym/health club of some kind.  These are all forms of cardiovascular exercise which involve major muscle groups and involve a significant increase in heart rate and respiration.

If you find having a personal trainer a helpful motivator, then by all means do so.

Alternatively (and less expensive) try and find a friend to join in with you.  Most gyms nowadays have reasonably knowledgeable exercise trainers on-site, so you should be able to get some guidance if you are unsure about the various machines.  But it’s essential you start gently – if you start too hard you will injure yourself.   Watch out for the personal trainer who thinks having sore muscles is the main point of the exercise.  It’s nonsense.

Aim for three gym sessions a week- about an hour or so each time.  And don’t sit around talking between exercises – you are there to work!

Finally, recent scientific evidence shows that both cardiovascular exercise and resistance (weight) training make a contribution to weight loss.  So make sure you add in some resistance training to your gym session.  Talk to the personal trainers and have them help you to put together simple programme.  Use light dumbbells or kettle-bells and/or the various machines to work the major muscle groups.  Again start with very light weights and make sure you perform the movement correctly.