Friday, February 19, 2010

How I Broke My Digestive System*

By: Linda Rohrbough

One of the things I discovered when I had weight loss surgery was my digestive system was broken. And I’d unwittingly helped to break it.

They say the truth will set you free. My journey to this truth started one day after my surgeon and I decided to do a book together about the adjustable gastric band surgery. I’d been banded for over a year at this point and I was doing pretty well, I thought. But evidently I still didn’t get it.

He got frustrated with me and quipped: “Where were you during your high school biology class?”

Like I was asleep at the wheel. I wasn’t. I told him I had straight A’s in high school but no biology teacher I knew taught me how anything inside worked, much less how to take care of it. We just drew where the organs were and memorized the names.

He looked thoughtful and answered, “I had a great biology teacher. Maybe that’s why I decided to become a doctor.”

I’m not sure why he was so curious about what motivated him to become a doctor. But I was glad to have the information in the simple form I’m going to share with you. Here is what I learned hanging out with doctors, and what I’ve learned on my own, about how my digestive system works, and how to break it. This may sound discouraging, but trust me - when I know how something works, it becomes much easier to take care of it.

First, and this is important, the body is an intelligent, dynamic system and it adapts. We all know our bodies are designed to heal themselves. But I found my body has smarts of its own, works to maintain fuel for me, and alters itself based on changing conditions, always aiming at survival. It is also determined and quite creative about all this.

So, here’s how I understand my digestive system is supposed to work. It starts when the stomach sends chemical and nerve signals to my brain to let me know it’s time to eat. So I eat, which means I break food into pieces, put it in my mouth and my teeth and tongue break it down more using fluid called saliva. Then it travels to my stomach where it’s further broken down.

The stomach acts as a repository and is designed to release food to my intestines over a period of time. The intestines do the work of removing nutrients from the food and releasing those nutrients into my blood stream as fuel. Anything my body cannot use is gathered together as waste products and pushed downstream until it exits at the other end. When my stomach is empty, it asks for more and the process starts all over again.

What I didn’t know is different parts of the intestines specialize in extracting different nutrients. Also, my stomach moves when it processes food. A critical point is my stomach has sensors that send messages to my brain to let it know my stomach is full. The majority of those sensors are near the top, which means I have to nearly fill it before “full” signals are dispatched to my brain. Plus it can take a few minutes for my brain to get and process these signals. Another critical point, and a big surprise for me, is my stomach is flexible and expands like a balloon depending on how much is in it.

Those two facts - my stomach can stretch and the sensors are near the top - have major implications when it comes to weight loss. Think of a child’s birthday balloon. When expanded either by air or water, and then the air or the water are removed, does it go back to the original shape? Nope. After being stretched, it is bigger, even though it’s empty. This means if I stretch my stomach, it will take more food the next time to trigger the sensors that tell my brain I’m full.

Now, back to how I broke my digestive system. One of the ways is to overeat. And I did that, but it wasn’t entirely my fault. When I was a child, I was made to eat whatever was placed on my plate. Wasting food was wrong in my home and the amount of food I was given was equal to that of my siblings, but never chosen by me. So I became a plate cleaner. If the portions were too big, I still ate all of it.

I also was under the mistaken notion I was shrinking my stomach when I didn’t eat. So as an adult, I would go all day without eating, then only eat in the evening. As I gained weight, I didn’t want people to see me eat. So I allowed myself to get very hungry and ate quickly because I was usually in a hurry. See how this was breaking my digestive system? I stretched my stomach out, then didn’t put fuel in it for my body during the day, but ate a lot each evening. And I ate fast, meaning big bites taken too rapidly for my sensors to keep up.

Further, by waiting all day to eat, my body adapted by storing fuel. It was like setting the idle down on an automobile to conserve gasoline. It became more efficient so I could be functional for so many hours without eating. I damaged my digestive system by training my body that it could not count on me to eat regularly and it needed to hedge its bets.

I also loved drinking straws and carbonated sodas. Those were treats when I was a kid and I took to them with gusto as an adult. Now that I have a band I’m very aware of how much air ends up in my stomach during activities like singing in church or talking during a meal. And a drinking straw is a great way to suck air into and expand the stomach. Think about how much of what’s in the straw is air. Carbonated drinks are the same way. They put extra air in my stomach and I end up burping or feeling uncomfortable. Both are expanding my stomach. So I no longer drink out of a straw or drink anything carbonated.

When I started to gain weight, the first thing I did was diet, which further deprived my body of energy. I was always hungry and thought eventually the hunger would go away. It didn’t. If you read my last blog entry here, then you know I stopped dieting after I was over 350 pounds because I didn’t want to get any bigger.

However, when I was heavy, the rail-thin husband of my former writing buddy asked me how to put on pounds. Smart man. He’d come to the right place. His doctor said he needed to gain and suggested he eat nuts. I said forget the nuts, go on a diet.

He said, “You don’t understand, I’m trying to gain weight.”

I responded with, “No, you don’t understand. What are all the fat people doing? Dieting. Based on results, that’s how to put on weight. Trust me. Diet for a couple of weeks, lose two to five pounds. Make sure you feel deprived and don’t eat when you’re hungry. When you go off the diet, you’ll pack back on that two to five, plus one or two more. You’ll have a net gain. Works every time.”

He decided not to take my advice, which is too bad, because it works. Ask any fat person. As far as I know he’s still underweight.

Dieting is deprivation. My theory, based on what I’ve learned from doctors and my own experience, is my body knows it’s not getting enough and it tries to compensate. It starts by reducing my metabolism. When I went back to eating what I ate before, there’s less ability to burn the fuel, so there’s more fuel available to be stored as fat.

What works with weight loss is a life-style change - a new method of operations. As they say, if you do what you’ve always done, you’re going to get what you’ve always gotten.

However, I think the biggest single thing that broke my digestive system was a brain injury caused by a horseback riding accident at age eighteen. I suffered a skull fracture. I don’t remember much about my week-long hospital stay, except that I gained five pounds in the hospital and had trouble controlling my bowls for another week after that. And I packed on the pounds especially in the months afterward. Did the feedback loop get interrupted? I think so. I do know when my adjustable gastric band is properly filled. I don’t spend my time fighting food cravings.

So there in a nutshell is my understanding of my digestive system and what I did to contribute to breaking it. There are many more ways to mess things up. Maybe you have a few you can contribute. Or a few tips on how you care for your system. Feel free to list them here. I know I’m interested. Inquiring minds want to know.

* Disclaimer: I’m not a doctor or any kind of medical expert. I’m relating here my theories and experiences based on what I’ve seen and heard and based on my results. This is not medical advice. I advise you to consult a doctor about your own situation.

Linda Rohrbough has been writing professionally since 1989, and has more than 5,000 articles, seven books, and numerous awards for her fiction and non-fiction. Linda’s latest book is Weight Loss Surgery with the Adjustable Gastric Band (Da Capo Lifelong Books, March 2008). Visit her Web site:


Michelle Butler on February 19, 2010 at 9:14 AM said...

Linda, thank you for sharing your story. I do agree that if a diet makes you feel deprived, your in trouble. That's one of the reasons I work so hard to make this journey "liveable" and not let me feel deprived.

Your anecdote about the doctor and Sally's yesterday in the comments is one of the reasons I like to have female and not male doctors.

Sally Kilpatrick on February 19, 2010 at 3:49 PM said...

Sometimes it's the "simple" things that help us the most. Thanks for your inspiring story and the biology refresher.

Linda Rohrbough on February 19, 2010 at 4:12 PM said...

I don't see much respect in the medical community for paid weight loss programs. Overeaters Anonymous is a group that gets respect, however, and I got that impression its because they're not trying to make money off someone else's misery. And they advocate a life-style change. But I was not ready to go no sugar and no white flour, which is what OA says works.
As for doctors, my experience has been that female doctors aren't any more tolerant of obesity than males. The doctor who told me to drink 100 ounces of water a day was a guy and that actually helped. There wasn't much else besides surgery that did.

The lifestyle change is the ticket. You go, girl!

Michelle Butler on February 19, 2010 at 4:19 PM said...

I actually had a female doctor recommend Weight Watchers once. I also think female doctors listen more. I'm sure that every person's experience is different with doctors though, and I'm sure there are wonderful male doctors out there and bad female ones. I just have a strong preference for female ones.

Best wishes to you too!

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