Q&A Wednesday: Should She Go Lap-Band?

Q&A Wednesday: Should She Go Lap-Band?

Q: My mother is well over 300lbs.  She’s a diabetic with hypertension and high cholesterol.  She’s considering lap band surgery, but I really think she should try to change her diet first.  Unfortunately, my dad is VERY stubborn and won’t try new foods or anything outside his comfort zone.  He offers no support to my mom and insists that if she makes a separate, healthy meal for herself that she still make him what he wants for dinner.  Now that my mom has lost her job and can’t contribute to household funds like before, she is limited in her purchasing capacity because “it’s not her money.”  I really worry about my mom’s health, but I don’t want to cause her more stress.  Should I just help her find a good surgeon to perform the lap-band?

I feel like…. I shouldn’t be answering this question. Obviously, people are going to do what works best for them and oooooobviously people only ask me questions just to get my opinion on things, but wow, here.

Although I’m rolling my eyes – hard – at your Dad… I sort of understand. It’s hard for someone who doesn’t see the immediate need to change their life to accept changes that “don’t benefit them.” Not saying that that’s the right (or selfless) way to look at it, but I do believe that’s how he looks at it. It’s a really rough situation, but there are a few hard truths that have to be realized, here.

For starters, I don’t understand why weight loss procedures are considered some great, grand solution to every obesity-related illness, especially when the only thing the surgery immediately solves is the “obese” issue – you lose the weight. You’ll still have the hypertension, you’ll still have the high cholesterol and you’ll still have the diabetes to contend with. It is not a cure all.

In fact, I can recall a conversation I had with an MD a while back regarding surgeries… because I feel some kinda way about how they are peddled as being The End All Be All To Curing The Real Health Woes In America. Her words to me were, “Surgeries aren’t intended to be a cure-all, they’re meant to aid the people who are genuinely unable to function because of the weight they’ve put on, or the people who actually need to quickly lose weight so that we can go in and perform other procedures. If there’s too much fat for us to go in and do what we need to do, then a procedure will be recommended for weight loss first… then the other procedures come afterwards.”

So, let’s be realistic – even if she does have the lap-band (and only y’all can decide whether or not that’s for you), she will still have to adjust her eating lifestyle. Why? Because that eating lifestyle not only allowed her to develop that weight gain and those health problems… but it also allowed her to maintain those problems. Her losing the weight and continuing on the lifestyle only ensures that her health problems will be furthered… and she might even gain the weight back.

Having said all of that, I can’t tell whether or not 300lbs is killing your mother (because 300lbs at six feet tall looks and feels wayyy different from 300lbs at five feet tall) and I certainly wouldn’t weigh in on whether or not she should have the surgery. What I will say, is this…

The reality of all of this is the following: Dad thinks that healthy food consists of rice cakes and dry chicken breasts, and outright refuses to go that route, right? I’m almost positive that’s what this is. Like, without a doubt that’s what this is.

The biggest problem with the idea of “healthy living” is that all us healthy eaters eat all day is nuts and berries.

Sorry – while I get in my fair share of cashews and cranberries, I can assure you: I’m not the one. I love my fruits, my leafy greens and my rices the same way I love my dark chocolate truffles. I also understand how to balance the two so that I can preserve my health.

I find it hard to believe that both Mom and Dad are eating the same foods, but only one is experiencing the problems… that being said, if the food that’s served for the meals each day is cleaned up, both will definitely enjoy the benefits.I don’t think it’s ideal – at all – for her to cook one meal for herself and another meal (one consisting of food she loves) for everyone else. The goal, really, has to be cleaning up all the food within the house. Having it in the house pretty much ensures she’s going to eat it regardless of what healthy meals she cooks for herself.

She’s going to have to do some digging. She’s going to have to find some absolutely delicious recipes that don’t use processed ingredients, don’t use much sugar per meal and keep the animal by-products to a minimum. This is not hard. It means that she’s going to have to sneak and collect some good herbs (the basics – oregano, terragon, basil, rosemary and thyme are great common starters), start sneaking and switching for more quality ingredients (getting better-grown meats will help cut the unnecessary fat and more proper portion sizes will help with cholesterol), and cooking more often… much more often.

She’ll have to sneak and add more veggies to recipes and scale back on the meat. She’ll have to get more creative with the recipes (or be very resourceful and find a website that shares lots of healthy recipes) and be sure to cook every day so that he never has the chance to complain. If the food’s already done, all he’s going to want to do is sit down and enjoy it. Keep it simple, but keep it delicious.

I find that once people realize that there is such a thing as delicious healthy food, they’re willing to convert. You just have to get them over that “healthy food is dry, bland, miserly and disgusting” hump, first. I think that’s the best way to get Dad to invest in the healthy conversion of the household.

In the end… the reality is that no matter whether or not she has the procedure, she’s still going to have to address how she deals with food and how she nourishes herself… and once she does that, her weight will begin to fall off. If she really believes in and resolves to support her own life changes, then she might realize that she can lose the weight without the procedure, and deem it too invasive especially when she’ll still have to do the heavy lifting after the procedure. It’s all up to personal preference, but the lap-band won’t deal with the big issues. She’ll still have to deal with those on her own. Talk to her, let her know your thoughts, and then be her support system and help her make the proper plans to get where she needs to go… just let her know that it’s a long and hard road ahead, and you’ll be there to help her with your map. 🙂

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By | 2017-06-10T11:22:47+00:00 October 31st, 2014|Q&A Wednesday|29 Comments

About the Author:

The proud leader of the #bgg2wlarmy, Erika Nicole Kendall writes food and fitness, body image and beauty, and more here at #bgg2wl. After losing over 150lbs, Kendall became a personal trainer certified in fitness nutrition, women's fitness, and weight loss by the National Academy of Sports Medicine. She is also certified in sports nutrition by Precision Nutrition. She now lives in New York with her husband and children, and is working on her 6th and 7th certifications because she likes having alphabet soup at the end of her name.

29 Comments

  1. Evelyn November 24, 2010 at 1:32 PM - Reply

    PREACH girl! I loved your response, it was dead on. My question is – how is it that it would be ok to use limited funds to pay for expensive surgery, but not to buy healthy food? This is what constantly baffles me when people say they can’t afford to eat healthy. I can get a bag of frozen veggies for $1. What processed food costs that little?

    • Erika November 24, 2010 at 1:41 PM - Reply

      I presumed they might have the ill supreme awesome amazing insurance plan. LOLOL

  2. Abstruse_Fangrl November 24, 2010 at 2:19 PM - Reply

    You know, what I’ve never understood is the people who act like getting some sort of weight loss surgery is the cure for obesity. You can have someone open you up, put on a band, lose massive amounts of weight…and still gain it back.

    Like you said, it’s the way a person eats and their attitude towards food which has to change. Until they make that change, they’ll never achieve the health (or body shape) that they want.

    • Erika November 24, 2010 at 5:08 PM - Reply

      Not only that, but you absolutely CAN re-stretch your stomach out to the size it was BEFORE the surgery. It’s bananas.

      • christine October 15, 2013 at 12:53 PM - Reply

        maybe its safer but back in the day i know some folks who got it..shudders..you think Alli is bad lol

  3. Madame: The Journey November 24, 2010 at 4:14 PM - Reply

    It’s so true, if your diet doesn’t change and you don’t address your issues with food – any form of bariatric surgery is merely a temporary fix. My mother was 650lbs when she decided to have her procedure (roux-en-y gastric bypass). 400lbs lost later, she still relays the message to others, that it is not the be-all end-all. You’ll drop weight quickly in the beginning, as most do … but keeping it off … requires work and a genuine shift in behavior and nutritional understanding. People can and DO gain weight after these procedures, if they don’t adhere.

    • Erika November 24, 2010 at 6:40 PM - Reply

      Wowwww… kudos to your mother for doing what she needs to do AND for spreading the message! I’m almost positive that she’s got an awesome daughter helping her along the way, though. 🙂

  4. beverly November 24, 2010 at 5:58 PM - Reply

    I think that bypass is not the answer — gastric bypass is! I have 4 friends whohave had the bypass. The last was 5 years ago and not 1 has gained any back. All 4 no longer require meds for diabetes hypertension or cholesterol. Your mom is not in a environment condusive to weightloss and so by any means necessary. And everyone, if you are on this page you are also a bulge warrior – for shame on the judgementalness

    • Erika November 24, 2010 at 6:23 PM - Reply

      Now… if you can tell me how gastric bypass cleans out your arteries, changes the way your body handles sugar and lowers blood pressure… that’d be great. The reality is… they do NOT. LIFESTYLE changes do that.

      Another reality – your friends, plain and simple, are not you. You’re not with them twenty-four hours a day, seven days a week. We’re women.. we know the reality of womanhood – we lie to our friends. We lie to make things seem simpler than they are. We lie to make things seem easier than they are. How many of our friends wound up with “foreclosure” signs or eviction notices on their front doors, to our surprise? We didn’t know they were struggling. We don’t know about the struggles of our peers because we don’t live with ’em. I say all that to say… you don’t know WHAT your “friends” are doing or dealing with. I’d never hope that they ARE struggling, but if they were, I wouldn’t expect YOU to know it.

      Where do you see judgment? Where do you see anyone judging those who choose surgery? This isn’t about judgment. This is about the hard facts, and the hard facts are that you CANNOT avoid weight and health issues if you don’t change your life.. no matter HOW you lose the weight. It doesn’t matter to me whether or not a person chooses surgery – I even conceded in my post that there are situations where surgery is downright demanded, Madame above shared her story regarding her mother – what matters is the fact that that person WILL have to address their lifestyle and habits.

      And gastric bypass, for the record – which is the process of getting the stomach cut and surgically made smaller so that you eat less – can ABSOLUTELY FAIL, because if you’re someone who binge eats and stuffs themselves, you CAN restretch your stomach out and your surgery would’ve been a waste.

      I’m not trying to be forceful or rude, but it is absolutely vital that we stop fooling ourselves into thinking we don’t have to change or be realistic about weight loss and any adjoining health concerns. Just because someone was successful doesn’t mean we know, for sure, what brought on their successes or how they maintain them (as evidenced by the eating disorder post from the other day)… but if you failed at this weight thing, I can absolutely tell you why. Flat out. I want realistic perceptions of weight and wellness in our community, because all we’ve got thus far is doctors pushing procedures on us and leaving us with less information than what we had when we began. So… c’mon. I can’t let that go without making it very clear.

  5. JoAnna November 24, 2010 at 7:01 PM - Reply

    I have a friend who is 5’10” tall and weighs around 425lbs. She gained the last 30lbs whole wearing a lapband that she just had removed in August. Somehow she ate the same amount of food in teeny tiny meals, ALL DAY! Since vegetables caused her indigestion, she didn’t eat them. So lots of meat and potatoes, and starches. Because she gained that extra weight, the lapband was rubbing against her liver causing pain and internal bleeding..

    We get along as as long as the topic of food doesn’t come up. Now she’s on a mostly liquid diet of 1000 calories/day to lose weight in preparation of gastric bypass surgery in January. She said she doesn’t want to develop Type 2 Diabetes like me, so she going to get herself cut up. I understand her fear, but I cringe whenever I think of what she puts in her mouth. Since she’s limited to 1000 calories, she stocked up on fat-free puddings, and diet pop. I asked her to just do herbal teas, and a few squares of dark chocolate but she complained that that little bit wouldn’t fill her up. And she HATES water!

    I love the idea of getting a tummy tuck: cosmetic surgery to tighten up loose skin. Like gardening: you do the work of clearing the ground, making the beds, wedding, watering, and eventually harvesting produce. If you have extra time, you make your garden pretty. But if you don’t put in the elbow grease of the stuff you don’t see (conditioning the soil, etc), your harvest will be poor. Same with our bodies. I’d rather have a slightly pudgy healthy, athletic body than one that’s tight and toned, yet weak with high cholesterol, hypertension, and no stamina.

    • Erika November 24, 2010 at 7:05 PM - Reply

      See, that’s what I’m not getting.

      If type 2 diabetes comes from what you’re putting in your mouth… you avoid it by… addressing what you put in your mouth. Not by surgery.

      What is going ON out there? My gosh!

  6. Lynn November 24, 2010 at 7:40 PM - Reply

    Now I do know several people who were diabetic and hypertensive that had either the bypass surgery or lap band and have totally changed their lives. They no longer take hypertension meds and have also either greatly decreased their insulin needs or no longer have problems with their diabetes. I have one women who came into the office and she had surgery about 5 years ago and she no longer takes any diabetic meds at all and she was able to stop her blood pressure meds about 5 months after she had surgery. While I do know that obesity surgeries are a great help to individuals that need help especially immediately with health issues I do agree that if a person has an obesity surgery just to lose weight but never deals with their issues with food the surgery is sure to fail. I would say to this young lady to make sure her mother does all the research as far as these surgeries are concerned and then make the right choice for her. Like you said there are a lot of ways she can change her eating style to please herself and her husband she just has to really get down to business about it. Now if she has a medical emergency or is on the highest dosage of insulin that she can get and her diabetes is still not controllable or her pressure is out of control and they are telling her if she doesn’t lose weight soon it will be detrimental then I definitely understand her want to use the surgery to her advantage. Also I know that lap band surgery is not for everyone. You have to worry about throwing up and being to tight and if you throw up a lot you will have to have it removed. If you have not dealt with your eating issues YOU WILL throw up because you will continue to try and eat as you used to. Also I know that as far as bypass surgery is concerned if you don’t deal with eating issues you may lose the weight but after your sweet time of the surgery expires which is usually a year most start to regain the weight because they began to eat sugar and sweets again and not watch their diet which is the problem they had before they had the surgery. I would say see a nutritionist and learn all you can about surgery and then make the decision that you feel that is right. I think that if she can find some good recipes and maybe add some workouts even just walking it will help her to improve her weight and health without surgery. Try helping your mother first and maybe with you helping her to make the right choices then she will make that best decision that everyone can live with.

    • Erika November 24, 2010 at 8:20 PM - Reply

      The surgery “expires?”

  7. monica November 24, 2010 at 9:33 PM - Reply

    i know SO many people who have had either the band or the bypass and seem to do well with it and have lost tons of weight, but for me i just can’t do it. i also know of a past friend who has had the band and has to keep going back to get it tightened because the weight’s not coming off “fast enough”. in my mind, that means she’s not making the right food choices nor is she doing any exercise in order to lose weight. in other words, she’s not doing her part, she expects the band to magically fix her weight, and that’s not realistic. but hey its not my stomach so oh well….

    i really do think for certain people it works because they’re physically not able to eat the types/quantities of food as they did before or they’ll get those unpleasant side effects from it. which leads to better food choices….and weight loss. which is something that can be done without surgical intervention and is why, even though i struggle like hell on the daily, i’m in the process of teaching myself to put the right things in my body.

    i mean don’t get me wrong i’ve definitely thought about it, but i just can’t go under the knife and try to fix something that i feel won’t be fixed by a band or bypass. i’d be that fool in the hospital who ate too much and busted her band or something because, like i mentioned earlier, my problem with food is something that i feel a band or bypass won’t fix. but i guess i’m in the minority though, seems like everyone’s looking to have gastric bypass or the band instead of doing it “the old fashioned way”.

    and i was about to disagree with you on the point u made regarding preexisting conditions (such as htn, diabetes, etc) not being cured by the surgery but i see what you meant by that. the elimination of these conditions are thru the change in diet, not the surgery itself.

    good post!

  8. Kimberly November 24, 2010 at 11:35 PM - Reply

    I wrote the post lap gastric bypass/calorie restriction post yesterday and I feel that there are some necessary clarifications to be made about bariatric surgery.

    1) Whether lap band or bypass, you will regain the weight if you don’t change your behaviors. Period. Limiting calories to1,800/day, exercising, eating healthy food…that’s the only way to go to have long-lasting results.

    2) The gastric bypass surgery functions quite differently from the lap band. The bypass removes approximately 95% of the stomach (although not following directions can cause it to stretch back to its original size) and affects the hormones released by the digestive system. These hormones affect how the body processes food, burns it, and can absolutely change your palate. Pre-surgery, my problems were with sugar (thankfully I didn’t have high blood pressure, diabetes, or any other co-morbid condition). Now, I can’t eat some natural sugars because I’m so sensitive to it. A slice of pineapple almost had me updating my will. I’m an outlier; all folks don’t have this experience. However, since sugar was my main problem, my surgeon and I are very confident of my success as I can no longer tolerate (nor do I crave it). I also work out 3x week with a trainer. This, in addition to the surgery, accounts for how I’ve lost more than 60% of my excess weight in less than 11 months.

    3) The lap band physically reduces, though not permanently, the size of the stomach which limits intake. There is no cutting. It does NOT affect hunger hormones and there is no “dumping” syndrome, where the body rids itself of everything (it seems) if the patient eats too much fat or sugar in one sitting. Lap band folks can eat sugar, fat, anything they want, just in smaller quantities. This is why a significant proportion of lap band patients eventually have the bypass surgery.

    No matter what you do (surgical or non-surgical intervention), your eating habits and exercise regimen will ultimately determine your weight and thus, your health. I had years of therapy before I had the surgery, which is partly why I’ve been successful. And for the record, I lost nearly 50 pounds BEFORE the surgery (30 pounds MORE than my surgeon required) because I was able to address many of my psychological issues around food and “practice” my post-surgery habits for a full 11 months before the surgery.

    Bariatric surgery is not for everyone. No matter how good your intentions, how great your support system, you should not have the surgery until you’ve addressed emotional/psychological reasons for eating.

    I’m a doctor and can address more specificities of the surgeries. However, I’m not here to give medical advice; that’s for your primary care physician.

    One more thing: one can be too obese for the surgery. At my highest weight, 400+ pounds, there are surgeons who would not have accepted me as a patient. My surgeon, PCP, and therapist all knew that I was in it for the long haul and that I would comply with all requirements. No surgeon wants an extremely obese patient who can’t follow directions. It sounds callous, but it destroys their surgery statistics…and that matters quite a bit for reputational and malpractice purposes. I’m shocked that someone above stated that their 650 pound mother had a bypass. NO way surgeons at my Top 10-ranked hospital would have accepted her as a patient. She got very lucky.

    • Erika November 25, 2010 at 6:34 AM - Reply

      I think this is a stone cold reality of weight and health:

      “One more thing: one can be too obese for the surgery. At my highest weight, 400+ pounds, there are surgeons who would not have accepted me as a patient. My surgeon, PCP, and therapist all knew that I was in it for the long haul and that I would comply with all requirements. No surgeon wants an extremely obese patient who can’t follow directions. It sounds callous, but it destroys their surgery statistics…and that matters quite a bit for reputational and malpractice purposes. I’m shocked that someone above stated that their 650 pound mother had a bypass. NO way surgeons at my Top 10-ranked hospital would have accepted her as a patient. She got very lucky.”

      I mean, that says a LOT.

      To me, the bottom line in ALL of this is that there is NO way around the reality of weight loss… and that no matter HOW you lose the weight, there’s only one way to keep it off. My word, my word. Thank you SO much for contributing. I’m sure I’m not the only person who values your input. 🙂

    • Kelekona October 17, 2011 at 12:36 PM - Reply

      Wow, your gastric bypass surgery matches some symptoms that I have.

      I followed the “vending machine diet” back in the late 90’s which is the name I made up for something that would later imitate “the twinkee diet” except that I did get real food on occassion and I continued the madness until I decided that starving was preferable 3/4 of the time. (4 out of 7 days with the occasional cave-in.)

      It’s never been officially addressed, but I like to believe that I scarred my stomach in ways that result in most desserts causing me to curl fetal on the floor, and it’s very rare that I eat enough of a restaurant meal to not want a box.

      The difference is that I can eat gassy or expansive food with only mild discomfort if it is bland or lacking in grease and sugars.

  9. Notorious Spinks November 25, 2010 at 4:52 AM - Reply

    I found some great recipes over at Eat Better America and I also subscribe to Weight Watchers magazine. Those recipes are so good and you can barely notice the calorie difference.

    • Erika November 25, 2010 at 6:35 AM - Reply

      I can’t co-sign either of those because I know they push less-than-healthy products, but if someone can find value in ’em, so be it.

  10. Lucy November 25, 2010 at 12:58 PM - Reply

    This is so true. One prime example I remember is on a show showing one woman’s decision to get surgery. When she lost a lot of weight and was preparing for a skin lift, she had to have the ban loosened a little. The minute the band was loosened, she went home, made 12 cookies, and ate 9 of them. It was especially sad, because the parents, who paid for all the surgeries, were obviously kind of skeptical that anything had changed regarding her attitude towards health. It was just really sad to see her eating 9 cookies as soon as she had the stomach capacity for it. She was really young too, no older than 26/27 I believe. Now I think surgery can be good and may be the best for some people in some situations, but if it is accompanied by a change in habits then….. I think that is especially true when people have less than a 100 pounds to lose and are relatively young and for the most part physical able-bodied to lose weight. At some point, for some people, it may just be a way to skirt around the issue of why you eat 9 cookies in one sitting, or why even your own family sees that your relationship to food is off and doesn’t think your attitude has change to a healthy one.

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