I have been determined to get a lap band but lately have been reading articles that say gastric bypass is better. Now that my surgery date is set, I am wavering. Should I ask my surgeon to do the bypass? I have about 100 lbs to lose and I am doing this to help with many comorbidities I have. I do not know how to decide. I know there are more risks with the bypass but maybe I should just go for it? Any thoughts out there?

Thanks in advance

Spartan, I agree with most everything you've posted here. As a matter of fact, you don't strike me as a bandster, you seem more as someone on a medical team. Anyway.....Any surgery that slices and dices or disects or reroutes is more "invasive" in my book. I didn't say the surgery itself was more dangerous than any other surgery.

You said something like "the surgery picks you, we don't pick the surgery"....I don't know what other's experiences have been, but my doctor didn't tell me what he thought was best for me. He asked ME what I wanted...and when I said I was looking into the lapband, well that was that. Your post stated that we should see endocrinologists, psychologists, etc. to determine the best surgery for our specific metabolic, eating or other disorder. I'm not disagreeing with this at all, but do you seriously believe the majority of surgeons are going to get into all that? Medical care is a business just like any other and working closely with doctors for several years now, I know that the goal is to retain the patients, not delay or hinder procedures Thoughts?

I am in a continual state of amazement whenever I come here and see so many "experts" on a surgery that they DIDN'T have.

I don't want the OP's original concerns to get lost in this, so my first comments are for her.

As far as the articles/studies you may have read, yes, there has been a significant number of observational articles that have been published recently (and one new study) concluding that the Bypass is the preferred methodology for treating obesity. For SOME reason, there have been very few hard-core studies performed comparing the two over long time frames. Part of that is because the Lap Band is still relatively new, in terms of being able to observe long-term outcomes. The Lap Band was only approved for use in the US 10 years ago, and it has only come into what would be considered "common" use in the last 4 years. And, a "critical mass" can only be considered to have been arrived at in the last couple of years, where you see tons of advertising, Billboards, bus benches, etc.

In other words, there is no way to effectively compare the two in terms of outcomes longer than 4 or 5 years.

The Gastric Bypass, on the other hand, has been performed and studied for over Half a CENTURY. And with the advent of laparoscopic surgical technologies about 12 years ago, the procedure has become incredibly safe, with regard to the actual surgical procedure. The Bypass and the Lap Band are now considered to be EQUALLY risky in terms of Death on the Operating Table and Death in the Short-Term, post procedure.

So, the Bypass is Safe. Period. It is considered to be the Gold Standard in bariatric Surgery, and will continue to considered as such for the foreseeable future.

Now, while it might seem like I am championing the Bypass, that is not necessarily the case. ALL the various WLS procedures are useful, viable alternatives. But here's the part that most people (including many Bariatric Professionals) simply do not get: Not all Surgeries are good or will work well for all people. It's not just a big "WLS Smorgasbord" where you just pick the surgery that appeals to you and go have it done. Many people are unaware of the fact that there are 6 major forms of WLS, and a few more obscure methodologies. And, in addition to those, there are even more being tested. But they are all DIFFERENT….they are meant for DIFFERENT people with DIFFERENT eating disorders and metabolic issues. I am not going to describe the details here; that is something you need to discuss with your Bariatric team. ALL WLS's do not work for everyone. In the last month here on LBT, there has been quite a bit of discussion about the Fact that the Lap Band does NOT work for everyone, for a variety of reasons. Some people simply eat TOO much. Some people have a metabolic disorder. For some it is emotional. There are LOTS of different reasons why people get fat, and you need to look carefully at ALL of the options available to make sure that you will choose the one that right for YOU. A former member here once said that "YOU don't choose the Type of Surgery…..The Type of Surgery Chooses YOU" And that is VERY true.

You need to visit more than one Doctor. You need to see an Endocrinologist. You need to speak with different Surgeons. And , you need to begin a course of Psychotherapy with a Mental health Professional who has DEMONSTRABLE experience and skill in the area of Dealing with Obese people.

Unfortunately…..most people do not do that. They do what they are "comfortable" with, and more often than not these days, that means the Lap Band. The advertisements on Bus Benches, Billboards, and those particularly obnoxious Television ads that show Lap band patients "morphing" from something like Roseanne Barr into something like Jessica Alba, are all pushing people into thinking that the Lap Band is a "one-size-fits-all" solution. And it is NOT. It works for some people. In fact it works VERY well for some people. But NOT most people.

Mattie7632 said:

"I had lapband and would never do the bypass due to it's so invasive and the potential complications."

Mattie, My Dear, I have to disagree with you on this one.

People always give the same reasons why they choose the Lap Band. "It's reversible" ."It's adjustable". It's "less Invasive than the others". "It's safer".

Because someone mentioned it here, let's looks at the "reversible" argument. The way that the Lap Band is "reversible" is that you can remove it. So…why would you want to remove it? Because you are experiencing one of several problems that REQUIRE removal, that's why. Like Erosion and Slippage, the two most common adverse outcomes. Slippage can cause Damage to the esophagus. SERIOUS Damage. Erosion:….have you ever seen a picture of erosion?….it's ugly, and potentially very dangerous. And there are other problems that occur with the Lap Band that can cause serious injury to your insides. So, while you might be able to REMOVE the Lap Band (reversible), in most cases you CANNOT REVERSE THE DAMAGE IT DOES. So….it's really not all that reversible, is it?

How about "it's less invasive than Bypass". This one is pretty comical to me. Sure, they do some re-routing. BUT THAT IS BECAUSE IT IS WHAT YOU NEED. If you need a Coronary Artery Bypass, I suspect you wouldn't say "oh, it's too invasive". And for MANY obese people, a GASTRIC BYPASS is what THEY need to help them with their problem, in the same way a Heart Patient needs a Coronary Bypass. And what about all of the other stuff we do to our bodies to solve some kind of problem.

And the COSMETIC stuff. Facelifts, tummy tucks, butt implants, chin implants, hair transplants, ear-pinning….it is a long list. And what about all of the piercings that are being done today, eh? Nose…Nose BRIDGE. Tongue. Ears (seen the huge holes people are poking in their ears and putting pieces of metal in?) Eyebrows. Cheek. Belly Button. Penis. Clitoris. And, again, the list goes on…..and NONE of that gives you ANY physical benefit.

How about Tattoos? The Skin is an ORGAN. And a sensitive one at that. But people seem to love injecting ink into it for some reason.

Many people here are planning on having some significant Plastic Surgery performed after they lose enough weight…..you don't think THAT'S invasive? Several pounds of an ORGAN removed…..you don't think THAT is invasive? And the simple fact is that Plastic Surgery is FAR more risky that ANY WLS.

Sorry, the "invasion" complaint doesn't make a lick of sense.

Potential Complications? Well, ANY surgery has those, some of which have nothing to do with the TYPE of surgery. There are, in fact, very few complications that happen with any frequency with the Bypass.

One is a ruptured Staple Line. Very Rare. VERY rare. If you choose your surgeon correctly, this is NOT a problem.

Stricture: This is where one of the openings that was created during the procedure begins to close a bit. The solution is simple and takes just a few minutes. Not an issue.

Small Ulcer: On occasion, this happens at the point where the aforementioned "hole" is created. Again…easily treatable, not really an issue.

Malnutrition: This is the one you hear about the most, and the solution is also very simple. In virtually every case where people were not getting the proper nutrients it has been found that patient was NOT following the Surgeons directives concerning nutrition. This means, mostly, NOT taking their Vitamins, or taking the WRONG kind of vitamins. Plain and simple. Take your vitamins (the right ones) and you'll be fine. And, you have to eat correctly.

The Chief of Bariatric Surgery for one of the Largest HMOs in the country put it this way: "If the patient is reasonably compliant with the instructions given, we can predict the outcome with great certainty".

Not much more to say about that.

I'm hoping you see my point. People make decisions based some pretty foolish notions., and WRONG INFORMATION.

PrtyAntOvrYt said:

"This is a also a trend now where doctors are placing Lap Bands over Gastric Bypass stomachs"

It's not a "trend"…..it is an occasional event. This is not being done THAT often, but it IS an alternative for those people who have been able to screw up their Bypass.

" The bypass weight loss comes to an end eventually and you have to struggle to continue losing if you're not at your goal."

It comes to an end if the patient STOPS DOING what he/she is supposed to do and starts eating/drinking what they SHOULDN'T….it works the SAME WAY with the Lap Band.

" I got a LapBand 1/2008 and I've lost over 200lbs. My friend got Gastric Bypass 9/2008 and she stalled at 155lb loss and hasn't been able to lose anymore!"

And that happened because she (again) stopped doing what she was supposed to do.

"She works out but the malabsorption is no longer happening for her. Her body has learned to compensate and if she eats anything unhealthy she gains"

The Malasorptive component of the RNY does in SOME people lessen somewhat, but never "stops". Her body has not "learned to compensate" as much as she has decided to eat unhealthily again.

Here's the line I really love: "and if she eats anything unhealthy she gains".

Uh….ya think? Maybe? And guess what…..same thing with the Lap Band, the Sleeve, Mini GB, FB, etc, etc.

I cannot believe you actually said that. Eating healthy is CORE to ANY FORM OF WEIGHT LOSS PROGRAM, whether it be surgery, aerobics, Nutrisystem, or any other form of WL system.

And I know what you're gonna say, so don't bother….."but she does eat healthily, blah, blah, blah….."

No, she doesn't, If she did, she would be at goal. That is the one thing about the RNY that you CANNOT say about any other WLS…stick to the rules, and you WILL lose the weight. You may have a small challenge keeping it where you want, but that is true with EVERY WLS. A certain Percentage of RNY patients do, in fact, put some weight back on. But it is a small percentage, the best guess is around 8-12 percent. Again, the words of the Bariatric Surgeon quoted earlier: "it is very difficult (and rare) to put weight back on after a Bypass….you almost have to make a conscious decision to do it."

And….some people DO make that decision. Maybe not so conscious, but there is a part of them that WANTS to be fat…a part that feels comfortable in that condition. So, they self sabotage. That Happens in the Lap Band world as well. Which is why I STRONGLY recommend that EVERY WLS patient seek a long-term course of Psychotherapy as mentioned previously in this…uh….novel.

"I have known many with gastric bypass and 80% have had major health issues. And two did not have resolution to their diabetes."

I keep seeing stuff like this over and over and over. And I believe VERY little of it. If the two did not have their Diabetes resolve, they were eating inappropriately. Period. Or they had an incompetent Surgeon. %80? Ridiculous. Unless they were having major health issues that pre-existed the surgery and they continued to present with the symptoms post-procedure. I don't even buy the "I have known many with Gastric bypass". Most people do not know "many". Maybe 2 or 3. But WLS patients do not generally announce it to the world. Unless you were part of a support group that included Bypass patients, but you did not indicate that. And having a group of Bypass Patients of which %80 have "major" issues is just SO out of proportion to the experience of the Bypass Population at-large (no pun intended) that I would have to call BS on this one, OR suggest that they all went to the same incompetent surgeon.

There is one member of this forum who I find particularly uninformed but babbles about everything anyway, who claims to have personally known 11 Bypass patients. Red flag pops up on that alone. Out of those, they claim that FIVE have died, and only ONE had a positive outcome. Right. Of COURSE that happened. (snicker). That is so out of line with reality. I have told several Surgeons about that comment; they ALWAYS laugh for a few minutes, and say something to the effect that there is an agenda in place somewhere there. And I think that is probably the case.

I have plenty more to say on this, but I won't. I will simply advise the OP to Consider the Bypass, and ignore the people here who have never had one, and have nothing but tales of dubious origin. There is also another post here I will comment on later….more BS from, I think, familiar sources.

You should NEVER base any life-changing decision on comments made in a forum like this. See another doctor. See an Endocrinologist. Talk to several surgeons. See a Psychotherapist. You didn't become Fat overnight, so you can afford to take the time to do the research you NEED to do that will help you in making the RIGHT decision.

I wish you the best of luck in whatever choice you make.

S.

I haven't been here in a little bit but I have read through the comments to the original post. Nice to see everyone responding to the original post with personal experiences and advice. Of course it is always the best ideal to follow that of your qualified medical professionals who will come up with an agreed upon course of action bases upon your particular health issues and concerns. Each person should do what is in their best interest. I experienced some unfavorable results as a result of my gastric bypass surgery as did a few of my friends and family members. Not that it was anyones fault but as previously discussed here each person is an individual and results may vary. As I said, my diabetes isn't resolved but it is much improved I might be one of those people who won't see a resolution to my diabetes for a few years or not at all. If this is the case for you jesse, don't let people make you feel bad or imply that you aren't doing what you are supposed to as had been the case for me during my weight loss surgery journey. My A1C levels are very good since I have switched from using insulin in a needle to using the pump. Which has dramatically changed my life and my diabetes. Everyone is different. I eat very well and exercise regularly. I always did but diabetes is genetic in my family and after I had 4 children my weight and blood sugar levels just kept going up with each pregnancy. So, after 2 years of prequalifying medical screening for weightloss surgery and a bettery of doctors monitoring me, we went with RNY as the best option. My advice previously given here was based on my experience. I am in no way a medical professional and having had RNY surgery does not make me a qualified to giveany medical advice in this area. But, just be advised that there can be complications with ANY surgery. I just want to put out there that there can be some unpleasant results with RNY that you may not have with lapband. Then again you might have them anyway. Ultimately despite whatever advice you may receive from others your own feelings and the advice of your medical team should be primary in your decision as to which surgery you finally decide to have. In the end, my doctor said if he had anyway of knowing that I would have had these issues after surgery he would have recommended the gastric sleeve for me, but hindsight is always 20/20. LOL! Good luck and best wishes!!!