I have just started my new weight loss journey. Like many others, I have a history of failed diets and temporary weight loss. Several years ago, I managed to lose 70 lbs in one year using traditional methods such as exercising 6 days a week, eating one small meal a day and taking prescription diet pills. I ended up looking great except for the hair thinning, heart palpations and tachycardia and the loss of 3 teeth and gum disease. Starvation is not a good plan so I started eating 3 meals again. I only kept it off for a short while and within a year it was all back plus 30 lbs more. I now weigh more than I ever imagined I could ever weigh. I am pre-diabetic, borderline hypertension, borderline hyperlipidemia, have probable sleep apnea, osteoarthritis and severe GERD. I am way overdue for a lifestyle change but I need help.

I had a consultation with a weight management doctor last week. He recommended bariatric surgery right off the bat. He suggested I have the gastric sleeve procedure. My insurance will not pay for it so he then recommended gastric bypass surgery or gastric banding. My insurance will pay for either one. He told me that he felt that the Lap-Band is a waste of time and that most of his patients end up having it removed. He recommended that I have the gastric bypass surgery. He has a stellar reputation as a bariatric surgeon. BUT.....

Here is the problem: I do not want any part of my body cut off or re-routed. I do not want my intestines altered in any way as I have enough trouble with them as it is. I do not want my digestive system altered and suffer the effects of mal-absorption. Before I had the consultation with a bariatric surgeon, I had already decided I wanted the Lap-Band to use as a tool to help me lose the weight in a healthy way. So, why are some doctors now saying that it is a waste of time??? Is it really true? What to do now?

I am more confused and frustrated as ever.

Let me interject a slightly different point of view?

I went with the band for many of the same reasons you prefer the band. But I know myself, I know I'm in control and I understand how this all works. Maybe your physician has some insight into your own personality and feels you may not be true to the band? The band will require much more attention than the other WLS techniques. No grazing, no bingeing, following the eating very slow and chewing chewing chewing is a must. Follow up and aftercare is so important with the band. Can't tell you how many posts we've seen from people who are 8 years out and haven't been back to see their doctor for 6 years, mostly due to loss of insurance and lack of funds.

There are some patients who should not be Lap Band patients. The Lap Band was the marquee WLS 4-10 years ago, but many surgeons didn't understand how much follow up would be required and many surgeons suck at communication and follow up. Many patients were given maintenance instructions that were counter intuitive to what the best surgeons communicate today.

So, are you a good candidate? Get a 2nd opinion and be very honest with your surgeon so they can recommend the best surgery for you.

tmf

Hi omg just today i went to see my doctor in Perth WA and he said the same thing to me dont do it dont go there ...well i cried i was so upset i told him i am i am doing it .....if i could diet and exercise on my own i wouldn't be here in the first plc ...omg i wanted to die... but iv made another appointment with my daughters doctor he will give me a referral is all i waned .. i will do this i am confidante and positive. thanks for your post everyone.

Good luck Tljohan and Fatima! You have done the research and have made the decision that you feel is right for YOU! Good for you not giving up.

Sumner

Edited September 9, 201411 yr by Summer Rain

I agree with your surgeon. Go big or go home. Who wants a foreign object implanted in them only to erode or slip. Then most likely at some point you will have it re done cause it does not work well in comparison to iterate methods.

Go with the sleeve, you keep your stomach and no nutrient absorption!

whatever WLS you and your doctor feels is best for you and your (lifestyle)

i wish you all the best...please note that just having WLS wont fix/solve your weight issues.

it will help but it is UP to you to eat better (yep you can and you will) and exercise (start small

and finish strong) and do the best you can and as your doctors advise for best results.

you can do it..best of luck

I know this has been beat-up and bashed on both sides of the debate. I for one got the band with my own money. doctors love to take cash. Not all want to teach and follow up. which did cause me to gain some back. I learned found good doctor, and l learned a lot from this site.

I do read about problems with All the different wls. I read the other day that gastric bypass that has a feeding tube put in, also a sleeve that leaked. yes you hear the band slip.

you will hear them all, first it is yours to choose. I don't mind the slow way, I have developed eating routine that helps me loose. i am Happy and isn't that why we are doing this!!!!!!

Good responses on this thread. Let me just add that I started at your weight, and the first surgeon I saw said a similar thing...he was seeing more lapbands come out than go in, and he recommended a sleeve for me. I wasn't comfortable with that option (although if I ever lose my band and cannot reband, I might consider a sleeve) so I went and found a highly-competent bariatric surgeon who DOES do bands and was fine with my choice.

Personally I am thrilled my band. While my loss so far is not as impressive as some others, I know without a doubt I could not have lost this much and maintained this loss without my band.

As others have said, the form of WLS you choose should be your choice, and it's best to do your surgery under the care of a surgeon who supports your choice.

Edited September 9, 201411 yr by parisshel

Let me interject a slightly different point of view?

I went with the band for many of the same reasons you prefer the band. But I know myself, I know I'm in control and I understand how this all works. Maybe your physician has some insight into your own personality and feels you may not be true to the band? The band will require much more attention than the other WLS techniques. No grazing, no bingeing, following the eating very slow and chewing chewing chewing is a must. Follow up and aftercare is so important with the band. Can't tell you how many posts we've seen from people who are 8 years out and haven't been back to see their doctor for 6 years, mostly due to loss of insurance and lack of funds.

There are some patients who should not be Lap Band patients. The Lap Band was the marquee WLS 4-10 years ago, but many surgeons didn't understand how much follow up would be required and many surgeons suck at communication and follow up. Many patients were given maintenance instructions that were counter intuitive to what the best surgeons communicate today.

So, are you a good candidate? Get a 2nd opinion and be very honest with your surgeon so they can recommend the best surgery for you.

tmf

Very good and important points, tmf. It could be that the surgeon has done a psych workup on the patient and found that the results suggested that a WLS that would be a better match with the patient's psychological make up.

I am very grateful that my surgeon does preop in a team, including a psychiatrist specialized in this sector, and a NUT. This multi-discipline approach gives a complete picture of the patient, and from there the surgeon can make a recommendation for the best type of surgery.

To to OP, you really need to examine all options, and ask yourself if you have what it takes to be successful with the options out there. The band lifestyle is not easy--certainly when compared with the other options which are really "plug and play", so you need to be mindful of this.

I agree with your surgeon. Go big or go home. Who wants a foreign object implanted in them only to erode or slip. Then most likely at some point you will have it re done cause it does not work well in comparison to iterate methods.

Go with the sleeve, you keep your stomach and no nutrient absorption!

You keep your stomach? Uh, better check those X-Rays Marie? And malabsorption is a possibility even though it's a remote one, just like slips and erosions are rare.

Do you have fillings? Ever have any kind of mesh implant? How about if your organs fail, no heart valves or stints for you? ACL reconstructions? No cadaver ligaments and no plates or screws for broken bones? How about silicone? Tattoos? Piercings? Total knee and hip replacemenets? This infatuation with not having a foreign object in one's body is so silly it's laughable. Virtually no one escapes this world without some kind of foreign body on or in our bodies.

But the fear of having 85% of a major body organ cut out is understandable.imo There's no turning back after 85% extraction. And I believe that some people need this form(sleeve) of WLS simply because they can't control their eating habits. Likewise for the band. But there's a % of patients who are in control and only need a little help with curbing their appetite to make it over that hump. That's where the band comes in.

tmf

Edited September 9, 201411 yr by 2muchfun

I am so pleased with my band. at my age (67) I did not want to have drastic surgery. I had a friend who died after having by pass, now he could have had different problems that caused it but his parents said he got malnutrition first then had an infection so I don't know. Anyhow I am extremely happy that I made the band decision. I have lost 60 lbs , no more diabetes, high cholesterol or high blood pressure.. I can walk for miles, loads of energy and a new lease on life... I am not qualified to give you advise about the other surgeries but just remember there are down sides to every type of surgery. the band is not invasive . You will lose slower but I think that is a good thing

As most have said, there are pro's and con's. The most recent statistics actually show that up to 60% of banded patients choose to have their band removed or convert to a gastric sleeve within 10 years of the original procedure. I was well aware of this before I chose the band. Unfortunately people see that 60% and assume there must be something wrong with the band or procedure - but it's actually what's wrong with the patient. WAY too many people think they will get the surgery and they will be skinny and it will be easy. They don't truly prepare themselves for the way their life is going to have to change - just having the surgery won't fix everything, you have to be committed to making changes for the rest of your life. Additionally, there is no "long-term" data on gastric sleeves to compare to this. In order for medical studies to include legit long-term data, they must have ten years worth of documentation and the gastric sleeve is still too "new" to offer this kind of information. This means we don't really know what is going to happen 10 years down the line and if they might need a further procedure.

While the sleeve might offer faster and more significant weight loss, it also offers the potential of much more severe complications. I'm a nurse and the hospital I work at is a certified bariatric procedure - the vast majority of our patients on the surgical floor are bariatric patients, and a good chunk of those are patients admitted for complications after sleeve or bypass. The thought of having a gastric leak and the infections and problems that can arise from that (and what I've seen from that!) terrify me. Yes, there is potential for complications from all procedures, but the lap band has the lowest risk.

Knowing all of this, doing all of my research, I knew I wanted to do the procedure with the overall LEAST risk for me and something that I could still be in control. I chose to go through with the band and had my surgery last week. I know this will HELP me lose weight - but that's just it, this is a TOOL to HELP me. It's not the solution. My behavior and lifestyle changes are the solution. Until every single person being banded has that mindset, there's no way it can have a 100% success rate.

Like everyone has said, do your research and get another opinion - but know yourself and what changes your CAN and are willing to make. Best of luck to you!!

your surgeon Is being irresponsible. Not all Dr's are professional and honest. the foreign object argument is dumb as tmf explained excuse me but you lose a huge portion of your stomach when you are sleeved so it's pick your surgery wisely. the sleeve is relatively new and bypass is a drastic surgery so it's not a matter of big or little it's a matter of choosing what you feel is best for you.

I agree with your surgeon. Go big or go home. Who wants a foreign object implanted in them only to erode or slip. Then most likely at some point you will have it re done cause it does not work well in comparison to iterate methods.
Go with the sleeve, you keep your stomach and no nutrient absorption!

Your Doctor is absolutely right. Band is awful. By the way has anyone seen the 300+ pounds my stupid band misplaced? It's September and I am already freezing without all my excess fat!!

I have seen 3 Bariatric Surgeons (because I felt like I needed 2nd opinions). The last one I saw, who is the chief of surgery at the hospital and Harvard Medical School educated told me he no longer does Lap Band because he simply does not believe in it. He has done over 2,000 weight loss surgeries and the outcomes are not very good for Lap Band.

It does work for some people, he said, but in his opinion if you look at statistics, the evidence simply is not there.

Good points on both sides, but, 2muchfun nailed it when he says that the band requires much attention and rules must be followed, else you become a statistic on the negative side. Here’s a great example:

Let’s say a successful gastric by-pass or a sleeve patient is years out with no complications, everything has healed, they are losing weight, happy as can be, then the food head games come back and they slip into old eating habits, which is very easy to do. The long term repercussion is that they will stretch their pouch and the weight starts coming back on and life goes on. When this occurs with banded patients, we not only gain weight, but, the stretched pouch will cause band slippage or worse. Not to mention the other complications that can occur to our esophagus.

In all honesty, before getting the band, I was in denial of the rules. With all the research that I did before surgery, in my mind, I had found the equivalent to the fountain of youth for weight loss and regardless of what I read I was determined that this was “the magic” that was going to do it for me. The “band rules reality” kicked in for me after my head hunger woke up from its nap and I ignored the most critical band rule of eating slow, small bites and chewing well. Had I continued without a checkup my stretched pouch would have evolved and I would have ended up with slippage and possible band removal.

Another consideration is the amount of weight you need to lose and how active you will be with exercise. LapBand weight loss is much slower than other WL surgeries and will eventually come to a halt at which point it is all up to you, then you really realize how the band is only a tool.

Future band patients really need to understand what they are getting themselves into before proceeding! With that said, in most cases, we fail the band, the band doesn’t fail us. My advice for those considering the band – do your research, but also, attend lapband support groups, talk to bandsters and better yet, get to know someone successfully traveling the band journey. The band saved my life and am grateful for it! Jake

Edited September 10, 201411 yr by jakealta