No more lap bands in my area?

[5.0junkie 770]

Of the three bariatric practices I visited in my state, two refuse to do lapband (entire practice, not just individual docs) and the third had one doc out of twelve who would only do it if you did a WHOLE LOTTA pre-op work. I wasn't interested in LB but I did find this trend interesting.

Which state? Did any of the surgeons happen to provide reason as to why they wouldn't do it? Did the one doc say why he would do it but required so much pre op work?

[5.0junkie 770]

My surgeon, nutritionist, and my own research all confirm that it's a big myth that you can't lose weight both quickly and in a healthy manner. If you're starving yourself or losing because of malabsorbtion, then yes you can become unhealthy and sickly looking. But if you're getting the necessary Vitamins and calories you most certainly lose quickly while remaining healthy.

Protein is pushed immediately after surgery, second only to hydration for VSG patients.

(I cannot speak to RNY aftercare)

This is in part to ensure that vital organs, like the heart, are staying healthy while the rapid weight loss occurs.

If a patient chooses to ignore the postop diet, designed with healing and health, then there certainly is risk.

If a patient follows those guidelines then the risk is greatly mitigated.

This makes sense. I appreciate the response. I had always wondered if it was fact or myth because I had always heard regardless of healthy you did it, it was still unsafe to lose rapidly. Basically always heard something to the extent of "you didn't gain it overnight, don't lose it overnight." The only other part to my question is this, if you lose so much so quickly, does your skin have time to catch up? Is such rapid weight loss what contributes to having loose skin or is that attributed to just losing in general? If slow and steady wins the weight loss race, can you prevent having the need or desire for future cosmetic surgery or does it even matter?

[AmandaRaeLeo 2,145]

The amount of loose skin is affected more by age and how stretched it was to begin with. Plus hydration.

Rapid weight loss causing saggy skin seems to mostly be an urban legend.

[LipstickLady 25,682]

Which state? Did any of the surgeons happen to provide reason as to why they wouldn't do it? Did the one doc say why he would do it but required so much pre op work?

Virginia.

Yes, I was given a reason for no lapband just I was given a reason by one of the surgeons as to why he preferred not to do sleeve. No, I really don't want to list them here for fear of being strung up by my toes for being a band hater, something I am not.

As for the doctor who would do it, I didn't pursue it because I was not interested in the band, but a friend of mine did and from what I understand, it's because there is so much more of a learning curve with the band, the doc wanted to make sure you were completely prepared. From what I've read here about full, unfills, green zones, sweet spots, ticklish area, pink butterflies, zombie apocalypses, etc., I see why!

[mrsto 2,925]

I'm glad you said this. Brings up a lingering question I've had. It seems like I read or hear so many instances of huge loss amounts within months of the surgeries aside from the band. This is great for those people losing weight and I commend them on their journey. My question is this though, can you lose weight too fast?? I've heard that you can and its obvious that dramatic amounts of pounds can be shed quickly with the other surgeries. Excuse my ignorance again but is that really all that healthy or safe? Again, I'm asking, not trying to wage a war. I truly seek an answer.

I'll go back to my "in a perfect world" state of mind…… I think it is healthier to lose a bit slower than weight virtually melting off from malabsorption. However (as I've been told), some people are in such a horrible state of health, which is more dangerous to them than the rapid loss. I agree with you……I don't think it's healthy, but some folks are at deaths door from diabetes, etc.

The thing that I don't like about the RNY honeymoon period, is that the weight seems to come off effortlessly. Effortlessly isn't reality, and sooner or later that stops, and they end up where we were immediately post op. I almost had that surgery; was scheduled for it, but freaked out 10 days prior. I was deathly afraid of potential irreversible complications, so I went with the band plus plication. I sleep a lot better at night knowing that I can "undo" the whole thing, should problems arise. I had lunch with a woman yesterday, who has had her band since Allergan put them on the market. She did very well; lost lots of weight, looked great, etc. But over the years and various life events, she's put back all but 20 pounds. She's still got the band, but she's not working it. But she has had that band inside her body for many years, with zero issues. I hope to God that is me……not the weight gain part, but a happily settled in band :-)

I know I keep saying this, but I feel strongly about it. No one surgery is better than the other. It just depends on the person, and what works best for them. I went to a general support group at my doctor's office, and there were several RNY patients. All of them felt that if they were going through surgery, that they wanted to go through with (as they put it) the BIG surgery. They've all done very well…….to date. With compulsive overeaters, it really is a day to day thing. I've heard people (one in particular) stand up in these forums, claiming to be cured of this affliction. I say…..the jury will always be out, until our dying day. I'm not a pessimist, I'm a realist

[mrsto 2,925]

:-)

Protein is pushed immediately after surgery, second only to hydration for VSG patients.

(I cannot speak to RNY aftercare)

This is in part to ensure that vital organs, like the heart, are staying healthy while the rapid weight loss occurs.

If a patient chooses to ignore the postop diet, designed with healing and health, then there certainly is risk.

If a patient follows those guidelines then the risk is greatly mitigated.

If you stroll through the VSG forums you will find many a post bemoaning Protein shakes.

This is the same for band patients. Protein is numero uno, and hydration. The post op diet varies widely, as we've seen in the LB forums, but typically, it's protein protein PROTEIN, and other foods are slowly added back. Even still, it's always protein first, with at least 8 glasses of Water per day.

[Purple Iris 14]

I met with my PCP on Friday and he said that a lot of surgeons are not recommending the band anymore. Interesting!!!

[mrsto 2,925]

This makes sense. I appreciate the response. I had always wondered if it was fact or myth because I had always heard regardless of healthy you did it, it was still unsafe to lose rapidly. Basically always heard something to the extent of "you didn't gain it overnight, don't lose it overnight." The only other part to my question is this, if you lose so much so quickly, does your skin have time to catch up? Is such rapid weight loss what contributes to having loose skin or is that attributed to just losing in general? If slow and steady wins the weight loss race, can you prevent having the need or desire for future cosmetic surgery or does it even matter?

There are various factors that play into the loose skin issue. Number one being, how much weight is lost. The other is age. I lost 90 pounds when I was 43 (lost the weight many times, but before now, that was the last time). Other than my legs, I had zero skin issues. I don't carry the weight around my mid-section, and I was pretty lean and tight from the waist up. This time around (I'm 58), I'm flabbier, but still don't have (and will not have) any apron or other issues. STILL, from years of gaining and losing, my lower body is disgusting (imo). Anyway…….the other thing is, if someone has to lose 200 pounds, I don't think it matters how slow or fast it comes off. That is a lot of stretch in the skin, and a snails pace of weight loss isn't going to avoid some sagging.

Long winded answer……caffeine is kicking in - LOL.

[SoccerMomma73 1,867]

I'll go back to my "in a perfect world" state of mind…… I think it is healthier to lose a bit slower than weight virtually melting off from malabsorption. However (as I've been told), some people are in such a horrible state of health, which is more dangerous to them than the rapid loss. I agree with you……I don't think it's healthy, but some folks are at deaths door from diabetes, etc. The thing that I don't like about the RNY honeymoon period, is that the weight seems to come off effortlessly. Effortlessly isn't reality, and sooner or later that stops, and they end up where we were immediately post op. I almost had that surgery; was scheduled for it, but freaked out 10 days prior. I was deathly afraid of potential irreversible complications, so I went with the band plus plication. I sleep a lot better at night knowing that I can "undo" the whole thing, should problems arise. I had lunch with a woman yesterday, who has had her band since Allergan put them on the market. She did very well; lost lots of weight, looked great, etc. But over the years and various life events, she's put back all but 20 pounds. She's still got the band, but she's not working it. But she has had that band inside her body for many years, with zero issues. I hope to God that is me……not the weight gain part, but a happily settled in band :-) I know I keep saying this, but I feel strongly about it. No one surgery is better than the other. It just depends on the person, and what works best for them. I went to a general support group at my doctor's office, and there were several RNY patients. All of them felt that if they were going through surgery, that they wanted to go through with (as they put it) the BIG surgery. They've all done very well…….to date. With compulsive overeaters, it really is a day to day thing. I've heard people (one in particular) stand up in these forums, claiming to be cured of this affliction. I say…..the jury will always be out, until our dying day. I'm not a pessimist, I'm a realist

There's a learning curve with RNY just as there is with band and sleeve...as a revision to RNY I never got that awesome 10 pound a week weight loss some others do, I think I maxed out at 3 a week a time or two, very similar to my band loss (dammit!!) (off topic, if anyone has data to explain why revisions lose slower I'd love to see it!!! My surgeon warned me, my personal experience says the same. I assume it's because my body has gotten smart from the previous ups and downs and knows how to conserve every ounce it gets but really have nothing to back it. If you read the RNY boards (which I encourage, cuz again, we're all in the same boat essentially) at some point between months 3-6 there tends to be a rather long stall then a significant slow down in how fast weight is lost. If you've done the lifestyle changes things pick back up, if you haven't then they slow way down.

The thing with Amy of these surgeries is that the surgery is only a small part of the equation. Long term, eating healthy and exercise are what will get you to goal and keep you there, the surgery helps for sure, but it's not magic.

Two of my best friends are sleevers who have lost next to nothing over 2 years...they don't exercise, one lives off soda. This equation doesn't add up to weight loss. I have at least 2 acquaintance that are years post RNY and are around 300 and 400 pounds respectively...they had decent success initially but again, being parked on your ass with a Big Mac and big gulp does not work long term. I am VERY direct with my patients about this before I refer them to a bariatric surgeon. They look at me and think damn that was easy but in reality I'm 40 pounds from goal and work hard for what I lose....the RNY helped (couldn't have done it without it!) as did the band in step 1, but the majority,of this was hard earned

[AmandaRaeLeo 2,145]

Awhile ago I started a VSG Urban Legends thread. It was educational and absurdly hilarious at times.

http://www.bariatricpal.com/topic/247367-vsg-urban-legends/

[DELETE THIS ACCOUNT! 12,703]

Mis73

Congrats on your success. I hope to share very similar numbers when Sleeve Perry and I get to goal.

I'll not quote you but it seems like your last two posts proclaimed your success, as well it should, and slammed alternative WLS options, which is counterproductive and fuels the fire.

If you do not want the drama then perhaps join me and many others in ignoring those who stir the pot and instead wish to share in each other's successes?

How did my posts even remotely slammed other WLS? I never even mentioned other WLS in my post about my own weight loss speed.

[AmandaRaeLeo 2,145]

I apologize if misunderstood...

Perception is reality and tone is subjective.

I did not misunderstand how impressive your success is. Congrats. I hope to achieve very similar numbers. I'm approximately half way to goal.

[2muchfun 8,927]

I met with my PCP on Friday and he said that a lot of surgeons are not recommending the band anymore. Interesting!!!

My Pcp said the same but my bariatric doc immediately recommended the band for me. Pcp's are not the experts in this field. Imo

Tmf

[DELETE THIS ACCOUNT! 12,703]

My Pcp said the same but my bariatric doc immediately recommended the band for me. Pcp's are not the experts in this field. Imo

Tmf

You are dead right, TMF. In fact, a lot of PCP's are just as ignorant as the general public about WLS surgery in general. I wouldn't get advice on knee replacement surgery from my neurologist, just like I wouldn't get bariatric advice from my PCP. Totally different specialties and fields of expertise.

[Sharpie 3,306]

wow this is quite a active thread.. I had 55 emails related to t this subject.. I joined this site (Lapbandtalk) to see other people's success and learn about their issues with their band.. I don't want to banter back and forth with bypass and sleeve people all the time.. it's counter productive.. You are not going make me run out and get a sleeve or bypass because you think you are right... I lost a friend who had bypass surgery and was okay for a little while then had severe malnutrition.. I see people who have re-gained all of their weight then some who had bypass (case in point Carnie Wilson).. she now has a band over bypass.. don't know about the sleeve don't care I'm not have my healthy stomach hacked up... My surgeon specializes in lapbands.. however he did discuss the other options with me.. It was my decision.. I am totally happy with my band.. I think some people just need to get a life and stay out of other people's business... I am going to stop visiting Bariatric Pal.. it's no pal to me...