The needle the doctor was holding was about as long as my forearm. He was right, I shouldn’t have looked down. I stood in his office in Glendale, California, my shirt off and my pants pulled down to my ankles. My abdomen was on full display for every doctor, nurse, assistant, and caregiver who came by and peered in to see the procedure up close. It was 2010 and the lap belt was still considered an exciting “wonder drug” for obesity rampant in Los Angeles. You couldn’t drive down any highway without seeing the “1-800-GET-THIN” billboards.
Gastric band surgery is like a rubber band around your abdomen. There is no internal cutting (a great advantage), and your stomach remains intact, unlike gastric bypass, where the stomach is cut and the intestines are rerouted. The hip belt fits snugly in the upper curve of your abdomen and forms a small upper abdominal pocket. Basically, it tricks your body into thinking you have a stomach the size of a pigeon. You eat much less and feel full faster – these were all big selling points. Of course my body would have to be tricked. I knew it wasn’t going to let a single pound come off easily at that point in my life.
I was only 19 when I got the tape, but I had been put on a diet since I was seven. fat to begin with. So I had the doctor push a needle into the port behind my ribcage and inject a full cc of saline. I felt the sides of the band swell and close my stomach all the way. Slowly he pulled the plunger back and my stomach opened just a tiny bit, enough for water or other liquids. I had already lost 30 pounds – only 80 to go. Only 80 until my life could finally be mine.
I didn’t know then that the lap band wouldn’t be a gateway to a new life. It was just a trap, sold to me for $6,000 – an eating disorder I bought and now I can’t escape.
I got the lap belt because a girl was mean to me. Okay, that’s the short version. But it’s not untrue. I moved to Los Angeles at age 18 and 320 pounds. I fell in love with my roommate, who didn’t mind the attention but never took me seriously as a date prospect. She didn’t mince words either: I was too fat. Not too fat to mess with, but too fat to be seen with, too fat to fall in love with.
The long version is a lot longer. My mother was obsessed with my weight and put me on a diet throughout my childhood. By the time I was 18, I’d been to fat camp three times, was a hardcore Weight Watchers member, and could recite you the basics of every fad diet that’s been around since 1997. I drank cabbage soup, avoided carbs, stopped eating lunch, had a liquid breakfast, and had a personal trainer two, three, five days a week. No expense was spared and yet I was fat. (One night, when I was at my thinnest, my dad decided over dinner to calculate how much each pound of my weight loss had cost him. It was meant as a joke, but I don’t think I laughed much.)
We paid out of pocket for the lap belt and I qualified based on the BMI requirement – I was at the end of the chart in the “why aren’t you dead yet” section. I didn’t need a letter from a therapist or more than one consultation with the surgeon I chose. A deposit, some blood, piss and a CT scan of my intestines and I had a day of surgery booked. I only drank liquids for 10 days before surgery. I spent them chain-smoking Marlboro Reds and chugging orange juice. I lost my first 10 pounds.
Under anesthesia, I dreamed that I kissed Catherine Zeta-Jones. When I came to, the pain was thick and wavy, my chest pulled in and the top half dropped off me. It took weeks before I could walk fully upright again and days before I slept well. That was worth it to me then. I felt myself shrink and reveled in the compliments that came thick and fast.
I will always remember those first few days after surgery. I lay in bed eating only handfuls of ice chips, popsicles, and thimbles of chicken stock. The world felt empty and strange without the ritual of eating – coffee with breakfast, drinks with friends. But it also felt open, new, possible. I no longer needed food. I beat it. I would destroy any memory of my fat self and start over, with a slim shiny body that everyone would love.
The first thing I puked was an apple. That’s not on the billboards – the puke. Nor is it potential hair loss or tooth damage or symptoms of general malnutrition. The hip belt is a real physical barrier – it literally prevents food from entering most of your stomach. If you don’t chew slowly enough or often enough? vomit. Things that are too fibrous? Eating too fast? Or in bed? All of those things make the food come right back up. And sometimes it happened when I drank water too fast or ate things that were too cold or too spicy. Sushi, pizza and hot dog buns were all a no-go. I’ve puked in garbage cans, puked out of car windows, walked behind a tree mid-date, and on the corner of Notre Dame Cathedral when I couldn’t help it. But the very first time was an apple.
After having my tire filled with saline (it’s called an adjustment), I was put on an all-liquid diet. Adjustments began to take place about two months after surgery, after the band had loosened from the first implant. Saline was injected through a needle into a port behind my ribcage in a humiliating ritual that I then had to repeat every 30 pounds or so. Adjustments were essentially resets – they closed my stomach to anything but water and broth.
Weeks of broth and prune juice (to try to keep my bowels working) eventually gave way to a soft food only situation. As the saline in the band evaporated, the band loosened up and I was able to try foods that a toddler might be able to handle. The sheets I was given suggested cottage cheese, plastic-flavored baby food, and sugar-free pudding that gave me the creeps. Some nights I would go to a deli and order a side of hot gravy and sip it slowly with a spoon, careful to work every bite on my tongue.
I quickly ignored the suggestions and devoured everything with relish, getting creative with the word “soft.”
I decided that “soft foods” included Whole Foods’ homemade pico de gallo with crumbs of nice blue cheese for punch. I sliced fresh avocados and dipped them in sweet soy sauce to curb sushi cravings, ate smoked salmon with lemon juice and a thin layer of cream cheese when I wanted a bagel. I drank miso soup like water and was obsessed with young Thai coconuts with their delicate flesh and vitamin-rich juice.
However, eating at home wasn’t the problem – it went out. Every social event suddenly seemed to revolve around food. It was everywhere – everything I couldn’t have. At first I sipped lattes while friends enjoyed cheeseburgers. I reminded myself that I was now out of food. Above cheeseburgers. Months went by and I was (literally) hungry for something with bite, with texture. I lost weight quickly, new clothes fell off me just weeks after purchase. Eventually I stopped buying new jeans and just got a belt that I punched my own holes in when I ran out. I felt like I was under constant siege — watching people eat and drink and live normal lives all over the place while I carried bottles of Pedialyte and protein shakes to school so I wouldn’t pass out. Eventually I figured out I could eat whatever I wanted and then put it all back in the toilet.
I was hungry and vomited. I got used to the vomiting. I got good at vomiting. I couldn’t do it before the band – not alone. Now I knew exactly what would come back up and how soon. I could bend my head back like a pigeon and let an entire meal go. I started eating things I knew wouldn’t stay down. Why not? What did it matter? I was still losing weight. No one cared how it came off as long as it kept coming off.
I lost 100 pounds and then about 20 more. And then I got no more adjustments. And then I got 50 back – and they don’t budge.
The lap band isn’t as popular as it used to be. No more billboards. The stomach sleeve is now the most commonly performed weight-loss surgery in the US (a procedure in which a large portion of the stomach is cut away, leaving a smaller stomach intact). While other people may have had success and are completely satisfied with their banding experience, it reportedly results in less weight loss than other bariatric procedures and as of 2019 represented only 0.9% of all bariatric procedures performed in the US With injectables like Mounjaro and Ozempic flooding the market, weight loss surgery could soon be a thing of the past altogether.
I get the pull of a silver bullet. At my heaviest, I would have given an entire limb to be thin, and I mean that literally. But the miracles are not real because people need food. We have to eat. It is non negotiable. When I was at my heaviest, I was lonelier than I had ever been or ever would be. Life felt like it was happening around me – with other people. I was stuck on an island, trying my best not to take up so much space. I want to tell you that I wouldn’t get the tape again, but I can’t promise that. I was so desperate.
The world wants fat people to be desperate, to be apologetic, to be invisible. The body positivity movement may have changed things up a bit, but we’re still incessantly searching for the “cure” to obesity. It took me a long time to understand that I didn’t need to be healed. That my body and my stomach did what they had evolved to do over the centuries: hold weight and keep me alive. No plastic strap would change that – not really.
I am not condemning anyone who uses these new “miracle” drugs. I wanted that miracle too. I only now know that miracles are not real. However, your body is. And it’s worth loving no matter what.
William Horn is a writer living in Boston. You can find him on Twitter @WillsHorn and read everything he ever put on the internet here. He is currently working on a memoir and a book about being a professional fat guy.
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