Archive for February, 2009
Wednesday, February 25th, 2009
“Eating Margin” is the term I’ve been using to help patients understand the proper way to use their band. Those who will have the best results understand that the band is not there to “stop” them from overeating, but should help them stop themselves from over eating. The most successful patients stop at 4 oz. even though they know they could physically fit more food into their pouch. These patients have a large “eating margin.” They can eat all types of food comfortably and eating is a much more enjoyable experience.
If you are using the band to “stop” you from overeating, you will have very little “eating margin” and will find that you are frequently getting foods stuck. You will also find it very difficult to find the “sweet spot” or “green zone” band adjustment. If you keep on eating until you can’t physically eat ONE more bite, you have zero “eating margin.” Please do not be tempted to challenge the band by eating more than just 4oz. Remember to stop eating well before you have to stop, so you can increase your “eating margin” and lose more weight!
– Dr. Darren Soong
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Tags: Bariatric Surgeons, Gastric Band, Gastric bypass, Las Vegas Weight Loss Doctors, Weight Loss Surgeons, Weight Loss Surgery
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Tuesday, February 17th, 2009
Recently, many patients and prospective patients have been asking about the “sleeve” procedure or the Vertical Sleeve Gastrectomy. We have been performing this innovative bariatric procedure and seeing amazing results. The weight loss result from gastric bypass has always been excellent, but because bypass was never designed to be an operation specific for weight loss, there are some long term complications such as internal hernias causing bowel obstructions, anastomic stenosis, dumping syndrome, gallstones, and nutritional deficiencies. The band, designed specifically for weight loss, eliminated those issues but because it is a foreign body, created some new potential issues like slippage and erosion.
The sleeve procedure, like the band, was specifically designed for weight loss and is a purely restrictive procedure. The restriction is created by surgically decreasing the size of the stomach by about 80-85%. The hunger control after the sleeve procedure clinically appears to be very good. It is thought that the gastric cells which produce the hunger hormone Ghrelin are removed during the gastrectomy and Ghrelin levels after the sleeve procedure have been reduced to lower levels than after bypass or band. The pylorus muscle controls the outlet from the stomach pouch rather than a band or anastomic opening. The band remains and will likely continue to remain the safest of the weight loss procedures and with the quickest recovery. I foresee the sleeve procedure rapidly becoming more popular as more and more insurance plans begin covering this procedure for their members. Likely, the band will remain the most popular choice especially for lower BMI patients because of its safety profile.
There are certain groups of people who we’ve seen the sleeve most appeal to: patients with “needle phobia” for whom the adjustments would be very traumatic, patients who live very far away and would have trouble following up for adjustments, patients who have had previous antireflux surgery like a Nissen fundoplication where band and bypass may be difficult due to scar tissue, and patients who have failed adequate weight loss and hunger control with their band, but don’t want a revision to a procedure as radical as a bypass.
– Dr. Darren Soong
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Tags: Bariatric Surgeons, Gastric Band, Gastric bypass, las vegas, Las Vegas Weight Loss Doctors, Weight Loss Surgeons, Weight Loss Surgery
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Friday, February 13th, 2009
Food choices
Unfortunately, the band doesn’t choose what you put in your mouth. You do. If the majority of the time you choose to eat healthy protein type foods for your 3 meals, such as fish, chicken, meat, and vegetables, you will lose weight. If your band is adjusted properly, small amounts of these types of food will satisfy your hunger. If instead you frequently eat soft slippery carbohydrate type foods, (mashed potatoes, pasta, bread, ice cream and desserts), you won’t lose weight because these types of food slide through the band easily and don’t fill you up as well.
If you’re eating correctly and still not losing weight, call the office to set an appointment to discuss an adjustment. Remember, tightening the band doesn’t make you lose weight. Eating fewer calories is what makes you lose weight. The band just helps you to do this by setting limits on your portion size.
Eating Time
Remember to eat slowly enough so that you can recognize the point where your stomach pouch tells your brain to stop eating. This is the point BEFORE it gets uncomfortable or you throw up. If you eat too fast and you don’t pay attention to look for this point, you will be frequently getting heartburn and throwing up. Patients who use their band correctly rarely throw up or get chest discomfort after eating. They have learned to stop eating before they get uncomfortable. Usually at this point, patients aren’t hungry anymore anyway. The band “helps” you recognize this signal so you can control your portion size.
Lastly, losing weight is a difficult task. The gastric band is not an “easy way out” for losing weight. But if used properly, it can be “a way out.”
–Dr. Darren Soong
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Tags: Bariatric Surgeons, Gastric Band, Las Vegas Weight Loss Doctors, Weight Loss Surgeons, Weight Loss Surgery
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Thursday, February 12th, 2009
Liquid calories
The band is effective at controlling solid food intake but not very effective at controlling liquid calories. Patients who are trying to lose weight should avoid all liquid calories until they reach their goal weight. This goes for not only Starbuck’s drinks but also milk, orange juice, apple juice and other fruit drinks. A small glass of apple juice has about 100 calories. You could easily drink 10 glasses of apple juice and get 1000 calories and your band would do nothing to help you. Also liquid calories go right through the band and do nothing to control your hunger. If your band is adjusted properly, it would be impossible to eat 10 solid apples without getting sick. So given the choice, always eat your calories and DON’T drink your calories. The band helps you with solid calories only. Remember, if you are taking your daily multivitamin, you will get all the calcium, Vitamin C, etc, with 0 calories and so there really is no health reason to drink milk or fruit juices if you are trying to lose weight. Protein shakes and soups are considered liquid calories and should be avoided. If you don’t have time for a meal, a protein bar would be better to fill you up than a protein shake, and would be better than skipping a meal so you’re not super hungry before your next meal.
Come back for the final tip tomorrow!
–Dr. Darren Soong
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Tags: Bariatric Surgeons, Gastric Band, Weight Loss Surgeons, Weight Loss Surgery
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Wednesday, February 11th, 2009
There are 3 ways I see patients unknowingly sabotage their gastric band surgery and cause a plateau in their weight lost. I see this often enough that I have written a handout to serve as a guide which can help remind patients how they can stay on track. Sometimes patients are unaware they are doing these things and seeing it written down helps the light bulb go on. I’ll post these tips over the next three days. Please comment if any of these have worked for you!
Snacking or eating in between the three scheduled meals
The band keeps you from eating large portions of food at each meal, but we can’t adjust the band so tight that you can’t eat small meals. Snacking or small meals between breakfast, lunch, and dinner defeats the goal of the band, which is to reduce your daily caloric intake. If you’re snacking because you’re hungry, maybe an adjustment may help and you should come in to see someone from our adjustment team. If you’re snacking because you’re bored or stressed, YOU must take a minute to reassess why you’re having the urges and help yourself avoid them, unfortunately, the band doesn’t help with that.
More tips to come tomorrow and Friday!
–Dr. Darren Soong
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Tags: Bariatric Surgeons, Gastric Band, las vegas, Weight Loss Surgeons, Weight Loss Surgery
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Friday, February 6th, 2009
A common question we hear from patients considering gastric band surgery is which band they should choose, the Allergan Lap Band or the Ethicon Realize Band. In my opinion, the difference between the two is minimal since the weight loss results, complications, and adjustments are fairly identical. There are some subtle differences in design and placement technique between the bands, but for the most part, we could place either band safely in any patient.
Most patients are familiar with the Lap Band as it has been FDA approved for placement in the U.S. for about 6 years now. The Realize Band, although available in Europe for over 10 years, was recently approved by the FDA last year. Dr. Atkinson and I are certified to place either band. Typically, our physician assistants, Brian and Melissa, will discuss with patients both bands in the pre-operation meeting and before surgery the patient will tell us if they have a preference. About 90% of patients don’t have a preference and leave it up to Dr. Atkinson or myself to decide at the time of surgery which one we think would be the most appropriate for the individual patient. Success or failure is not related to the brand of the band. It is directly related to the patient’s commitment to the lifestyle changes that we strongly encourage during the pre-op classes.
–Dr. Darren Soong
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Tags: Allergan lap band, Bariatric Surgeons, Ethicon Realize band, Gastric Band, las vegas, Weight Loss Surgeons, Weight Loss Surgery
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Tuesday, February 3rd, 2009
For those of you who weren’t able to stop by and see for yourself, the clothing exchange was a huge success! We had a great turnout with dozens of patients walking in to see the seminar room converted into a boutique complete with racks of clothes, chic decor and a personal stylist, then walking away with armfuls of clothes. We even had our own photographer who was also on hand to snap photos of patients “celebrity style.” Even more difficult to recognize than the seminar room, were some patients I hadn’t seen in a while because of their incredible transformations. It took me a moment to identify the mother/daughter team of Michele P. and Jayme P. who had their band surgery together the same day in August and have lost a combined total of about 100 lbs. I also ran into Tracy K. who said she felt as good as she looked. She has been a great example to her co-workers and I’m sure they appreciate having a resource like her to help them.
 Tracy K. showing off her new figure More so than how our patients’ outer appearances change, what is really satisfying to me is how their inner self-confidence changes as well. Patients become more active and confident in social situations like the clothing exchange. They were comfortable talking to the media and even being photographed as well! It has always been interesting to me that after weight loss surgery, rather than being very private, most patients go out of their way to share their experiences with others. We appreciate thosw who want to shout it from the rooftops as it helps in leading others to learn of the mental, health and physical benefits of weight loss surgery.
Thank you to everyone who donated clothing! To our patients who came to the exchange, it was GREAT catching up with you. Hope to see you again at the next Gastric Band Institute event.
–Dr. Darren Soong
 Patient Pattie L. with her partner Chuck  Becky Hines showing off her fashion finds!  Me with patient Jessica B. No Comments »
Tags: Bariatric Surgeons, Gastric Band, Gastric bypass, las vegas, Weight Loss Surgeons, Weight Loss Surgery
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