At Goal
Appetite Suppression
by Terry Simpson, MD, FACS
Weight loss surgery works by decreasing the appetite—allowing people to eat less and utilize their fat stores more efficiently. What successful weight loss surgery DOES NOT do is stop you from eating anything.Whenever a patient says they don’t “feel restricted” it means they want the operation to do something that they cannot do for themselves. In this case they want the operation to keep them from eating too much, or eating something. Successful patients DO NOT describe appetite suppression in that manner.
This became clear when several groups showed that food remains above a well adjusted band for only a minute or less, not longer. It is not that the band keeps food from going through it - it is the act of food going through the band that allows the satiety mechanism to go into effect. The study was simple. Take a patient who is losing weight and feels their band is at a good point. Give them food that they say satisfies them for a long time and label the food with something we can see on an x-ray.
We were shocked at the results, and others repeated the experiment with the same results. But, then it all made sense. Whether they have a band, a bypass, a sleeve, or a DS – all of the operations allow a smaller amount of food to provide appetite suppression. Without that, appetite suppression does not occur.
This is revolutionary in all aspects of patients – it is not “restrictive,” and having the band tight is not helpful, and a micro pouch does no better than a standard size pouch. The bottom line is simple: solid food, slowly eaten, provides prolonged appetite suppression. This can be all overcome by eating too fast or by drinking liquid calories, or soft food. (For band patients, eating too fast leads to esophageal dilation, erosion or slips. For RNY patients this leads to stomal enlargement, and failure of the operation.)
So the latest revolution in weight loss is not in a new tool. It is in those four simple words that will keep your tool sharp: eat small portions slowly.
Terry Simpson, MD, FACS is a weight loss surgeon in Phoenix and has authored several books. For more information visit www.drsimpson.net.
Click here for the PDF version of this article from its appearance in OH Magazine
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