I went to the required community seminar this past Sunday. The surgeon whom I have an appointment with the 7<SUP>th</SUP> was not there, but there were two others from another group. Needless to say I am now very confused. This particular group of surgeons is not performing the lab-band, and did not recommend it over the bypass. They quoted data showing an only 50% excess weight loss in banded patients compared to an 80% excess weight loss with the bypass. They kept emphasizing that with the band you have an appliance in your body for life, and that if you opt for the band first, it is very difficult medically, to then have the bypass. They also explained that they felt more confident with the bypass because patients reported being more satiated than with the band. This they felt gave their MO patients better odds at keeping the weight off.

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I’ve been researching the band and know the weight loss is slower which I am ok with. I also like the fact that the recovery is faster with the band, back at work in a week compared to two weeks with the bypass. However, the idea of the appliance slipping is a little disconcerting. I have two coworkers who have had the bypass and they seem to be doing fine, lost a lot of weight etc. There is a woman in my hometown that had the band about 6 weeks ago. She told my wife she has not had any problems at all and is already eating Mexican food again. She says she has lost 14 pounds so far.

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So I am confused. I like the idea of the less complicated reversible band. But if it is harder to lose and keep the weight off with the band, then maybe it is worth having the bypass. Any thoughts?

My thoughts? Keep thinking. Keep researching. Make sure you are sold on whichever surgery you choose.

And maybe it's more difficult to remove a band and revise to RNY, but it's POSSIBLE. Once you get RNY, you are pretty well optionless after that, although I have heard of folks getting banded AFTER RNY when the weight came back after a few years.

To be fair to yourself, you really need the opportunity to hear a doc that has had success with banded patients and knows what it's about. Surgeons who do not perform Lap Band don't want you to choose it...they lose your business.

It's YOUR choice. Make the one that's right for you. You will have peace about it.

I also had my mind set on getting the lap band. I had an appointment with a very highly recommended doctor about the surgery. He informed me that I also have another choice, I could have RNY bypass. At first I firmly said no, I have done a lot of research...ALOT and I am stuck on the Lapband, then he gave me more information about the bypass, and coming from a doctor, it made me change my mind. He said that he is not talking me into it or trying to force me to do anything, he told me it was strictly my decision.

He got me thinking, and I asked the Dr. "being overweight all my life, and then doing everything to lose weight, losing and then gaining all the time, and now being 28 and 310 pounds, and you being a medical professional with over 30 years experience, which surgery would you choose if you were in my shoes" he said the bypass. I asked if it was reversible because the main reason that I wanted the band was because it was reversible, he said yes the Rny is reversible as well but both surgeries require that you have a lot of complications to be reversed they just don't take it out when you want it out, so I have to think of both as permanent. Then he told me that they both cost about the same. Many bodies reject the band, it has just as many complications as the RNY, you could have obstruction, leakage, port infections, minimal weight loss only 50%, GERD, to top it all off you have to always go for fills which are expensive, and constantly be at the DR.

After hearing all of that from a medical professional, I decided to go to a support group meeting of many people (30)that have had gastric bypass, RNY. I asked questions to all of them left and right, they were very forward, and told me everything I needed to know. It was very encouraging to me. Hence, I decided to go with the gastric bypass. I would rather do that, lose all the weight I need to instead of 50% meaning if I need to lose 150 then I will only lose 75. Doesn't seem worth it for only that amount. I was freaked out about having rearranged my anatomy, but knowing it is reversible, put my mind at ease. GO to a support group. It will make the world of difference. It changed my VERY confused mind, remember, I have done months of research and I think RNY is the best for me.

One person put it very simple for me...he was very confused as well, did not know what to do, he had his daughter (who is very smart) and an attorney that is very successful do loads of research in every which way, books, online, etc. and basically the conclusion is that it is a lifestyle change for the best and the only requirement is that you are very careful with your Vitamins to take daily, and to eat slowly, exercise. Then there is what is called a honeymoon period where your body just loses the weight the first year. I can't wait for this. GOD be with us all and help you make your decision, trust in HIM who is Great and He will help you as He did for me.

WITH CHRIST WE ARE SAVED

Take this for what it's worth. I asked someone I know who is a nurse and banded (very pleased with the results, btw) why on earth the bariatric surgeons in my area aren't doing bands. I thought it might be because they are invested in a certain procedure and don't want to learn a whole new one. She disagreed.

She knows several bariatric surgeons personally. She has seen the results for many people (friends and patients) who have had both bands and bypass. Her take on it was this:

1. Bypass costs more, so generates more fees for the doctor. (And for his hospital -- remember, many hospitals are owned by physician investor groups.)

2. Bypass produces very rapid and noticeable weight loss. Patients are thrilled (at least initially), which means the surgeon gets a lot of positive feedback from them. Also the huge change is great "advertising" for the surgeon.

3. Due to increased complications, there is lots more aftercare and follow-up surgery for bypass, which produces even more extra income for the doctor.

4. Many/most bariatric surgeons have some sort of financial relationship with a surgeon who does tummy tucks. TTs are pretty much inevitable with bypass due to the very rapid loss.

I was kind of shocked at her cynicism, but I can't deny some of this makes sense. I'm sure many surgeons have their patients' best interests very much in mind, but in reality that has to compete with their own financial interests sometimes, I suppose.

Mary

I am with Free on this. What it boils down to is money, it's all about the money. To have the RNY here is an additionl 12 grand. That is 12 grand for about an hour and a half of extra work. Over the last 2 years I have been folowing gene theropy. I am only 34 and if the band fails me hopefully in the next 10 to 15 years gene theropy will be available. I am thankful that I was denied 2 1/2 years ago by my insurance for the RNY. I was not interested in lining someones pockets nor was I willing to be replumbed. Which by the way it ticks me off big time when I have a doctor try to talk me down to a lower price for my services ( I have a lawn and landscape business ) yet they won't budge on their highly priced services. Sure they got overhead as well but I do to. Sorry for the rant. Anyway I know several women that had RNY and they are steadily gaining weight becasue of the stretched "new" stomach. So in theory you will be in the same boat either way. Also it would be far less invase to remove a band vs. revised RNY.

I personally chose the band because of forced relearning. With RNY the weight "falls" off because of the re-routing (malapsorbtion). But because of that, you don't HAVE to learn to eat correctly.

Fast-forward to 2 years out:

RNY folks have been at goal since 18 months (more or less). They're feeling good & probably aren't monitoring themselves as closely. They're eating worse & starting to stretch the pouch.

Band folks are just getting to goal. They've learned to eat small gradually. As they learn one amount & lose to that point, they get a fill to decrease the amount they eat. They know that they can eat around the band, but that will effect their success. They've HAD to work hard to lose it all... the band was just a tool that helped them be successful at it.

Of course there's more to it then that, but that was my basic thought process. I'm lazy... and won't change if I don't have to!

Good luck on your decision!

I’m on a diet now in preparation/hopes of either the band or bypass, and as usual I am loosing weight. As in the past, I know that if I keep dieting I can loose 25; maybe even 30 pounds, but I have always gain it back. I’m 42, 5’7” and weigh 238 pounds. My total cholesterol is over 250 and my fasting triglycerides are over 500. I’m smart enough to know that I can either have some sort of WLS now, or heart bypass surgery later.

It just feels like such a failure, at least to me being a man, to have to resort to surgery to not be fat. I know in the seminar they said that 80% of all WLS patients are female. I know there are a lot of fat men out there; I wonder why more don’t opt for help? My wife is very skeptical about “me” having WLS, but would be in complete empathy with her friends if I had to have a triple bypass or had a heart attack. That’s what men have. They either live healthy or die.

I went to the required community seminar this past Sunday. The surgeon whom I have an appointment with the 7<SUP>th</SUP> was not there, but there were two others from another group. Needless to say I am now very confused. This particular group of surgeons is not performing the lab-band, and did not recommend it over the bypass. They quoted data showing an only 50% excess weight loss in banded patients compared to an 80% excess weight loss with the bypass. They kept emphasizing that with the band you have an appliance in your body for life, and that if you opt for the band first, it is very difficult medically, to then have the bypass. They also explained that they felt more confident with the bypass because patients reported being more satiated than with the band. This they felt gave their MO patients better odds at keeping the weight off.

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I’ve been researching the band and know the weight loss is slower which I am ok with. I also like the fact that the recovery is faster with the band, back at work in a week compared to two weeks with the bypass. However, the idea of the appliance slipping is a little disconcerting. I have two coworkers who have had the bypass and they seem to be doing fine, lost a lot of weight etc. There is a woman in my hometown that had the band about 6 weeks ago. She told my wife she has not had any problems at all and is already eating Mexican food again. She says she has lost 14 pounds so far.

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So I am confused. I like the idea of the less complicated reversible band. But if it is harder to lose and keep the weight off with the band, then maybe it is worth having the bypass. Any thoughts?

My advice is to do your homework. I was going to have the bypass, but instead went with the band. Also, it's not entirely correct that the bypass is reversible. I was advised that it is much more dangerous if they go back to try to reverse it. Good luck with whatever decision you make.

There's quite a few guys on here, I know my husband already says he would do it again. (If you want to hear from the men, lol, change your title to say: "Confused! Help wanted from the men out there!" From watching my hubby, they pick & choose their threads a lot, lol.)

I think it's harder for guys because you're expected to "be strong" & admitting you need help is the opposite of that. And for your wife (assuming she's the cook), it means a new way of life... it can be scary for the spouse!

I'm SOOOO glad Mikey & I did this together... we never would have succeeded alone!

Gastric Bypass was never a choice for me. I didnt want my stomach cut up and redirected. I picked the band because it is less invasive with less serious complications overall. My doctor does both surgeries and in his seminar goes over each in detail. He does not push one over the other, just gives the facts on each surgery. According to my doctor RnY is extrememly difficult to reverse, and he said most attempts are unsuccessful.

So as other have stated....do your homework!!! My friends sister had bypass...lost well over a 100lbs....and has gained it all back, her eating habits did not change...and she expanded her new pouch and is eating the same way she used to. I think when you look at long term results with the band vs bypass you will see quite similiar results for weight loss.

Bottom Line: Do what is best for you, research it all so you know you made the right choice.

My perspective is this, before you make any decisions take the time to really understand what motivates your eating. There are many reasons people are overweight and the reasons you over eat are crucial factors in your decision.<O:p</O:p

<O:p</O:p

I am, and always been a big eater with a big appetite, I am less of an emotional eater, although I do at times eat for emotional reasons. If your eating is primarily physiologically based then I think by-pass might be a better option, if however you’re eating is more physiologically based then the band may be a better option.<O:p</O:p

<O:p</O:p

Simply put because I am more of a "food lover" and less of a "me hater" I chose the band. If you eat to fill a hunger chose the band if you eat to fill a void choose bypass. (And possibly invest in a psychiatrist).<O:p</O:p

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The surgery should be a consideration but your eating habits must be considered as a primary decision driver.<O:p</O:p

The "male" part of this is interesting, isn't it? Ok, I realize that many of the non-males in this forum may not think it's interesting But the fact is, there is that aspect of this decision that might feel like failure. If I was enough of a man, I would just choose to be thinner and healthier - and it would happen. After all, I am master of my domain - not an intentional Seinfeld reference, but since it's there, we'll go with it!

When I chose to have the band surgery, there was definitely some of that 'maleness' I needed to overcome. One of the aspects of 'maleness' that kept jumping out at me was the (misguided) belief that I needed to have more control over my circumstances. I needed to be able to just 'decide' and things would immediately start getting better.

But it didn't really take me very long to change my thinking a little. I came to the conclusion that my decision to have the band was a choice - a way for me to re-assert myself, to impose some control over the situation. As you said, our choices at this point are fairly limited. For many years, I demonstrated that I was either unable or unwilling to make the necessary changes on my own. So, as you said, I had to realistically look at a reduced set of choices: something fairly direct and drastic (like this band surgery), or something even more direct and drastic (heart attack or stroke or...).

I know the statistics show that the majority of patients for this type of procedure are female. And I know that the majority of the members of this forum community are female. But there are quite a few men on this board - and many of us actually post on occasion.

In my own personal opinion (as one who is not a medical professional or a mental health professional or a Inamed Lap Band sales person - but as a male) the lap band surgery is a better choice for men... all things being equal. In general, the band forces us to make conscious changes in the way that we do things - pretty much permanently. In general, RNY or other gastric bypasses will allow you to lose weight without making any real changes. (I do realize that's a generalization - and that the right choices and changes would help the RNY's effectiveness.)

Already - I've only been banded for a month - I can see the difference in my life. I've made changes in my habits, and I can see changes in my body. This simple cause-and-effect scenario is very appealing to my simple male mind - and as my wife said a couple of posts back, I definitely don't regret my decision to have this surgery... I would do it again in a heartbeat.

Hi Wssmith! Welcome to LBT and Bandlandia.

It is really hard to get an objective point of view on WLS. It is such an emotional issue. I think it is quite natural and obvious that your bypass folks would insist that their WLS was the superior, just as Bandsters know that we have chosen the only sane WLS option.

I view it as a religous thing. Folks that belong to one faith are pretty much convinced that they are the ones with the true answer, and anyone who doesn't believe the same way is just wrong. Banding v. Bypass is just the same sort of argument.

I'm always suspicous when people bandy about statistics like bandsters only loose 50% of their excess weight. According to what study? What's the time line, and how many long term bandsters were included in the study. I've been on this board for over a year, and have yet to see anybody involved in a WLS weight-loss study. We have two bandsters that I know of that were involved in a trial, but 2 out of 6,000 LBT members doesn't constitue any sort of sample size. No one from my clinic has been involved, at least not to my knowledge, and they are a pretty vocal bunch too.

I do know that I see the success stories here. I do know tht my husband has lost 200 pounds, and I'm pretty sure a bypass would have been too much for his system, and would have killed him.

I wish you the best in trying to figure out what way you want to go.

I personally chose the band because of forced relearning. With RNY the weight "falls" off because of the re-routing (malapsorbtion). But because of that, you don't HAVE to learn to eat correctly.

Fast-forward to 2 years out:

RNY folks have been at goal since 18 months (more or less). They're feeling good & probably aren't monitoring themselves as closely. They're eating worse & starting to stretch the pouch.

Band folks are just getting to goal. They've learned to eat small gradually. As they learn one amount & lose to that point, they get a fill to decrease the amount they eat. They know that they can eat around the band, but that will effect their success. They've HAD to work hard to lose it all... the band was just a tool that helped them be successful at it.

Janet put it very well, and this reflects a HUGE piece of my thinking on the matter. Banding leaves the control in our hands, and RNY takes it away--but only for a while. I recognized that I couldn't control my weight on my own, but RNY doesn't solve that problem permanently. 18 months is NOT long enough to unlearn a lifetime of bad habits. I needed, and need, continuing behavior modification.

Hi, and welcome to the board.

If possible, ask where their statistics came from. The last time I saw statistics like that, they were from over 3 years ago. A lot of changes have been made since then, and a lot more people have gotten the procedure - meaning a lot more chance for success. There's no biological/physical reason why someone wouldn't lose all their excess weight as long as they're maintaing good calorie intake to calorie expenditure ratios.

As for which procedure to get - that has to be your choice. I initially debated RNY nearly 5 years ago, but never felt good about the decision to have my anatomy permanently changed. I just couldn't comprehend that as an option, even though I'd seen co-workers get RNY and lose all their excess weight before their 1 yr anniversary.

Best of luck with your decision!

I found Tommy and Mikey's comments very interesting. I have to disagree with Tommy a little though, which is unusual because I typically think he is right on the money with all of his opinions. He really is awesome. Anyway, I am an emotional eater and a self hater and the band is perfect for me. As Janet pointed out, RNY patients lose the weight in spite of their typical eating disorders but two years down the road they haven't changed a thing about why they were fat in the first place. Many put the weight back on and are stuck with the results of a surgery that will be with them for life. The band reminds me daily that I have to be careful about my food choices and it prevents me from punishing myself with enough food to make me sick for hours after eating it. I noticed on Inamed's site that they say people with sweet tooths aren't good candidates for the band because sweets are typically in foods that are easily gotten around the band. I can see that being a real deterrent.

Mikey, men are not alone in that feeling of "I should have been able to do this on my own." I struggled so hard with the guilt of having to spend $26,000 (something we might never see again) for my band. I still have to eat smaller portions, make better choices, turn away from foods that make me fat, get exercise, and drink Water. Why on earth couldn't I just do that on my own? It was a tough one to get past, and only my family's reassurance that they couldn't think of a better way to invest that money helped me go through with it. I felt weak and selfish. Now I just feel grateful to them for loving me so much. And now I see myself as being in training. I'm not weak at all. I'm going through a boot camp of sorts, where my old self is being broken down and retrained to become something stronger. I can be proud of that. I now understand that when I reach my goal, it will be because of MY hard work and dilligence.. not because someone took away all of my choices and made it happen for me.

Anyway, Wssmith, I wish you the best in finding what's right for you. For me, I would never do the RNY. The surgery is far too risky, the sideaffects are far too bad, and the long term success rate is far too low for me to make such a choice. But each person has to decide what's best for them. I would, as many have suggested, find a different doctor and get more professional opinions about the options. That meeting sounded oddly biased.