This is my first post. I am housesitting for someone who told me she had Gastric Bypass Surgery. She showed me her before and after pictures. I went to see her surgeon. I was favorably impress with her surgeon.

I began the discussion saying that from what I've read online, it seems like lapbanding would be a good choice. He seemed adamant against it. He said it is an easier surgery and he has done it in the past. (He has been doing weight loss surgery for 15 years.)

If I remember correctly he said it only had a 50% success rate. That many lapbanded patients don't eat correctly afterwards. And they get lots of adjustments. That the band costs about 5K and it makes more sense to go with gastric bypass.

I am 5 feet 4 inches and weigh 235-240. I was just under 200 until I moved to the Seattle area in 1999. I lived in Southern California before that and swam outside a lot and roller bladed or biked along the beach. I didn't get as much exercise in the Seattle area.

I travel a lot as a researcher. While overseas this year I stayed at some hostels and to my horror realized I snore quite loudly. I have been told this is a result of being this obese.

If I am understanding correctly, lapbanding requires less 'follow up' visits. For gastric bypass this surgeon requires the patient to attend his pre-op support group, a pre-op class at the hospital, 2 more pre-op appointments, then 2 nights in the hospital for the surgery, then visits once a week for 3 weeks, once a month for 3 months, then every 3 months for 3 years, then annually. All the 'follow up' care needs to be paid in full before the surgery.

Given my family history of obesity, strokes, diabetes, etc - I'm 99% sure I want to follow through with at least lapbanding. I'm only 75% sure that gastric bypass would be the better alternative.

I'm thinking of 'settling down' in the Las Vegas area because condos/apartments might still be reasonably priced and I can swim outdoors year round. I figure subletting a Las Vegas place would be easier when I later travel.

Any advice on how to move forward would be appreciated.

Some surgeons who focus on bypass aren't necessarily giving their lapband patients the best aftercare and support. Sometimes to the point where they expect them to sit in the support groups that are made up of mostly gastric bypass patients, the nutritionists have the wrong info on what kind of diet the bandster should be eating, the surgeon tries to control the fill amount & schedule too much instead of allowing the bandster to take ownership of their band, etc.

If you decide to go with the lapband I really hope you look for a surgeon that is pro-lapband and offers excellent aftercare rather than staying with this one.

If you're in the Puget Sound area I highly recommend NWWLS (nwwls.com). It might be a few extra minutes of driving to get to their surgery center in south Everett but they have great care and do only lapbands. Almost all of the staff is banded, so they can relate to what you are going through.

I'm going to see my internist on Friday and I assume she will refer me to an ENT. I'm up late tonight once again because I can't seem to breathe out of left nostril. I have no clue what is going on. I've tried sprays to no avail. Guess I will have to let an ENT dr. figure it out. By the time I get the OK for this surgery I could be 80 years old

Flexible, to answer your question about the sleep study, no, it's not required for everyone the way blood work is. I had no sleep issues and did not have to have a sleep study. It wouldn't surprise me if it were suggested or required for you, because even though it's usually done to diagnose sleep apnea as a co-morbidity of obesity, there may be other reasons to closely monitor the sleep of obese people with breathing issues.

Every situation is different so we can't tell you the particulars you'll face. But I can say that pretty much all the tests you would have to undergo for bypass will apply even if you go for banding, particularly if you are hoping for insurance to cover the cost. Remember, there must be a case made for the insurer that bariatric surgery is medically necessary, and this is true no matter which procedure you're considering.

At the preop seminar I attended there was a very large woman who was hoping to get a lap band. The interesting thing is she already had a gastic bypass and had lost 175 lbs only to gain it all back. I think weight loss success depends on commitment versus procedure. As for me I choose the Lapband, and have been happy with my progess so far. Good luck!

The doctor I've spoken with about this had a good perspective. He said there are hands-down reasons for each surgery, as well as against, but when discussing options with his patients he looks at it mainly from the standpoints of 1) where is the highest potential for the person to fail at the lifestyle and 2) overall weight loss needed to be healthy.

Choosing band or bypass is a big decision. I am glad you are taking the time to look at both options before you jump into one or the other. I personally do not think bypass is an evil horrible decision...LOL. I just found the band to be the better choice for me. I think for some people bypass is a legimate need. Here are some of the reasons I chose banding instead. I liked the fact that 1) far less surgical and post-surgical risks and the possible complications are not as serious or life threatening as with bypass. 2) no malabsorption componant which lead to many problems down the road..for instance if I were to ever develop a life threating illness such as cancer, survival rates are low for people with malabsorption problems. 3) the band can always be adjusted!!! If five or six years after I have lost my weight, I find A few creeping back on and they aren't going away, I can go in and get a fill and loses the weight, with bypass, you are on you own to lose the weight. There is no safety net if you will.

As for non-compliance after the surgury, you can eat around either surgury. If you want to fail, you will. Those are my doctor's words. Basically, it is a little easier to cheat the band then the bypass but either way, they can both be cheated if that is the goal. Hopefully, anyone who is serious enough to have bariatric surgury is serious enough to be commited to losing weight and will try to eat around the surgury whichever choice they make.

One last thing, as for statistics, take them with a grain of salt, the numbers range greatly depending on who is doing the study and what they want the numbers to say. I have seen as many studies stating that five years out the band people are doing better than bypass (as for mainting a lower % of excess weight) as I have seen studies stating bypass is better.

im sitting here with a patient who had a GB 2 weeks ago. She has been in and out of the hospital with complications from the surgery. She flat lined on the table twice, she has lost weight, but has a gray tint to her face and skin. She can not drink or eat what she is supose to as she is so sick. She just got released from the hospital for the 2nd time yesterday for more problems, she is not having cardiac changes on her EKG and has home health coming to her house daily to take care of her. I see no reason this is better then a band. I know others who can not stop the weight loss and have broken ribs rolling over in bed.

There are GOOD & BAD points to both of these wls. I have met some remarkable people who have had success with the Band & the Bypass as well as some horror stories for both! I am having a revision to the bypass. I was banded in Oct. 2004. I have had many complications and it just keeps getting worse. My NEW surgeons office performs both surgeries and I am very happy to be having the bypass. I have a friend who had bypass last week and is doing wonderful. There are so many circumstances to be considered. Ther are the co-morbidies to be considered as well as the actual weight of a patient. At my highest weight of 400 pounds I never should have had the banding.. I needed to lose a lot of weight fast! Either way a person decides we should be thoroughly supportive, after all it's their lives not ours. I hope everyone makes an informed decision, not based on my cousins, brother sisters, 2nd grade teacher.....I think you should get other perspectives but this decision is between You, your Family, and your surgeon. I am behind anyone who makes the decision to have either surgery because they are choosing life...we all know how crippling a disease Obesity really is. You should LIVE & LIVE BEAUTIFUL!!!