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Hi :)

My name is Amber and I am 20 yrs old.

I weigh 450 lbs. I have been morbidly obese all my life. Ive tried diet after diet and nothing worked. I recently recieved an offer to get lapband surgery. I immediately accepted. After doing some research I begin to get nervous about the surgery, For reasons, people that are morbidly obese shouldnt get lapband surgery, lapband doesnt work, and there are a lot of complications. I looked at other WLS but I dont think I want to undergo that kind of invasive surgery. I need help!! What are you guys opinions? thoughts? suggestions?

Thanks

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Hi, it's understandable to be nervous and anxious and not know what's right to do.

I'm 35 and always been morbidly obese since my teens. I decided about 4yrs ago I needed help as dieting etc just weren't working for me. I knew I didn't want a band so I got myself all in the mind set of a sleeve then when I see my surgeon in May she said they may do a bypass I got myself in a state and didn't know what I should do but in the end I went with what my surgeon thought best and in July had a bypass and don't retreat in one bit. You have to go with what you feel is right not what others tell you. All the best in whatever you decide

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I wish I had gotten sleeved a decade ago. A sleeve is less invasive than bypass, you can eat normal foods after your healing process and there is less chance of dumping and malnutrition.

The sleeve works by restriction, not malabsorption, and your intestines all stay intact.

Do some research, ask a WLS specialist what they would recommend for YOU and do one thing before your knees and back go, before you develop co-morbidities, while your skin will stll shrink back and while you are young enough to live a long life of health!

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Oh so much to talk about with this..... Sorry, but I'm going to ramble a bit.

First off, there are risks and benefits to each of the three surgeries (as background I had a lap-band, miserable with it, prolapsed, lead to emergency removal, and now have a gastric bypass. I'm also a family practice physician assistant. I'm not a bariatric expert, but I've been around this a bit).

On average, lap-band patients do not lose as much as the other 2 surgeries. That is why surgeons typically don't recommend lap-band above a certain weight. That said, I know people that have lost 200+ pounds with the lap-band. Average weight loss is just that, an average. For everyone that loses 10%, there's someone that loses 80% of their excess weight. It's impossible to predict where you'll fall in that spectrum. Some of it is how good your surgeon is, some of it is how dedicated you are to lifestyle change, some of it is sheer luck. As far as the band, I won't say don't do it. I will say research your butt off. Again, weight loss tends to not be as much as compared to the other 2 surgeries. I would like to add that, while the band is known for it's reversibility, that is not entirely an accurate statement. My personal story was that my band prolapsed, stomach herniated (and before i get jumped for being a bad band patient, I wasn't a bad band patient....sometime crap just happens). I had an emergency removal and was supposed to revise to gastric bypass, however, once the surgeon got in to remove the band I had so much swelling and inflammation that he was not able to do the revision. They removed my band, sewed me up, sent me home to heal for 6 months, then I had my revision. I know of at least 2 individuals in my area that had band removal and had so much damage that they could not revise to another surgery....while the band is removable, I don't really feel the term reversible is 100% accurate.

Another point I'd like to share is 'invasive' truth be told, you're having major surgery. All 3 surgeries are invasive. The sleeve does not have the malabsorption issues or dumping associated with the RNY. However, they are essentially cutting off a large section of your stomach. The RNY does have malabsorption and possibly dumping (most people don't dump, I happen to be in the minority that dump easily, it's really not a huge deal if I watch what I eat). Yes they are making a small pouch in your stomach and bypassing and small portion of your intestine, you are getting some replumbing done with the RNY. That said, RNY is reversible (again, subject to scar tissue and such associated with previous surgeries) IF you need reversal. The vast majority of us will never consider reversal because we need this surgery to maintain a healthy weight.....(reversibility was not a factor in my choosing RNY).

I know people that have been hugely successful with all 3 surgeries. I know people that have lost almost nothing with all 3 surgeries. I know people that have had bad complications, hospitalizations, ICU admissions with all 3 surgeries. None of them are magic. None of them work without a commitment from the patient. It is not something to step into lightly.....

My advice, research, research, research. Find a surgeon that you trust and listen to what they say and what they suggest. Ultimately you have to make a decision that you are comfortable with and that you can commit to. But know that every day you spend morbidly obese is taking a toll on your body and your health. Most of us just cannot lose an maintain a healthy weight without surgery. Most of us have lost and gained a thousand times. There are some that regret the surgery but the vast majority of us wish we'd done it sooner. The RNY is right for me, I wish i'd done it in the first place. But I'm not you.

I wish you the best of luck with the decision and applaud your choice to start considering surgery. If you ever have questions I'm happy to try to help. Best of luck with this decision and congrats on trying I take control of your health. It's a tough choice but at least you're considering it. That's a step in the right direction.

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i think most bariatric doctors, etc would recommend bypass to you simply because you arent going to lose as much weight with the sleeve. you will lose only a percentage of excess weight not matter what route you go, bypass will allow you to lose the most.

i am not sure you are a candidate for any wls right now though. i know the hospital i was at will only operate on people 400 pounds and under, its simply too risky for most people at 450 pounds. but it might depend on your co-morbidities. if you are generally healthy, which at your age, you might be, they might agree to do it. have you gone to see a bariatric doctor yet?

really this is all about how bad you want this. if you are ready to do whatever it takes to be normal weight, then you accept the risks... 'cause seriously, what is your quality of life right now? honestly? if you can be truly honest and really look at what your life is as a morbidly obese person, versus what it would be like if you weighed a third of what you do... well then the surgery doesnt seem so invasive anymore, yk?

do some heavy duty soul searching and then you will have your answer. good luck.

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There are bariatric surgeons who are able to successfully operate on patients weighing >400 lbs -- if you live in the U.S., I would strongly encourage you to limit your discussions to Bariatric Centers of Excellence who have the expertise, equipment, facilities and experience to successfully provide WLS.

At my hospital, we regularly provide WLS to patients in our region in this weight range. Of course, the work up prior to surgery ensures the patient is physically and mentally able to tolerate surgery and have a positive outcome following.

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