[Suzanne 3FC]

Band constricts the cravings, weight
Date: 05-09-2002; Publication: USA Today; Author: David Kiley


ANN ARBOR, Mich. -- Seven months after my weight-loss surgery, and I am down 75 pounds. That's exactly the rate I was hoping for.
On Sept. 26, I had surgery at the Hamilton Medical Center in Dalton, Ga., to implant the Adjustable Gastric Band to help me lose the 200 pounds I want off my frame by July 11, 2003. That's my 40th birthday, and I plan to weigh about what I did when I was 18.

A sedentary writer's lifestyle, sloppy eating habits and a genetic line of heavy relatives got me ballooned up to a heart-sickening 431 pounds the day of my surgery. Thirty of those pounds were packed on in six months as I awaited insurance approval for the surgery. I had too many "last meals."

I suffered Type 2 diabetes and severe arthritis in my knees. Mowing the lawn or climbing stairs was an ordeal. My first baby was on the way, and his pending arrival scared me into action.

The "band" is a hollow silicone ring implanted around the top of my stomach. Running from the ring is a tube that connects to a "port, " which is about the size of a quarter and lies under my skin near my breastbone. "Adjustable" is just that: My surgeon, Dr. Jaime Ponce, periodically injects saline into the port, which in turn fills up the ring. As the ring is adjusted tighter, it forces me to eat much less, and more slowly.

This surgery is much different than the gastric bypass surgery made famous by singer-actress Carnie Wilson. The only celebrity I know of who has been banded is Sharon Osbourne, Ozzy's wife.

Gastric bypass, also called Roux-en-Y, involves creating a golf-ball- size pouch in the stomach to receive food. The pouch fills up quickly and stretches over time to about the size of a baseball. Intestines are rerouted so that most of the intestinal tract is no longer part of the digestive process. This is the most commonly performed weight- loss surgery in the U.S. But rearranging my intestinal tract wasn' t for me.

The band, more common in Europe and Australia than the bypass, was installed laparoscopically (with a scope) through a few small slits in my abdomen, rather than an open incision. I was out of the hospital in 24 hours. Some patients leave the same day.

"Bandsters" tend to lose weight more slowly than bypass patients, some of whom drop 200 pounds in six or seven months. I reckoned slower is better, but not everyone agrees.

While I have averaged about 10 pounds of loss per month, it's been a bumpy ride.

From Sept. 26 to Nov. 10, I lost 18 pounds as my stomach healed. After my first tightening, I lost another 18 pounds by Jan. 3. But in the following two months, I gained five pounds back. I had put off my scheduled adjustment as my wife and I awaited the arrival of our baby, Henry, and I ate too many cookies on the couch and my opening was too large.

I was adjusted again on March 3 and lost 29 pounds in the following four weeks, then 15 more in the last four weeks -- a total post-surgery loss of 75 pounds.

Since my tight adjustment in March, I have taken in soy protein/vitamin milkshakes twice a day to make sure I get enough daily protein and vitamins while my food intake is so low. I have only been eating one real meal per day for the past month -- at dinner. That's usually seafood, minced vegetables and/or potatoes -- barely 350-400 calories of real food. Sometimes a small yogurt or even smaller ice cream for dessert.

Losing 200 pounds relying on mostly milkshakes is folly. I tried and failed with Optifast and SlimFast. That drastic a move gets horribly boring and doesn't address the bad eating habits and bad biological and genetic wiring that made me the poster boy for the obesity problem in America.

As I lose weight, the band will loosen on its own, allowing more " real food" into my diet. When my weight loss slows, Ponce will tighten it again. Meantime, I occasionally have wine, French pate, scrambled eggs, slow-cooked Southern grits with cheese and even a few chicken wings -- all in small amounts -- as I average a bit more than 10 pounds lost per month.

I don't deny myself the tastes I love, just the volumes that were killing me.

I no longer succumb to cravings for food I don't need when I'm not really hungry. To eat a gratuitous cheeseburger, fries, sandwich, pizza slice or giant cookie -- all too common for the old me -- now would result in a painful period of stomach agony. That stuff would plug up the small opening into my stomach until I vomited it up.

I have experienced no ill side effects. Honestly, I never feel hungry. No more hair loss than I was already experiencing at the hands of creeping middle age. But I have vomited a handful of times when I have eaten too fast. "Bandsters" learn fast after a couple of plug- ups. The band acts like a speed governor on an engine, a device that keeps a car from traveling too fast.

At a recent stop at McDonalds to use the diaper-changing table, I scanned the menu board full of stuff I no longer wanted and couldn' t eat anyway. I left with only coffee, and was thrilled.

I'm exercising as much as possible -- swimming, weights and walking -- and hope to avoid having excess skin removed as I come nearer to 200 pounds (see adjacent story).

The Type 2 diabetes I suffer from is already in retreat. I am almost off the pills and on only half the insulin I was on when I had surgery.

Can the band work for everyone? That's hard to answer. I have a few "banded" friends who haven't lost enough weight yet to justify the surgery in their minds. My reporter's nose tells me it's because many doctors performing the surgery are gun-shy about adjustments, leaving the opening to the stomach wide enough to accommodate too much food.

One banded friend tells me she hasn't been able to get over her emotional connection to food and admits to defeating her band by eating high- calorie sweets like cookies, which go down easily with milk.

Bandsters' first commandment is, "Thou shalt not drink with food." If you do, the food can get washed through the band rather than keeping you full. Still, I drink six glasses of water daily, but without food at the same time. I'm only one-third of the way to my goal, but I feel three times better now than in September. And I feel smart for losing at this gradual rate.

As for the emotional connection to eating, I am still a confirmed "foodie." But a half-pound of my favorite German salami or French jambon lasts me 10 days now instead of 10 minutes. And I eat so slowly that I have discovered amazing flavors I had been missing.

When I reach my goal weight of 220 pounds next year, I will keep my band filled at a level that allows me to lose additional weight by limiting food intake as I exercise more. Two hundred pounds would be my ninth-grade wrestling weight, which seems like a dream for now.

Motivation to keep losing is no problem for me. My emotional connection is to my wife, Amy, and Henry, and I've promised him that we'll go hiking and biking through Ireland when he's old enough. But I plan to be physically ready much sooner than he is.