Eating Disorders / Mental Health

BANDED

In April 2012 I was 46 years old. I’d battled weight my entire life and I was tired. All the weight I’d previously lost was back on – again. All the tricks I’d used before were failing. I tried eating less, exercising more, eating more, exercising less. Shakes and weird shit and anything I could think of. I was still fat and getting fatter. So in tears and desperation, I made an appointment to see an obesity surgeon on a Thursday. He had a cancellation the following Monday.

I booked in, had a gastric lap band fitted, and changed my life.

Now just to be clear, I was not morbidly obese at the time of the surgery. I won’t name numbers as I know they can be triggering for those with eating or body issues. I was in the obese range but not even close to morbidly obese. By Christmas I was close to my healthy weight range and stronger, fitter and healthier than I’d been for a very long time.

Immediately after having a lap band, you live on liquids, and over the following weeks and months food is increased in texture until eventually, you’re back to eating normal food. The surgeon monitors this period of time to check you’re healing well and to make adjustments to the tightness of the band.

For the first six months everything was fabulous. I had virtually no hunger, I was keeping food down, and I was losing weight. After about six months, I’d figured out how to purge. It wasn’t deliberate – I just accidentally ate sushi too fast and it was too painful to keep it down.

I had purged for years in my early twenties but once marriage and motherhood came along I just let myself get fat. Periodically over the next twenty years I occasionally purged but not for long.

Fast forward six months post lap band and I was purging a little, which quickly escalated into a lot.

In order to keep food down, you have to eat incredibly slowly. Just that one simple thing. I have never mastered it but will add it to my to-do list.

About 15 months after surgery I had increasing issues with the lap band. I was returning to the surgeon on a regular basis to have adjustments up and down. If the band is tight I lose more weight – because I throw up all the time. If the band is loose I gain weight – because I can’t throw up, and I had not at that point dealt with any of my emotional or mental health issues.

I was ending up in the emergency department more regularly and having periods of time where I couldn’t even keep a sip of water down. A few scans were done and eventually, it was discovered scar tissue had built up under the band and my stomach herniated through the top. I was popped onto a drip for a bit of rehydration and surgery scheduled to replace the band.

It was never explicitly said the scar tissue built up from excessive vomiting, but I suspect that is the case.

Post-surgery the lap band was good again. But life was becoming unbearably traumatic and my eating disorder issues escalating out of control. Within two years of having the lap band, I was deep into full-blown bulimia. I have been in that place since then – using the band to make purging easy. Too fearful of losing control over my eating to let go of the purging.

Stuck in a vicious cycle of negative behaviours and thought patterns.

Lap bands are also notorious for introducing reflux issues. And again as I wasn’t managing the band entirely well, I had significant problems with reflux, requiring hospitalisation on more than one occasion.

Fifteen months ago I had my breakdown and stopped eating altogether. Bingo – I learned the art of anorexic behaviours as well. Now I had a choice – I could starve myself, or I could binge and purge. And I was so tired of the binge/purge cycle I chose to starve. I lost weight rapidly then had the lap band tightened as weight loss makes it looser and it’s too easy to eat.

This year I am in a better headspace, making psychological progress. I no longer restrict food intake and have chosen to eat on a daily basis for over five months. I have also gained weight. I am reliably informed it was necessary weight gain, as I’d lost a lot of muscle. But it also meant the band felt tighter and tighter. I found myself once again using it as a tool to progress bulimic behaviour rather than safely lose weight. I was purging multiple times per day and finding myself having more difficulty keeping any food down at all.

I have known for some time lap band needs adjusting – as part of my recovery, and to enable me to eat nutritiously – but I was saving this big change for “later”. I had other bridges to cross first. Those bridges are now crossed (no more scales, no more restricting, no more self-harming) and today I returned to my surgeon to have one mil of saline removed from the band. One mil. Sounds absurdly tiny! I have a ten mil band and it had 5.8 mils of saline in it. Now down to 4.8.

The trouble with lap bands – if you’ve never spent much time thinking about it – is healthy foods are often harder to consume than unhealthy foods. Chocolate and ice cream slide down easily. Smoothies and milkshakes can be consumed in large quantities with no consequence. But a tiny bowl of salad or a chicken drumstick are incredibly difficult to keep down.

Every lap bander I speak to finds some foods easier than others.

But we’re all unique. Some don’t hesitate to eat steak, chips and salad – incredibly slowly, in tiny pieces and small portions. Steak, chips and salad look like pre-purge food to me. Nothing on the plate is going to stay down.

After today’s adjustment, I’ve had pumpkin soup and toast for tea. A pretty safe choice and the bread went down incredibly easily compared to recent weeks.

Tomorrow the real work begins. Now I can eat more easily. Now it is more difficult for me to purge – because I learned once food has gone past the band, it’s incredibly difficult to get it back out again. It’s like a one-way road. I have been working on eating five times a day on a regular basis – breakfast, lunch and dinner with two small snacks. It might sound commonplace but historically my inclination is always to figure out how many meals I can skip, not how many I can include. It’s quite a mind shift.

I’m ready to start prioritising fruit and vegetables and foods with high nutrition, rather than going for the easy option of lemon slices, lattes, yoghurts and smoothies. I’ve been moving towards this in recent months and it’s time for health to take precedence over hedonism.

Many people have asked would I recommend a lap band.

I can’t have an opinion. It’s an intensely personal decision – one that needs to be made over time, as a last resort, in consultation with several people and with lots of research beforehand. Despite the lap band bringing a resurgence of full-blown eating disorder, and the medical complications that came with it, I am personally glad I had it done. I have learned a lot. I am in a healthy weight range and I’ve been fairly fit and strong for five years now. Well – most of the time! I have not managed the band well and from the research I’ve done, most complications arise from not following instructions.

I do think anyone contemplating the surgery needs a support team – the surgeon alone is not enough. You need a dietitian, a psychologist, and an exercise program. You need a holistic approach to weight loss.

A lap band is not an easy fix. It’s bloody hard work and it messes with your head. From a surgical point of view, recovery is quick and easy. It is an effective weight-loss tool. But it is just one tool in the toolkit. So I can neither confirm nor deny the value of having a lap band. All I can say is that it helped me physically and harmed me psychologically. That is my personal, individual experience. Your mileage may vary…