10 Years Out, Only 14% Lost?

anonemouse · August 30, 2007

I'm going to agree with WABB here. It's a well-known fact that over the last several years, the techniques used for banding have evolved and improved, resulting in increased success and fewer complications. Statistics from a study that was begun well over 10 years ago, using techniques that are now considered to be dated, simply aren't applicable to today's Lap-Band surgery.

So while I wouldn't necessarily ignore this study, I'd definitely take it with a very large grain of salt. I prefer this study, which looked at all studies published in English-language journals up to September 2005 that had more than 100 participants and at least 3 years follow up.

fabfatgrl · August 31, 2007

I hear what you're saying re: operative technique. But, I thought that only affected slippage and erosion... not weight loss.

Here's a 12 year study out from Favretti & Co. I know Favretti was one of the Lap-Band pioneers... my doctor trained with him in 97, I think.

Laparoscopic adjustable gastric banding in 1,791 c...[Obes Surg. 2007] - PubMed Result

This study examines 1,791 consecutive laparoscopic adjustable gastric banding (LAGB) procedures with up to 12 years follow-up. Long-term results of LAGB with a high follow-up rate are not common. METHODS: Between September 1993 and December 2005, 1,791 consecutive patients (75.1% women, mean age 38.7 years, mean weight 127.7 +/- 24 kg, mean BMI 46.2 +/- 7.7) underwent LAGB by the same surgical team. Perigastric dissection was used in 77.8% of the patients, while subsequently pars flaccida was used in 21.5% and a mixed approach in 0.8%. Data were analyzed according to co-morbidities, conversion, short- and long-term complications and weight loss. Fluoroscopy-guided band adjustments were performed and patients received intensive follow-up. The effects of LAGB on life expectancy were measured in a case/control study involving 821 surgically-treated patients versus 821 treated by medical therapy. RESULTS: Most common baseline co-morbidities (%) were hypertension (35.6), osteoarthritis (57.8), diabetes (22), dyslipidemia (27.1), sleep apnea syndrome (31.4), depression (21.2), sweet eating (22.5) and binge eating (18.5). Conversion to open was 1.7%: due to technical difficulties (1.2) and due to intraoperative complications (0.5). Together with the re-positioning of the band, additional surgery was performed in 11.9% of the patients: hiatal hernia repair (2.4), cholecystectomy (7.8) and other procedures (1.7). There was no mortality. Reoperation was required in 106 patients (5.9%): band removal 55 (3.7%), band repositioning 50 (2.7 %), and other 1 (0.05 %). Port-related complications occurred in 200 patients (11.2%). 41 patients (2.3%) underwent further surgery due to unsatisfactory results: removal of the band in 12 (0.7%), biliopancreatic diversion in 5 (0.27%) and a biliopancreatic diversion with gastric preservation ("bandinaro") in 24 (1.3%). Weight in kg was 103.7 +/- 21.6, 102.5 +/- 22.5, 105.0 +/- 23.6, 106.8 +/- 24.3, 103.3 +/- 26.2 and 101.4 +/- 27.1 at 1, 3, 5, 7, 9, 11 years after LAGB. BMI at the same intervals was 37.7 +/- 7.1, 37.2 +/- 7.2, 38.1 +/- 7.6, 38.5 +/- 7.9, 37.5 +/- 8.5 and 37.7 +/- 9.1. The case/control study found a statistically significant difference in survival in favor of the surgically-treated group. CONCLUSIONS: LAGB can achieve effective, safe and stable long-term weight loss. In experienced hands, the complication rate is low. Follow-up is paramount.

PMID: 17476867 [PubMed - indexed for MEDLINE]

So, on average, people were maintaining a 26 kg weight loss 11 years out... or about 58 pounds. That seems to be on par with the Swedish results, actually. And hey, I've maintained that much off for four years with no fills (well, short lived fills )... and prior to Banding, the most I'd lost was 21 pounds and I maintained that for less than two weeks. My surgeon used the pars flaccida approach.. back in June 2001.

musicalmomma · August 31, 2007

I may get flamed for this...... but I think if you are LOOKing for the negative.. you will find it.
I choose to look for the positive, because I WILL FIND IT.

DITTO!!!!!!! I totally agree with you Tracy.

You can find a "study" anywhere to support or debunk a particular subject. I know I'm a newbie to the band, but I am not letting any study dictate my personal stats. We all knew going into this (well we all SHOULD have known) that there are rules for the band the must be followed to acheive success. So, what does this study prove? That the rules weren't followed? Or that the band didn't work? OR that there were complications, causing weight regain? The stats aren't backed up with 'sub-stats'...like how many gained weight back because of complications/removal...or didn't follow the rules...or didn't follow up with their doc's and gaining proper restriction...or didn't exercise...etc.

Yes, there are 'stats' and those stats aren't 100% EWL for all...but they sure are a hell of a lot better than the 5% or less of those who mantain weight loss on a diet, without medical intervention. I'll take it!!

WASaBubbleButt · September 1, 2007

I hear what you're saying re: operative technique. But, I thought that only affected slippage and erosion... not weight loss.

If people have a serious slip or if they erode, isn't their weight loss (or lack of) still included in the stats? Meaning, their band will be removed, they won't lose weight, yet their lack of weight loss will still be included. If people had much much greater risk of slips and erosion way back when vs. today, how can you use those stats considering they should be considered part of the study. Seriously, how can you use those stats?

I'm not reading anymore studies on how things WERE done, I'm happy to read studies on how things ARE done.

Again, we can't make a good determination on the study without all the facts.

If you want to look for only negatives, you'll find them. I prefer a balance myself.

fabfatgrl · September 2, 2007

Usually, slips or erosions would be eliminated from any study. As this appeared in a peer-reviewed journal, I have to believe that was the case.

I understand trying to be positive... especially as many of you are recently Banded. But, I want to point out that even if these stats are true, it still makes the Band a very powerful weight loss tool. If you can maintain any weight loss long-term, you're better off that you were without the Band. This study shows that the people kept off 70% of what their maximum loss. That's very impressive over 10 years. If you assume that with the better Bands, operative technique, and even after care you may lose more, then you'll be keeping off a lot more as well.

Telecia · September 2, 2007

Bah statistics, Now that everyone has access to the internet if you look hard enough there are statistics to back up ANYTHING.

I know for a fact that 15+ years ago for gastric bypass patients they did not give the same advice they do now to patients. Cause my step mom had bypass surgery in 1985. And I went with her to appointments. They never told her to change her eating habits, never told her to avoid foods, to avoid drinking with her meals. And said she didn't have to change anything about her lifestyle.

Well guess what. She lost her first 100 lbs fine. But that was about it. She had all the nightmare complications, malnutrition, A miriad of stomach problems, constant PB'ing etc. And is on around 5 different stomach medications now that she will be on for life. Because she didn't change anything in her diet habits. She still ate out 5-10 a week, ate alot of junk. And things with no healthy nutrients in them.

Myself I take this message board and others like it into more consideration then any so called study. Suposedly long term weight loss isn't so great with the band and large amounts aren't possible but yet there are handfull upon handfulls of people on this board who have proved different.

WASaBubbleButt · September 3, 2007

Bah statistics, Now that everyone has access to the internet if you look hard enough there are statistics to back up ANYTHING.
I know for a fact that 15+ years ago for gastric bypass patients they did not give the same advice they do now to patients. Cause my step mom had bypass surgery in 1985. And I went with her to appointments. They never told her to change her eating habits, never told her to avoid foods, to avoid drinking with her meals. And said she didn't have to change anything about her lifestyle.

Well guess what. She lost her first 100 lbs fine. But that was about it. She had all the nightmare complications, malnutrition, A miriad of stomach problems, constant PB'ing etc. And is on around 5 different stomach medications now that she will be on for life. Because she didn't change anything in her diet habits. She still ate out 5-10 a week, ate alot of junk. And things with no healthy nutrients in them.

Myself I take this message board and others like it into more consideration then any so called study. Suposedly long term weight loss isn't so great with the band and large amounts aren't possible but yet there are handfull upon handfulls of people on this board who have proved different.

I love love love your post! I couldn't agree more.