A question for Dr.C.. Or anyone that might have an idea.

amandalp · July 23, 2006

Ive had my consult with my surgeon and been going for my pre op appointments and should be on my way to being banded. However while I had my consult with my surgeon she told me that I should lose about 100 lbs with the band. That would put me at around 195.And asked me if I would be happy with that. But I have a friend with a differant surgeon that just had the band about 2 weeks ago and says that her surgeon says that she should lose alot more than that. And that band patients are at or around the same weightloss as rny patients in 2 - 3 years out. And that band patients keep it off better than rny pateints since they can get fills throughout their life. Is this true? Also everytime I say something that my sergeon has told me she says a whole differant thing that hers has told her. I was wondering do you recommend the band over rny or vis verssa? Any help would be great considering since shes told me this Im kinda wondering if my sergeon is very good. And thinking maybe I should go with rny.

Thanks alot Amanda

Alexandra · July 23, 2006

Hi Amanda,

Deciding which weight-loss surgery to have is a difficult thing. Most of us here opted for the lap band, obviously, so you're not going to get a lot of comments from us about the RNY being better.

There are several things to think about here. If the amount and speed of weight loss is the primary concern, then RNY would seem to be the obvious choice. However, for me and lots of other people there are other factors that are more important: safety, a desire to lose weight LESS quickly, control, speed of recovery, adjustability, safety.

For me personally, I wanted to lose at least 100 lbs but I wanted to lose it sanely and in a way that would guarantee I could keep it off. Banding seemed to me to offer the better opportunity for me to learn new ways to eat, new ways to live to ensure that the weight I lost would STAY off. I wasn't interested in losing 150 lbs in a year and then worrying for the rest of my life about malnutrition, or trying desperately to moderate my own intake to keep the weight off. I needed a tool that wouldn't abandon me two years down the road, that would remind me forever to eat small amounts.

Safety, too, was paramount for me but other people may be willing to take greater risks. If someone desperately needs to get the weight off immediately for health reasons then RNY would seem to make the most sense. But I was healthy aside from carrying all the extra weight, and I didn't want to create a problem where none existed. I just wanted a tool to let me eat less, permanently. Once I had that, I knew, the rest would be up to me.

As for how much weight you will/can lose, it is really up to you in a way it's not with RNY. You will not lose weight in spite of what you eat, like with the RNY, but to my mind that's a good thing. We can't learn if it's happening no matter what we do; we have to have the behavioral reinforcement of negative consequences if we eat the wrong things. Someone might say, but isn't that what the dumping syndrome is? The problem is, only 20-30% of RNY patients experience dumping at all; the rest are on their own. And after a year or two some of the caloric malabsorption disappears, so patients have to watch what they eat even more or the weight will start to come back on. Bandsters still have the tool they started out with years later; there is some changing of sensation, sure, but the physiological processes have never changed so there's nothing dramatic to compensate for.

To me, banding makes the most medical sense. If it doesn't work for whatever reason, it can be removed and the patient is good as new. Other options remain. If RNY results in complications or the weight comes back on, what's left? Particularly for young people it seems to me that banding should always be the first choice.

Sorry for the novel. :rolleyes:

Elisabethsew · July 23, 2006

One of the things that you might want to consider before you decide is, What type of eater are you? This was the frist question the surgeon asked me. Because simple carbohydrates begin digestion in the mouth, people who are sweet eaters and junk food eaters might want to consider Roux-n-y surgery.

Do you thrive on chips, chocolate, candy, yodels, cupcakes, cakes, icecream, french fries, pretzels and the like? Or, are you a relatively healthy eater who can't control portion sizes and is prone to binging? As my surgeon told me, It IS easy to "cheat" the band or "beat" the band by eating foods that can easily slip by the band despite band inflation to restriction levels.

I have a lot more than 100 pounds to lose but I'm not a junk food eater. I just received proper restriction on my third fill (last Thursday) so you have to be patient with the healing process as well as the fill process and can't expect the weight will fall off a few weeks after surgery. After a lot of research and talking with my surgeon, I opted for the band and have no regrets.

As long as you follow the guidelines, there is no reason to expect you can ONLY lose 100 pounds. As you lose, you pick up healthy eating habits and start to lose bad habits. If you're unsure of which surgery is right for you, DON'T schedule ANY surgery until your doubts are satisfied.

Dody · July 23, 2006

Thanks Elizabeth for an informative post. I'm not a "junk food eater" at all. I prefer meat and potatoes. Most of my problem relates to not getting enough excercise because of severe knee problems. I have to lose some weight, but in the end will probably need knee replacement anyway. I think you make some very valid points. I don't care for sweet things....just the basics, but they do add up without much excercise.

Hope you do great.

amandalp · July 24, 2006

I just wanted to thank you ladies for all the info. It has helped alot. My biggest problem I would say is eating to much, When I have a big meal I dont want to stop because I love the taste of food so much. I do eat sweets and junk also. But not all the time. I want the band, but Im just afraid that Ill get tierd of watching what I eat. Im afraid its to much like being on a diet, and I have never been able to stay with a diet very long. I get tierd of it and say oh well Ill just start again tomarrow and then I never do. Is this how some of you where before the band? Or am I someone that will be a failer to the band? Thanks again Amanda

Alexandra · July 24, 2006

Amanda, I was a big-meal eater too, and that's exactly where the band shines the most. It creates a sensation of fullness before you've eaten too much, which makes it EASY to push away from the table when it's time. It's not something that happens overnight--it can take a while for us to recognize that sensation as what it is--but once we allow ourselves to obey what the band is telling us it really is easy to just eat a whole lot less. I don't have to "watch" what I eat anymore; eating more than I need is what's harder to do.

You'll see a lot of people on these boards talking about food journaling and really sticking religiously to a certain number of calories a day. That's fine if it works for you. But I've never been a good dieter and would rather just live my life. With the band, I've been doing just that, and the only thing that's really different is that I EAT LESS. I pay attention to the rule about Protein first (since even if you're not banded, it's very true that Protein satisfies hunger longer), but otherwise I eat whatever I want. I no longer eat AS MUCH as I used to want, and that's precisely why I've lost weight. The kicker is that I no longer want as much as I used to want, and that's the band's doing.

sunsett · July 24, 2006

I just want to say Alexandra could not have said it any better! I too want to live my life and eat what I want. I have learned that making smart chioces is the key and if I want to have a piece of chocolate cake(like I did last week) I'll split it with some one and I won't finish the whole thing. It is comforting to me that I can live my life and not fret about food anymore. And to know that when I leave whatever # I'm on it's gone for good.

I met a ryn lady a few weeks ago. She lost 155 in a year. I think she had her surgery in 95. She has gained at least 75 of it back. I'm sure she's a 24/26 again. I was terrified! I kept thinking oh no is that going to be me. But then wonderful wise people like Alexandra remind me of why I chose the band. My grandmother is 97 yrs old she still drives travels shops drinks and has a full life. I want to be healthy like her and have a long full life.

Good luck on your desision.

xelapaul · July 24, 2006

Amanda, I was a big-meal eater too, and that's exactly where the band shines the most. It creates a sensation of fullness before you've eaten too much, which makes it EASY to push away from the table when it's time. It's not something that happens overnight--it can take a while for us to recognize that sensation as what it is--but once we allow ourselves to obey what the band is telling us it really is easy to just eat a whole lot less. I don't have to "watch" what I eat anymore; eating more than I need is what's harder to do.
You'll see a lot of people on these boards talking about food journaling and really sticking religiously to a certain number of calories a day. That's fine if it works for you. But I've never been a good dieter and would rather just live my life. With the band, I've been doing just that, and the only thing that's really different is that I EAT LESS. I pay attention to the rule about Protein first (since even if you're not banded, it's very true that Protein satisfies hunger longer), but otherwise I eat whatever I want. I no longer eat AS MUCH as I used to want, and that's precisely why I've lost weight. The kicker is that I no longer want as much as I used to want, and that's the band's doing.

Alexandra, you are soooo wise, I just got banded (july 17) and I love reading your posts, they are so informative and inteligent. I hope my altimate outcome will be like yours..... no counting, measuring, weighing, or journoling (new word:biggrin1: )....just knowing when to push your plate away without worrying about the children in Africa. You are an inspiration to me

Alex

amandalp · July 24, 2006

Alexandra,

Thats what I want the band to do for me. I dont want to never to be able to eat a piece of cake if I really want it, like a bday party or something, everyone wants cake for their bday.LOL,,, But I have the problem of even if Im full I still eat, will the band help me with that or do I just have to start making myself learn that Im full to STOP?

Everytime I read something that youve posted it helps me learn more about the band than I have in my search since March06. You have helped me so much. You have answerd the questions that I really wanted answerd, Keep up the good work in replying to everyone that you can. Thank you so much.

FunnyDuddies · July 24, 2006

with the band, in most cases, if you over eat you puke. its something that is very painful to do as well. so you learn quickly to not overeat like that anymore and watch for the signs of being full.

mousecrazy · July 24, 2006

I don't think I can improve on Alexandra's post, which is informative and wise. I only want to "second" it. The choice to receive a band and accept the responsibility of living with it has been the best choice for me. At the beginning, I did log my food, so I could learn to evaluate what I was eating. I don't do that anymore. All along, my goal was to learn to eat "normally." The food itself isn't the enemy; my use of the food was the problem. I've worked on that and am making lots of progress there, even though I still have periods of time where I know I use food as an emotional crutch. HOWEVER, because of the band, the amount of damage I can do is extremely limited. That's a big plus, and it teaches you that you are not solving any problem by filling up your stomach organ. Isn't that idea that absurd? Not that I don't do it sometimes, but how crazy is that, if you really, really think about it?

The band is healthy and safe for the majority of people. You are going to have to make some lifestyle changes, but don't worry about all of them right now. Face them one at a time, as you go.

Good luck with your decision, and read everything you can!

Cindy

Alexandra · July 24, 2006

But I have the problem of even if Im full I still eat, will the band help me with that or do I just have to start making myself learn that Im full to STOP?

Once you have good restriction, there is a point at each meal beyond which you simply cannot eat any more. If you try, you will cause yourself pain and suffering. Depending on your own ability to accept that reality, you'll either stop trying (MOST of us do that), or do damage to yourself by continuing to overeat in spite of your physical inability to do so. My guess is that you'll quickly learn how not to cause yourself pain.

Only you can assess your readiness to take this step. Think long and hard about your food behaviors and be brutally honest with yourself. Those who have the most trouble with banding are those who have obsessive or other behaviors that the band can't fix. For them, therapy may be necessary and may even be more necessary than a band. The band alone can't fix any problems that lie in our heads, and only we know what those might be for each of us.

NancyRN · July 26, 2006

Amandap,

Your first post asked for info about lapband and Roux-en-Y bypass (I think) -- I have some that may help you. A couple of weeks ago, Dr. C posted a link to an excellent article published just 6 months ago on complications of the two surgeries. I learned a lot of new information that would be valuable to consider when choosing between the two surgeries.

Among the conclusions were that for both procedures, excess weight loss is almost identical 3 years out from surgery and 6 years out from surgery (so, at least in this group of patients, the statement that we often hear that gastric bypass results in more weight loss is not true.)

I posted about this article in another thread and would like to share the info in it with you and others. I'm pretty new here. What's the proper Netiquette here? Put a copy of that post here, so people can read it easily? Or post just how to find on the site what I wrote ?