"Anybody who thinks Lap-Band is easy, it's a quick fix, it's just not," said Lisa Wolfe, a functional movement specialist.
Wolfe lost 75 pounds herself through diet and exercise, but gained new respect for those using the Lap-Band method after working with Pasadena resident Heather Hutchins, who once weighed 297 pounds.
"My stomach is like the size of a double big gulp," Hutchins said.
Hutchins is now comfortable at 160 because she followed doctors' orders.
"I started walking a month after, like longer distances," Hutchins said. "Started doing serious exercise like two, three months after."
She also attended nutrition classes and a support group to change long-term behaviors.
"You can't gorge yourself like you do when you're heavy," Hutchins said. "You find different ways to deal with your feelings instead of stuffing them."
And workouts must be tailored to this special population.
"When people have so much extra weight, there is terrible alignment issues," Wolfe said.
Wolfe uses strength training via weights, exercise tubing and TRX suspension training. She says heavy people can have strong leg muscles, but the upper body needs work. Also as weight comes off, there is often excess skin, which is why strength training is important.
"We find that those with lap band have a reduction in the muscular strength in their functional ability. So the strength training is going to target that lean mass," said Dr. Joe Raphael, and integrative care specialist.
While the Lap-Band is in place, the stomach can only hold a certain amount of liquid and food, but when it's time to eat, there are a few things the patient should be eating and a host of things they shouldn't.
"You eat protein first. It's always the rule," Hutchins said.
Raphael recommends having a little carbohydrate prior to exercise, and then a little protein 15 to 20 minutes after the routine.