kromi

My doctor is in a "Circle of Excellence." I wanted a sleeve, he strongly recommended the band based on my age, health and on his experience. My wife wanted a band, and because of some medications she had to take, he advised her to have the sleeve.
The band works... if someone goes to a "freeway clinic" and has problems, the fault most likely lies with the surgical group, and not the procedure.

I strongly believe that all procedures are safe and effective and that the choice of weight loss procedure is between the patient and their surgeon.
Here are key data points for the Safety and Efficacy of the LAP-BAND:
1. The LAP-BAND is the only FDA-Approved device for patients with a BMI of >30 with a comorbidity or BMI>40
LAP-BAND for Lower BMI: 2-Year Results from the Multicenter Pivotal Study
Obesity (2013) 21:1148–1158. doi:10.1002/oby.20477,
Robert Michaelson, et al.
· 149 Patients
· BMI of 30 -39.9 w/ Comorbidities
· Primary Endpoint - >40% of subjects achieved >30% EWL at 1 year
· Results:
o 84.6% achieved >30% EWL at 1 year
o 65% Mean EWL at 1 year
· Conclusion - LAGB is safe and effective for people with 30-30.9 BMI, with weight loss and co-morbidity improvement through at least 2 years.

2. The LAP-BAND has shown Long-Term success when patients are managed with appropriate aftercare
Long-Term Outcomes After Bariatric Surgery: Fifteen-Year Follow-Up of Adjustable Gastric Banding and a Systematic Review of the Bariatric Surgical Literature
Annals of Surgery , Volume 257, Number 1, January 2013,
Paul E. O’Brien, et al.
· 50.5% EWL at 3 Years
· 49.6% EWL at 5 Years
· 47% EWL at 10 Years
· 47.2% EWL at 15 years
· 3227 patients, 714 with 10+ years follow-up only 5.6% removal rate for the entire group
3. The LAP-BAND has been shown as safe or safer than any other bariatric procedure
There are a number of databases that healthcare organizations and professionals use to monitor bariatric procedures after surgery.
A recent review of data from the American Society for Metabolic and Bariatric Surgery and the American College of Surgeons databases showed the following:

LAGB Sleeve RYGB
Total Complications 6% 18% 24%
Reoperation Rate 1% 3% 5%
Hospital Stay After Procedure Less than 1 day Approximately 3 days Approximately 3 days
Illness After 30 Days 1% 6% 6%
· 75% lower 30-day morbidity compared to sleeve (ACS – Hutter 2011)
· 1/3 the complications compared to sleeve through 1 year (BOLD – DeMaria 2010)
· 68% lower readmission rate than sleeve (ACS – Hutter 2011)
· 1/3 the reoperation rate compared to sleeve (ACS – Hutter 2011)
· Shorter length of stay than sleeve and bypass (ACS – Hutter 2011)

Come on people...we really have to support each other and not bash each other. Just yesterday, I had a wonderful conversation with a colleague in my office who works in IT. He upgraded my computer and when he set me up with the new one, he commented on my photos. I have a couple before and after ones on my desktop that I keep there for when I want to post them with a thread.
At first I was embarrased that he saw them, and then perturbed that he mentioned it. Then he asked how much I lost and I though oh gosh, what nerve to ask something so personal. Then I took a good look at the guy and realized the reason for his interest. I asked him which surgery he had and he told me the sleeve. He also said he had dropped 230 lbs. in just over a year. Well....then I told him I was banded and what my stats were and before you knew it, we were like two old friends and talking about challenges, successes, excess skin, all of it. I congratulated him on his loss and he just said to me, 'you are lookin' real good girl'. I'm probably twice his age but a compliment is a compliment and it was really nice to hear it.
It didn't matter that we had different WLS, all that mattered was that we were both successful and so very happy with our outcomes. Why can't we do that here on this site? Let's stop the nonsense, OK?

The whole point is that WE as a community of WLS patients should not be tearing each other apart, but building each other up and supporting each other!! That includes Rosie and Gov Christy, you and me alike. We are picked on enough for being obese and we beat ourselves up enough over trying to lose weight we don't need to turn on each other we need to support each other no matter the modality of WLS we have had, revised to or are thinking of having.

I expect that kind of comment from Rosie O'Donnell but I don't expect to feel berated here for choosing one surgery over another. This is where I come to feel better, usually by trying to make others feel better. If people sound defensive perhaps it's because we keep having to defend a basic medical procedure. I did my research, I chose what was right for ME. Not any one else, just me. Why not support me on my weight loss journey? Are there people who want me to fail because I elected a different avenue? We are on the same path of wellness. Be supportive, PLEASE. It's the Star Belly Sneeches all over again.
Now, what I thought I'd be writing before I read all those comments -- great piece, Alex, and thanks for all you do for the WLS community through this site.

Amen to that! This isn't a freaken contest

I think I may have my band removed. It is failing me.....

whatever one WLS one gets (or removes to get another) or whatever,
lets just wish them luck..going back and forth with webpages and statistics solves nothing
and its kinda pointless to be honest...we all got opinions..
i like UNC and catfish likes UK, who cares??
so whoever reads my words, whatever WLS you have or about to get,
congrats and for best results, do as your doctor advises..and get well
that is what it is all about anyhow..

Let me just take a moment here to reiterate what some have already stated. WLS no mater the modality of it is all dependent on the patient. With the sleeve or bypass the results are faster and yes they are both restrictive and metabolic in nature and yet our bodies are a miracle of humanity and we can and do overcome and adapt. After that initial weight loss and shock the body can adapt and if eating habits, eating mechanics, attitude and life style changes are not been made the chances of regain in the long term are equal.
No one can say that one surgery is better then another. Recently I read a post by a patient who was diagnosed with Lupus. A lupus patient can not have such mal-absorptive surgeries as sleeve or bypass due to their condition which makes the lapband the perfect and only choice for such a patient.
No one of us is better or worse then the other. You can't say that people have not done their research, many of us who are banded have done more research then a college student writing a doctorate. I have my reasons for choosing the band and I have no regrets about it.
Making broad statements like those made by Rosie O'Donell in public forum only show her own ignorance and lack of empathy for the obese. Maybe she never saw her self as obese, but her health conditions, photo's and doctors tell another story all together don't they?
Don't knock those who are trying to make their lives better and become healthy. A smart intelligent woman would use her big mouth, comedic wit, and additional 5 minutes of fame to advocate for her comrades at large and open doors instead of shutting them as she did with her comments.
People who might have been thinking about getting help now maybe afraid that their "choice" is not the right one because some TV personality who has nothing better to do with her time but to cause controversy said it wasn't. She just called several Doctors who are banded, Lawyers, PHD's and people much smarter with higher educations then she has stupid.
Forest Gump had it right...stupid as stupid does aka Rosie O'Donelle.

well all i will say is what i thought when i read alex's post.
any WLS can work and any WLS cannot work
sometimes it could be due to a patients incompliance or it could
be an issue with the surgery or maybe a little of both...
BUT for any WLS to work, (with or w/o WLS), we must eat less calories than we can burn off
(and this is the truth and its reality to face and deal with head ON and accept.
at one time the lap band was the bomb...then along comes a new gadget
and all the naysayers jump on board and it will happen with the sleeve too (as it
is now happening with the other WLS that are not as (popular)..esp if new and improved WLS
are created..

Rosie is known for her outrageous comments! Of course she is going to criticize other surgeries because she did not choose that one. Does not make her view on the View right. Somewhere out people will start to realize that all weight loss surgeries are the tool for those of us that are at that point in our lives where we need help. Like she did!
That is what she should be focusing on not the procedures themselves. I don't watch the view either. Too jumbled with a lot of tension.

I don't think this article is applicable for many of us. You have to remember, shopping when heavy or obese is an ordeal. If you find something that fits, you buy it in every color and get the hell out of the store as fast as possible. For those who are/were heavy and obese for many years, this is the first time in a long time that shopping can be fun again. I've spent a considerable amount of money over the past year buying clothing that only fit for a few months or even weeks before going to another size.
I don't regret a moment of it except when I was still purchasing like a fat girl. One in every color. I understand now that I don't have to do that anymore. So...most of my clothes have gone to charity or to friends. I'm glad they are being used by someone else.
We also may overdo because suddenly we actually look good in clothes. That's a big change for many of us. I have to stop myself from overbuying. But it's hard when you see how nice you look now. My only consolation is that I try to buy from discount or lower end stores and I take advantage of sales as much as possible. I look good in dresses again so I just bought six of them. But they were half price so I got them all.
This could be construed as being a shopaholic but it's not. Nothing personal, but the last thing we need is to be afraid of something that is new again and pleasurable. As long as you can pay that credit card bill, there's nothing to worry about. Have fun shopping gals!!

Weight loss surgery is difficult, to say the least. The operation takes place after years or a lifetime of being obese and after months of research and preparation. Recovery can be anywhere from “not too bad” to riddled with complications. Nearly every aspect of your lifestyle changes, from your diet to the way you look to your relationships to your mental state. The entire experience is long and challenging, no matter how rewarding.


BariatricPal recognizes the challenges of being in the weight loss surgery community. You need every bit of support and information you can get to choose the best surgery for yourself, prepare for surgery, lose weight, and get healthy for the long term. The peer-to-peer support that BariatricPal members provide can be among the most powerful tools you have to help you achieve your goals. So please, help build the community up instead of tearing it down.
Potential for a Powerful, Unified Community
Our weight loss surgery communities began as WLSBoards, with four separate forums: LapBandTalk, VerticalSleeveTalk, RNYTalk, and SleevePlicationTalk. Each forum was dedicated to a single type of weight loss surgery. Members could discuss surgeons, diets, complications, and anything else related to weight loss surgery in general or the specific type of weight loss surgery in particular.
Then we merged the four WLSBoards to create BariatricPal, which is geared toward all types of weight loss surgery. This decision was based on the following beliefs.
We are all in this together. We have the same goal of fighting obesity through weight loss surgery.
The surgery types share many common characteristics and BariatricPal members can therefore benefit from having more input on topics such as the post-surgery diet progression, choosing a surgeon, ways to get more protein, and dealing with head hunger.
As a single community, we have greater potential to be a unified and strong voice for weight loss surgery than we did as separate communities.
Some topics are surgery-specific, and there is a need for surgery-specific subforums for certain topics such as fills for lap-band patients, experience with protein shakes for sleeve patients who may not be able to eat enough on a regular basis, and dumping syndrome for gastric bypass patients.

Has BariatricPal Become a Divisive Arena?
Unfortunately, BariatricPal members have had some regrettable experiences that contradict these principles. Rather than being supported, encouraged, and assisted, some members have felt attacked or belittled by other members who do not believe in their choices, whether in regards to type of surgery, food choices, or other lifestyle choices. Rude behavior, while unacceptable in any circumstance, is especially damaging in our community.
It weakens our collective voice.
It prevents some weight loss surgery patients and potential patients from getting the information they need.
It discourages WLS patients from pursuing their healthy lifestyles.

Avoid Destructive Posts
Most BariatricPal members are polite, helpful, and encourage. Occasionally, though, members post inappropriate and potentially hurtful posts that put down one type of weight loss surgery or another individual’s choice. In general, a poor post is one that makes a person feel bad and does not offer any useful information. These are examples of unacceptable posts.
“I didn’t even know they offered the lap-band surgery anymore because it’s so dangerous.”
“Weight loss is easy with the gastric bypass surgery. The rest of us have to work harder.”
“You shouldn’t be asking if you can eat that. If you even are thinking about it, you shouldn’t have gotten WLS.”

It’s okay to offer your opinion, but do it kindly. If you’re not sure if your post is okay, think about it before your post. The rule of thumb is to always err on the side of caution. Think how you would act if you were face-to-face with a good friend who had an opinion with which you disagree. You would listen to his or her position, then acknowledge the reasoning for that opinion. Then you would state your opinion and explain why you feel that way. Remember that feelings are harder to convey in written online conversations, and gentle words of advice can be interpreted harshly.
What We Have to Gain (or Lose)
When we all support each other, regardless of type of weight loss surgery, we have a lot to gain.
Positive atmosphere where everyone feels welcome, so those who need it feel comfortable to come and ask questions
Unbelievable wealth of experience and knowledge…among people who are kind enough to share it
A place where open discussions can lead to brainstorming and generation of ideas and strategies for success
A sense of pride that we are all here, with the same goal through the same means. Let us celebrate!

When rudeness and disrespect take over, we have just as much to lose. Just think about what would happen if you had a question, asked it, and got told that your question is dumb or that you are doing something wrong in your weight loss journey. Maybe you would leave BariatricPal or, worse, you would be afraid to ask your question anywhere else because you didn’t feel comfortable anymore. Nobody deserves to be treated like that.
Take a moment when you are on BariatricPal to appreciate the warm community, and think about what it means to you. The next time you post, ask yourself: are you helping to build a stronger weight loss surgery community, or are you tearing it down?

You know that you will never hit your goal weight if you intentionally try to cheat on your diet by sneaking bites or deciding not to log certain foods. But what if you think you are doing everything right and are still not losing the weight you expect? Hidden calories may be to blame. Figure out the sources of hidden calories in your diet, and you just may have a weight loss breakthrough!


Overeating is Possible after WLS

You got WLS so that you could lose weight, but it is important to remember that WLS is only a tool. To lose weight, you need to use that tool properly. If you fall into the trap of thinking that WLS automatically leads to weight loss, you might never hit goal weight. As a reminder, these are how the lap-band, vertical sleeve gastrectomy (VSG), and gastric bypass can help you lose weight.
Lap-band: The lap-band creates a small pouch, or stoma, to help you fill up faster so that you eat less.
Vertical sleeve gastrectomy (VSG): The surgery removes most of your stomach and creates a small sleeve out of the remaining portion. The gastric sleeve restricts the volume of food you can eat and it reduces hunger by reducing the amount of ghrelin, which is a hunger hormone.
Roux-en-Y gastric bypass: The surgery restricts food intake by creating a small pouch, and reduces nutrient absorption by having food from your stomach bypass much of your small intestine.

Your weight loss surgery will not work for you if you cheat in these ways.
You eat more frequently – and take in more calories – than your surgeon suggests without feeling the restrictive effects of the adjustable gastric band.
You eat sugary, fatty high-calorie foods. The lap-band, especially, is unlikely to cause you to develop dumping syndrome. That is good because you will not get the unpleasant symptoms, but it is bad because it does not prevent you from eating sugar, starch or fat. Even with a stoma size of just 4 ounces, or a meager 1/2 cup, you could fit in 400 calories’ worth of M&M’s in with room to spare.
You drink fluids when you are eating solids so that you are able to consume more at a single meal or snack. Drinking fluids while eating solid foods can also cause your stomach, sleeve or pouch to empty faster so that you get hungrier sooner.
You sip on beverages that provide calories but do not fill you up.

How Hidden Calories Might Be Throwing You Off

What if you think you are following your weight loss surgery diet diligently? You measure your food whenever you can, you use your dietitian’s food list when you go grocery shopping, and you order chicken and vegetables when you go out to eat. You get protein at every meal, and you drink plenty of water each day.

Hidden calories are the ones that creep into your diet. You might not know you are eating them, or you might think that you eat so few “extra” calories that they don’t matter in your diet. But, they do impact your weight loss. An extra 20, 50, or 100 calories here or there really affects your weight loss. Remember that a pound of body fat equals 3,500 calories. That’s an average of 500 calories per day to lose a pound a week. If you are getting hundreds of hidden calories a day, that could easily be a pound a week that you’re not losing.

Where Are the Hidden Calories?

Good question! They can be almost anywhere.
Starches are not necessarily unhealthy, but they should only be part of your meal after you eat your protein and vegetable or fruit.
Protein is the first thing you should eat at each meal and snack, but it is also a source of calories. Fatty meats and poultry with the skin can have 100 or more extra calories per 3-ounce portion compared to lean meats and chicken or turkey breast.
Healthy foods can be high-calorie. A handful of nuts or dried fruit or a big spoonful of peanut butter can have 200 to 300 calories.
Condiments can wreck your diet. A tablespoon of mayonnaise has 100 calories, a tablespoon of jam has 50 calories, and a tablespoon of salad dressing has 80 calories. Ketchup, teriyaki sauce, and marinades can have 15 to 20 calories per tablespoon.
Restaurant foods can be tricky. Vegetables that you think are steamed can have butter in them, and chicken, fish and other proteins that you think are good choices can come in sauces with 100 or 200 calories per serving. Portion sizes can be several times what you need: a 12-ounce steak is 4 to 6 WLS-sized portions, and a 3-cup plate of pasta is 6 to 8 WLS-sized portions.

o Examples of each of the below. Carbs: toast, crackers. Eat celery. Smaller pasta, more protein meatballs.
o Protein. It’s a nutrient, but it’s also a source of calories. Esp. if with sugar/carbs in supplements, or hi-fat protein foods. Bacon
o Healthy hi-cal foods: nuts, pb, dried fruit (fresh). Portion sizes. Avocado.
o Condiments. Fatty dressings (choose low-fat), use less (use herbs), sugary
o Portion sizes. MEASURE. Nibbling without measuring, eyeballing. You get 60 extra calories every time you take a piece of cheese that is the size of your thumb (1.5 ounces) instead of weighing it to make sure that it is only 1 ounce.
o beverages
o Restaurants: salads, fat added to “grilled” foods or steamed vegetables, beverages, “healthy” bagel instead of low-cal doughnut
o Eating too frequently. Tips for if you’re starving (protein, no fluid with meal); tips to make meal smaller (if you’re eating so many meals, don’t need to be big)

The Good News
The good news is that small changes add up to big calorie savings.
Have an ounce of low-fat cheese instead of full-fat, and save 50 calories.
Have a quart of regular or sparkling water instead of a quart of a sports drink, and save 200 calories.
Skip the bite of cookie dough after you finish baking for your children, and save 100 calories.
Have 3 ounces of 95% lean ground beef instead of 85% lean ground beef, and save 70 calories.
Rinse the spoon instead of licking it after you serve yourself peanut butter, and save 30 calories.
Spread peanut butter or tuna on 3 large celery stalks instead of 6 triscuit crackers, and save 90 calories.
Have one-third of a cup of pasta with your meatballs instead of a full cup, and save 120 calories.

This works for exercise, too. Every little bit helps. When you walk for just an extra half-mile, or about 10 minutes, you burn 50 extra calories.
Start to think about where extra calories may be coming into your diet, and see what you can do to limit them. You’ll be happier with your weight loss results!

Restriction is a myth, and it’s time to stop believing in it. The adjustable gastric band isn’t all about restriction after all. It’s all about satiety.


I tend to talk about satiety a lot. Why? Because recognizing satiety is absolutely crucial to our weight loss success and good health, no matter what bariatric surgery we have. Satiety is the sensation of having eaten enough food. Understanding satiety is so important to weight loss success that I’m dividing up what I have to say into three Satiety 101 articles. This is the first of the three.

Let’s start by asking an important question: do you think that your properly-adjusted band will restrict how much you can eat, so you take in fewer calories and lose weight? I realize that someone – perhaps more than one person (perhaps even your very own bariatric surgeon) may have told you that the adjustable gastric band works by creating a small stomach pouch that restricts how much you can eat. But I’m here to tell you, it’s a lot more complicated than that, and to go on thinking of the band as a “restrictive” method does bariatric patients a disservice.

The notion of restriction is a myth, a holdover from earlier times, before the band’s function and effects were fully understood. Now, after nearly 30 years of clinical use and studies, band manufacturers and bariatric surgeons are beginning to see that the old idea of the band’s “restrictive” mechanism is not only incorrect, but can cause a host of unpleasant and sometimes dangerous side effects and complications (such as band slips, esophageal dilation and achalasia, pouch dilation, and disappointing weight loss), and some of those complications can cause permanent damage.

If you swallow a few bites of barium-coated food (doesn’t that sound yummy?), fluoroscopy will show that food passes through the upper stomach pouch, right past the band, and into the lower stomach pouch within in minutes of each swallow you take, so that you can go on eating just like you did as a pre-op: fast and furious (when food doesn’t make that trip a quick one, it may mean that the band is too tight and needs fluid removed from it). That quick trip also means that you can eat far more food than you need, just like you did as a pre-op. Finally, the bariatric medical community is beginning to see that instead of being restrictive, the band works by reducing physical hunger (the need to eat) and appetite (the desire to eat), and by creating early and prolonged satiety, so that the patient, not the band, can reduce her/his food intake.

Now, let me re-state that from the point of view of someone who lived with a Lap-Band® for five wonderful years. It’s up to you, not your band, to make the band work for you. Your band is an inert, expensive piece of plastic that doesn’t limit how much you eat. It doesn’t know your name or that you hate broccoli. It’s not going to leap out of your mouth and throw your forkful of food on the floor when it’s time for you to stop eating. It’s not going to sound an alarm or start flashing red lights. It’s not going to shout, “Jean McMillan! Stop eating right this minute!” (Yeesh! In that last scenario, the band sounded an awful lot like my mom!)

Seriously, though. One of your jobs as a successful bandster is to learn when and how to stop eating, all by yourself. The “how” to stop is a big topic, not just for WLS patients but for every human trying to lose weight and avoid wasting precious resources like food, and far beyond the scope of this article. So for now, let’s concentrate on the “when” to stop eating part. We’ll do that in the second article in the Satiety 101 series: Satiated vs Stuffed, so stay tuned!

This is the first in the Satiety 101 series of articles.