Texas Arkansas Lap Band Blog from Texarkana

Community of hundreds of patients from Texas, Arkansas, Louisiana, and Oklahoma who have had Lap Band surgery in Texarkana.

Tuesday, April 29, 2008

Lap Band Dietician Notes




At the last support group, Amy Carmeli the registered dietician and nutrition guru offered these points on nutrition. Many of you asked for a copy of her presentation and Amy has been kind enough to share it with us.
By the way, don't forget to show up to the Lap Band support groups. We have them set up for you at our expense so that you can benefit and get the most out of your Lap Band. We believe (and studies have shown) that weight loss surgery patients have better results if they have regular participation in support groups.
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What we have forgotten about basic nutrition
1st in 3 part series


Our bodies need carbohydrate, protein, fat, vitamin, minerals, and water to function properly. Each one has a specific and special function in our body.
Protein, water, some lipids, vitamins, minerals help regulate body processes. Carbohydrates, protein, and fat provide energy to fuel the body.

We all know the name carbohydrate. In recent years carbohydrates have become “evil” or “bad” foods. However, carbohydrates are our bodies preferred energy source. The key is to know which carbohydrates we should eat more of versus less.

Two basic types of carbohydrates are simple and complex carbohydrates. Simple carbohydrates are foods like cakes, sweets, and fruit juices. Complex carbohydrates are foods like whole grain wheat products, fruits, beans, and starch vegetables. From the complex carbohydrates we also get two types of fiber, soluble and insoluble. Insoluble fiber increase fecal bulk and decrease intestinal transit time. Insoluble fibers are whole grains, all plants, wheat, rye, rice and vegetables. Terms associated with insoluble fiber are cellulose and hemicellulose, and lignins. Soluble fiber delays gastric emptying slows glucose absorption and can lower cholesterol. Examples of soluble fiber are oats, beans, citrus fruits, pectins, gums, and psyllium. An example of a complete fiber (soluble and insoluble) is an apple with the skin being insoluble and the inside being soluble.

Bottom line with carbohydrates – we need complex carbohydrates that contain soluble and insoluble fibers. Good choices are whole grain wheat, oats, vegetables, and beans.

With the lap band we talk a lot about protein. Consuming enough protein is vital for maintaining health. Protein is a key part of the blood, helping to regulate many body functions and can provide energy.

There are two types of proteins – complete or incomplete. Complete proteins contain all nine essential amino acids. Incomplete proteins must be combined together with another incomplete protein to provide benefit. It is basically an “all or nothing” idea. Without making a protein complete, by combining foods together, our body cannot support body growth and maintenance.
Complete proteins are eggs, meat, and milk.
Incomplete protein that can be combined to make complete proteins are: hummus and whole wheat bread, nut butter and whole wheat bread, rice and beans, green beans and sunflower seeds, beans and vegetable soups.

Food sources of protein
Tuna (3 ounces)
21.6 g Protein
Chicken (3 ounces)
21.3 g Protein
Beef chuck (3 ounces)
15.3 g protein
Yogurt
10.6 g protein
Beans and rice (1 cup)
10.2 g protein
Peanut butter and wheat bread
~10 g protein

Bottom line: We need adequate protein to maintain body functions. We can consume either complete protein foods or combine 2 incomplete protein foods to make a complete protein. Good sources of protein: meat, milk, eggs; or beans and rice.


Fat is what makes our food taste good and helps provide satiety (that full, satisfied feeling). Fat does play an important role in our body, but we actually need very little fat to provide these functions.

Fat can be broken into two groups of two: saturated fat and unsaturated fats; and essential fat and nonessential fat. The best fat to use in cooking is monounsaturated fat like canola, olive, or peanut oil. Fats that we want to limit are saturated fats, especially trans fat. Trans fat is found in foods like fried potatoes, bakery goods, and some margarines.

Essential fats that our bodies need are omega 3 and omega 6 fatty acids. These fats are found in salmon, tuna, sardines, trout, halibut, walnuts, and flax seed oils. We need these foods at least twice per week.

Bottom line: We should consume unsaturated fats in limited quantities and essential fat two times per week. Good choices: cooking with only olive, canola, or peanut oil; and consuming baked or grilled fish (listed above) two times per week.

Stayed tuned: next month we will discuss vitamins, minerals, and the forgotten nutrient water.

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Addendum:
Some Lap Band patients might have restriction for meats and in order to have an adequate protein intake might need to find other sources of protein, including low-fat or non fat dairy products or protein supplements such as those offered on the Estore.

Saturday, April 19, 2008

Hit a weight loss plateau with your Lap Band?


In our practice (including myself Dr. Ron Hekier, and my wife Dr. Rachael Keilin) we are learning as we go on. Having performed over 700 Lap Band procedures over the years we can notice trends in our patients. We have both noticed that a number of patients do very well with their weight loss for a year or so and then hit a weight loss plateau.

It seems to occur often in people who have lost two thirds of the weight we are trying to lose. For example, if you are trying to lose 100 pounds, you might hit the plateau after you lose about 65 pounds.

Here are some suggestions.



1) Are you getting enough calories spread out evenly throughout the day?

"What, I need to make sure I eat enough?" Absolutely. You need to eat to lose weight. Your body needs to be supplied with adequate energy otherwise it will store energy from the food you eat. Quick quiz what is the most efficient storage of energy in the body? That's right, fat tissue!So, are you eating at least 1200 calories a day? Are you eating regularly? Make sure you don't skip meals. 3 meals a day with small healthy snacks in between. Don't go more than 3 - 4 hours without eating anything. The



2) Are you exercising adequately?

This is usually the biggest problem. You hear people say they want to "increase their metabolism" and what they mean is that they want to burn more calories throughout the say. The only way to do this is to increase your level of activity. And not just leisurely walking, what Dr. Keilin calls "going out for a stroll." Exercise means getting your heart rate up, it means sweating. Work at it!

3) What is the composition of your food intake?

Out of the calories that you are eating are you getting adequate protein? Are you getting too much fat and carbohydrates? Make sure you are having an appropriate mix. Come to support group to speak with Amy, the dietitian, to help make proper choices. See her earlier post on Protein Power on this blog. Look at the products offerred by Bariatric Advantage to get some possible choices for protein supplements.

4) Have you forgotten the positive changes you have made?

Sometimes people forget that hard work it took to get them to their point of weight loss and they slack off and revert to old habits. Are you eating high calorie snack foods? Are you exercising less than you used to? Have you forgotten Betty's 10 Lap Band rules to stay in the box?

What works for you?
Leave a comment and share your thoughts with everyone!

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Tuesday, October 16, 2007

Winner of Walk Away the Pounds Book and DVD!

Congratulations to GP! They are the winner of the drawing and were selected to win a free copy of "Walk Away the Pounds". Lap Band weight loss goes through several stages. The initial stage is often easier because your body will lose weight simply due to the decreased calorie count. But after the initial weight loss, you might find yourself "stuck" at a plateau. I think the way to snap out of it and get back on the downhill slope of weight loss is to embark on a regimen of proper protein intake, and exercise. Remember, without adequate protein (and most of you need between 40 - 60 grams per day) your body will lose muscle mass and you won't lose fat. Take a moment to check out our Estore at the website for protein supplementation sources. And don't forget some form of exercise. Stay tuned for the next blog entry.
Congratulations to GP! Jamie at our office will contact you to verify your address and we will send out Walk Away the Pounds soon.

Monday, October 8, 2007

Walk Away the Pounds: Free Book and DVD



Tonight at the Texarkana Lap Band surgery support group meeting, our program coordinator Betty gave away a copy of the book "Walk Away the Pounds". (It also comes with a DVD!) We have a few more copies that we want to give away to encourage you all to exercise and get healthier. As for our prior contests, leave your initials and date of surgery in the comments, and we will randomly pick a winner next week on Tuesday morning. Good luck!

Monday, October 1, 2007

What is the Lap Band sweet spot?


We often talk about the sweet spot, and one of our blog readers recently asked about it. In baseball the sweet spot refers to that spot on the bat upon which you hit the ball there is virtually no resistance or vibration of the bat.

In the Lap Band what we consider the 'sweet spot' is the ideal fill. If I had to think about a perfect sweet spot I'd have to tell you about a patient. One of our patients was 66 years old when he had his Lap Band surgery. Over the course of the first 9 months he lost over 90 pounds! But he was confused and every time we saw him he would say "Doc my Lap Band must be broken. I don't feel restriction, I can eat what I want, and I never have food come back up."
That is the perfect sweet spot. The Lap Band was adjusted to the point that he felt control of his hunger and was able to control his eating portion size, but he had no significant restriction preventing him from eating any particular food nor did he ever have any regurgitation of food.
Many people who had lap band surgery find the sweet spot elusive and some people end up with a fill greater than they need because they rely on the Lap Band for restriction rather than hunger control.
If you are having a tough time keeping many foods down or having more than a small number of PBs (productive burps) you might be too tight and need some fluid taken it.
To summarize, the Lap Band is meant to help you with hunger control. By limiting the amount of food you eat with smaller portions, you can reduce your caloric intake, and lose weight.

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Monday, September 17, 2007

Winner of Ironwood Grill Gift Certificate

Congratulations to NT, she was randomly selected and is the winner of the $50 gift certificate to the Ironwood Grill.
Remember living with the Lap Band should be fun and we want you to eat out and enjoy your meals.

Focus on the Lap Band helping you with hunger, don't focus on restriction.
Some tips to our winner NT, and to everyone with the Lap Band when you eat out:

Remember not to drink while you eat. (See the earlier blog Losing weight with the Lap Band surgery.)

Pick healthy foods.

Don't try to eat mushy foods that ball up in your mouth as you chew them such as white bread or soft tortillas.

Recognize the proper portion size. In most cases what you are served will last you for 2 or 3 meals, so box up one half to two-thirds of your meal right away so you won't be tempted to eat too much.

Do you have any tips to share? Leave them in the comments section.
And one last thing, our next contest, to be announced in a few days, will be for a popular exercise book and DVD. Stay tuned!

Monday, September 10, 2007

Reward for healthy eating. $50 for Ironwood Grill


Dr. Keilin and I (Dr. Hekier) are always on the lookout for healthy food choices for eating out. Let's face it, with so much fast food out there, it's hard to find a place to eat that offers plenty of healthy choices so we want to help you make the right choices for you and your Lap Band. Remember, your success with the Lap Band is our success.
We strongly recommend the Ironwood Grill in Texarkana. The Ironwood Grill has plenty of healthy choices, and most importantly it serves a vast variety of fresh food choices including fish, salads, and vegetable dishes.
Check out their menu online at http://www.ironwoodgrill.com/ and you will find many choices and see why we call it the best family restaurant in Texarkana. It's also a good place to have small parties since they have an outdoor patio and large sandbox for the kids to play in, and a private dining area indoors. We've been there a few times with our office and Lap-Band team from the hospital and everyone loved it.
We are giving away a $50 gift certificate to the Ironwood Grill. Just leave a comment with your initials and date of surgery, (so we can identify you) and we will randomly select a winner next Monday.
Good luck!

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