I recently celebrated my seventh year “bandiversary”.  Wow, I am not sure back in May of 2004 I would have believed that I could have reached the level of success that I have worked so hard for.  No more medications for high blood pressure and asthma, no c-pap machine, no driving need yet for knee replacement although at age 62, with severe osteo-arthritis in my right knee it is coming sometime in the future.  Who would have thought that a 424 pound woman would find herself at the gym 5-6 mornings per week swimming, doing aerobic workouts on the elliptical, weight training, or even bicycle riding for FUN on the weekends and days off.  Not me, that's for sure.  The most I hoped for was to get off enough weight to be able to move around a little and not be in pain constantly.  I wanted to “resolve” as much of my high blood pressure as possible.  Instead here I am, 62 years young, celebrating life every day.  What do I attribute this to?  While I did “the work” I had a tool that made it all possible.  That's right, my lap band. My surgeon has said many times that he doesn't know why putting a band around the stomach of a 424 pound woman who was obviously doing a lot wrong would result in her losing 250 pounds.  The answer is - I AM NOT HUNGRY ALL THE TIME.  Reaching the anniversary of my surgery has me reflecting on what this has meant to me, from 2004 to the present day so let's review and see if it makes any sense:

• May 28, 2004 had lap band surgery and was on liquid diet for 2 weeks.  Was I hungry?  NO.  I was not hungry.  I missed chewing, but that is not the same as hunger.  I learned that in the first week.  I learned that I could help “relieve” some of that desire to chew by having liquids of different consistencies and flavors such as my protein drinks (sweet), chicken broth (salty), v-8 juice (in between but with texture that pleased my palette to some extent).  Supplement that with sugar free popsicles, water and tea (hot and iced) and I was about 10 days into it before I REALLY needed to chew.  I tried the tiniest bite of a saltine cracker and let it melt in my mouth and I made it to the next stage of “eating”.  I was still not hungry and recognized and acknowledged that daily.  I mourned food, wanted to chew, but had no physical hunger.
• June 12, 2004 was my first day of soft foods.  I was terrified, but ready to take a bite and chew for all my life was worth.  So, can anyone tell me how you chew one baby bite of scrambled egg 20 -30 times?  (Yes, I counted my chews) It dissolved in my mouth at about 10 chews, but it did taste wonderful.  Now I had to start learning how to not drink with my meals and to wait ½ hour after my meals (small and soft thought they were) to begin drinking.  Balancing this with getting in 64 ounces of liquid other than my protein drink took some planning - here's the beginning of my planning, something that is still with me, as strong as on this day after 7 years.  I barely finished my single scrambled egg which I served myself on a little salad plate and ate with a toddler fork.  I was not full (that means stuffed in an obese woman's terminology)but I was not hungry.  Hmmmm, is this feeling going to continue?  I will eat mindfully- paying attention to only eating and take note of all of this since I know this is a learning process.  Over the 2 weeks on soft or mushy foods I ate such delicacies as my scrambled egg or high protein oatmeal for breakfast, cottage cheese or yogurt for lunch, and refried beans or a baked sweet potato for dinner.  I know this is the time when many people “enjoy” mashed potatoes and puddings, but I was in this for the long term.  I made a rule - no white potatoes for me.  I'm glad I did because unless I fully lubricate a white potato with something high in fat like butter I cannot comfortably eat them today, so I still follow my 7 year old rule.  By the end of this 2 week period I was noticing that my soft foods provided sufficient food for me at meal times and I would supplement with a protein drink between meals to assure I was getting my allotted 60 - 80 grams of protein.  I was still not hungry.  Not full (remember- I define full as stuffed), but no longer hungry when I finished my well chewed little plate of soft food.  A miracle - YOU BET!  Not being hungry and looking for food 5 minutes after a meal was done if I wasn't stuffed like a Thanksgiving turkey is a new experience to me.  On to solid foods!
• June 26, 2004 This is day one on solid foods.  Time to add chicken and fish and some additional vegetables to my diet and see how that would go.  Time to start weaning myself off protein drinks so that I can get my protein from my food source.  This was more frightening than that first bite of scrambled egg.  I was going to have a bite of chicken with dinner.  Still too scared to do it for breakfast or lunch.  I was ready for this, I really wanted to eat food again.  So my little chicken thigh cooked skinless went on my little salad plate and I cut it into little pieces, and I ate it with my little fork and chewed each bite 25 times.  I counted.  I was terrified to swallow it, imagining the most horrible things would happen and I would wind up in the ER.  No problem.  The chicken was virtually a liquid before I swallowed it so I did not get stuck.  I actually watched the clock and it took me about 20 minutes to eat this little chicken thigh following the rules of fork down between bites and chewing each bite 20 - 30 times.  Again, I was done.  I didn't need any more food than the chicken thigh to reach that place of not being hungry any more.  Had I tried I probably could have eaten more but why - I wasn't hungry.  Ok, now we are a month since surgery and still no hunger between meals, and satisfaction during meals.  Wow, it was working, and my first weigh in validated that!  No fill for me - the doctor was amazed and I was more than thrilled.
• OK, let's take it to May 28, 2005.  By this time I had lost over 100 pounds by “following the rules”.  I was eating no more than 1200 calories per day, I was getting about 80 grams of protein per day, and I never drank with my meals.  Occasionally I would want to “snack” at night so I would have a sugar free popsicle, a 60 calorie yogurt, or maybe a 100 calorie popcorn.  The yogurt was the only one my surgeon approved of, although snacks were “prohibited” in his program.  Still no fill, still no real hunger.  I wasn't hungry between meals or after dinner I was either bored or stressed so I was eating for reasons other than physical hunger.  My band was still controlling the physical hunger.
• Somewhere right around my 18^th month after lap band surgery I became a “normal” band patient.  I actually started getting hungry too soon after meals and was back to “white knuckling” between meals as I had done with every other diet I had ever been on in my life.  Not good.  Having a cup of tea didn't help, nothing helped.  I was HUNGRY.  So, what was “wrong”?  Absolutely nothing.  I just needed a fill.  After the fill I was fine for a month or two, then needed another fill to keep that “just enough” feeling going and to not physically crave food between meals.

Long (7 years) story short I learned a lot about hunger and how the hunger mechanism interfered with my life, and how to get it under control.  Here are some of my takeaways from the past seven years of not “suffering” from a ravenous hunger that was almost irresolvable:

• With my lap band I could eat small portions and be satisfied with them.  That is, no longer hungry.  It was up to me to put those small portions on my plate.
• If I ate to full or beyond I would often regret it.  There is nothing pleasant about losing all or part of a meal because I am not paying attention to my body.
• Sometimes what I think is hunger is really thirst.  My body often gives the same signal.  If I am getting that signal and it is not mealtime the first thing to do is have a glass of water or a cup of tea and then check in with myself again.  Most of the time when I satisfy the thirst the sensation resolves itself.
• I now eat to live instead of living to eat.  I can still be a “foodie”.  As a matter of fact now that I eat small portions slowly I taste every bite.  I enjoy my meals more when I pay attention to what I am eating and what I am doing.  There is no benefit to resurrecting the shovel I used to use to “fuel” my body.  I tasted less when I ate quickly and shoved bite after bite into my mouth.  This holds true for the not so great choices as well.  I can now eat a single square of dark chocolate and savor it.  OK, ok, I know - but remember, dark chocolate is health food so a single square once in a while is good for me.  (at least for my soul anyway - whether or not I need the calories is another entire discussion)
• If I am bored and eating I should stop and find something to do.  This is not hunger.  There is always a closet that needs to be cleaned out or a load of laundry to do.
• If I am stressed and eating I need to go for a walk around the block and enjoy my surroundings to get “outside” of myself and give my head time to reprogram itself.  This is not hunger either.
• There is something I just recently learned.  I heard someone mention it and it just rang true with me.  Sometimes we eat at night because eating is a stimulant.  We are tired but are trying to keep ourselves awake.  This is mindless self stimulation (that sounds naughty) and getting up off the sofa is probably the best way to avoid this if going to bed is not an option.
• I have learned to use the absence of hunger as my message to stop eating, rather than the need to open the top button of my jeans.

That almost inexpressible state called satiety is really and truly within my reach as long as I pay attention.  All this because of a silicon band placed around my stomach.