Hi,

I was just wondering out of my own curiousity how something would work.

This is just a scenario, not a "real patient".

Say you have a patient who is banded and 18 months later they are eroded. This patient is down to say 125lbs from 250. At this point they are no longer obese or overweight.

In one of your posts you recommended changing over to gastric bypass or some other surgery (sorry I don't remember). Would such a thing be done on someone as small as 125 (or even within the normal limits of BMI) or would they have to gain a lot of their weight back in order to have a different type of WLS??

Like I said I'm just curious and not trying to start a debate. It's just something I thought up..

Thanks

I have always wondered this myself ! I am curious as to what the answer will be !

Of course, if someone is self pay, it doesn't really matter what their weight/BMI is, I am assuming.

I am a patient of Dr Pleatman and yes the person would still be able to have roux n y surgery. Dr. Pleatman would tell you that if a person is 125 and has roux n y they will only lose up to their normal bmi or possibly a little under. Your body has a way of stopping itself from losing more than that. I am only responding to your question because I have asked him the same thing myself. Hope this helps

I asked the exact same question in an email to him. I hope he doesn't mind me sharing his reply so he doesn't have to repeat himself:

"Hi (sorry but I don't know your name)

So far I don't have enough information to answer your questions. If you

were originally morbidly obese (BMI over 40) or severely obese with major

comorbidities, then most surgeons would agree that a different bariatric

procedure would be indicated following removal of the band, since chances

are you would regain all your weight if the band was removed.

I only say this because I've seen some patients who were banded in Mexico

with BMI below 35. In my opinion, they should never have been banded in the

first place.

There are always options after band. Whether eroded or slipped, you can

have another procedure done. For eroded bands, I generally prefer removal

as the first step, followed by gastric bypass later when all the

inflammation has subsided. I've done this on a patient who was banded in

Mexico 5 years ago. For slipped bands, I am happy to do the conversion at

the same time the band is removed. I've done this quite a few times.

If you are doing well with your band, recognize that most patients continue

to do well, and do NOT have these complications. Enjoy your life and weight

loss, and worry about problems if they occur. Try to avoid having your band

very tight, as this may minimize the risk of both slippage and erosion.

Good luck.

Mark Pleatman MD"