Wednesday, June 29, 2011

Genie's Lap Band Surgery Series, Part III: Updates

My Patchogue HS classmate and friend had Lap Band surgery and kindly shared her decision about choosing Lap Band over Gastric By Pass (dangerous) and her experiences before and afterward. Genie shared these first in her post and then I visited again with her in Part II of the Lap Band series in an interview. This is an update four weeks later.

Mike, Genie and Joe (Genie's husband Jim took the picture. Mike is engaged; Joe is married with two children.)
Genie has continued to lose weight slowly, which is the best weight loss. She is moving onward and making progress in her journey to relearn how to eat healthily, gauging portion control when eating out (bringing home a doggie bag where before she would eat the entire meal) and rethinking food selections.

For breakfast, she will have a flavored Greek yogurt which is less sweet at 140 calories and which is condensed and more substantial than other yogurts. During the day, she is currently favoring smoothies that she makes in a Vitasmart, a super fast food processor great for making drinks (in the past, margaritas) and setting up soups like French onion or vegetable soups. She also makes thick shakes with vegetables she likes, i.e. broccoli, carrots, and mixed vegetables, always fresh in the summer mixed with yogurt or another shake mix, using soy protein, Greek yogurt or nonfat milk. For a delicious smoothie, she makes fresh strawberries, cut up in quarters or halves, Greek yogurt and Agave which is a sugar substitute.

We discussed portion sizes in comparison with the past. When we used to go out to eat in the 1960s to our favorite diner or restaurant on LI, the sizes of the burgers, the salads, the french fries and the entrees were moderate; they fit inside the plate with an inch or two of room to spare. Now, of course, such items are piled high and hang over the plate in some instance (prime rib). Genie laughed, "On the Today Show, they were saying that the portions are 14 % larger than they were in the past, adding an additional 4000 calories to our food intake each week."

No wonder that the American waistline is expanding and those who are not necessarily in the two-thirds of the population currently dieting, will gain 10 pounds each year if they are not careful to exercise regularly in the gym or engage in a sport like tennis, cycling, or a team sport with friends. Portion sizes (except in upscale restaurants which cater to the wealthy uber thin women and  health conscious who pay to have gourmet meals in celebrity chef restaurants) are unnecessarily huge and the paying public expects them to be oversized. I find this to be especially true the farther ones goes from  NYC, and out on LI and up in Westchester and the other NY counties, unless it is to the CIA upstate or other foodie places.

For dinner Genie has been having pre made salads topped with chicken or turkey that she often gets at the Farmer's Market. If food is not in the house, all the better. Then she won't see it and she won't eat it. Not having food around or being near food is a good thing: out of sight, out of mind. The grazing and nibbling between meals has been curtailed and she is trying not to overeat, trying not to get sick and eat more than her lap band will allow; avoiding the syndrome of letting the memory of her former appetite override what her stomach can bear. And for the most part she is succeeding. It is a retraining that is laborious, slow and steady. The weight did not come on in five month or even one or two years. Genie has been practiced in her old eating habits for many years. It will be a steady, slow process to reverse them, sometimes through trial and error. But her food habits are being revamped and she is moving forward.

Genie will go in for a readjustment in one month's time. I asked her what a readjustment was. "The doctor sticks a needle in my stomach, finds the portal and injects saline into the contraption to tighten the lap band which does have some give. When it's tighter, my stomach notifies me that I must not overfeed it or I'll become ill and vomit. The threshold for allowing food is decreased and I will feel full with less food than before the tightening, so I'll eat less. Eating less means I'll continue to lose weight. The tightening ultimately translates into more retraining, more portion control, more weight loss.

When I asked Genie what she thought of shows like The Biggest Loser, she made a telling observation based upon her experience with "Extreme Makeover, the reality series about home make-overs which visited a neighboring town and conducted a makeover of a couple's house. The story behind the scenes was very different from the impression givens before the cameras. People were asked to donate materials and supplies, time and effort to help the contractor in charge upgrade the house. Rumor had it that in a number of instances, the mortgages used for the makeover upgrades had been defaulted on and foreclosed. And the people who had sealed their claim to fame in having their house made over, later sealed their doom in not being able to pay back the mortgage.

Likewise, Genie feels that in The Biggest Loser, the more interesting story is behind the scenes. Because participants most likely have to sign non disclosure agreements to be in front of the cameras, they cannot tell the truth about what their weight loss was really like behind the cameras, with the digital edit suited to the viewpoint of the show's producers. Genie felt the show was exploitative and encouraged negative practices for weight loss: fast, artificial (How many people can afford a trainer, etc.) and highly supportive, initially with abandonment after the show is over. And the follow up? What happens when the contest is over? What happens when the contestants go home to the environment which spawned their obesity? To what extent did they, in that relatively short period of time, deal with, work through and free themselves of the incredibly complex issues (emotional, physical, psychological, social, spiritual) that mired them in weight gain to begin with? Like Genie says, "It's all in the back story." We'll never know it unless someone breaks their confidentiality agreement and comes forward.

For now, weight loss like Genie's is not a "show," it's a hard reality. At times it can be lonely and depressing. Other times it can be exhilarating, especially when a barrier or weight plateau has been broken. That's what we're waiting for. The next milestone in Genie's weight loss.

For anyone interested in pursuing lap band surgery and speaking to those who have had it, you may contact and join the following site. Individuals who have already had the surgery and have lost weight will give you information, tips and explanations you may need to help you make an informed decision beyond what your doctor tells you.

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