I know it may be wrong of me but this is the R&R board. I have been hearing more and more stories of people just barely over 200 or under 200 getting lapband...do you think this is normal or needed etc. Let me know YOUR opinion.

The results are private in the poll...feel free to be truthful.

Voicing your opinion is allowed too.

And I am talking people completely healthy and average height or more.

Edited June 29, 200818 yr by Froggi

i got my doc to write a letter to my wls and that was that i paid out of pocket ..i was really 190 but i ate like a pig until preop diet..im done to 178 and super happy the weight is coming off im 5,5 and 29 ys old

you now froggie i am one of these people but i had a bad accident and put on heaps of weight, i went from being athletic to not so healthy.

I am having the band for myself so i can be happy insurance are not paying for me i have worked hard to save for this so yes i do believe if you want it get it.

Its hard but i never had a weight problem until i had my accident and i no as a healthier person i am a lot happier and my self esteem is better

susie

I find it odd...overweight people are discriminated against all the time. It's even legal.

You feel judged, you know you hate it, and yet here's a poll that is so judgemental, it's inflammatory.

It's just more of this: "you shouldn't" __________(insert X) "because you're" ___________ (insert Y).

You shouldn't wear a bikini because you're too pale.

You shouldn't eat ice cream because you're fat.

You shouln't still live with your parents because you're 30.

You shouldn't have a lap band because you're ________

You get the point.

It's just stupid.

I believe people under 400 lbs should not get the surgery. They should just diet and exercise.

Now, lets take a poll on it.

Can you see how some people are upset by this poll?

(By the way, the above statement really is not my belief.)

Enough with this poll. It should be shut down. This thread has generated alot of chatter and it has offended alot of folks. I know Froggi did not mean this poll to be hurtful, but it has stirred up a lot of emotion. Everyone should just do what makes them happy. If you want to get the lap-band, then I say go for it. If you do not want the band, then don't get it. It is that simply. You are responsible for your happiness. Don't let others dictate to you how to live.

The other question is, if something can be done early to stop a person getting to the point of needing this operation almost as a life and death matter, should it be done? If a step can be taken that will prevent all the associated health risks developing and making having the band op so much more risky should that step be taken?

Or do we say, no they can't take preventative health measures. Because I put on all this weight and suffered with short breath, heart palpitations, low self-esteem, cruel behaviour, the onset of diabetes (and whatever else you wish to add) - then everyone must have to reach this point too before they can do something about it.

Is this really a case of "its not fair"?

At the end of the day, lap band surgery is SURGERY. It has its risks. Its not a walk in the park for anyone, true its less risky for those who are smaller. This really is a matter for the individual and their surgeon to decide. Besides, I thought most Americans had to do the 6 month diet thing first? If they are doing that and the weight isn't getting down to a "normal" range in that time, then maybe they need the op as much as I do?

Who am I to judge another until I've walked in THEIR shoes?

Of course it's okay!!!!! I know more people in the smaller category that had it done than larger people. Glad I did it and have no regrets!

In his research at the University of Texas-Houston Medical Center, Brad Snyder, MD, reviews data on weight loss surgery outcomes every day. When he wanted to isolate the factors leading to success or failure after bariatric surgery, the data led him to an intriguing conclusion. Dr. Snyder recently shared his findings about starting BMIs with OH Magazine.

What sparked your interest in considering starting BMIs in weight loss surgery outcomes, and what did your research uncover?

I wanted to define what might predict a person’s outcome after weight loss surgery. When I looked at the gastric banding patients, one significant difference between those who failed and those who succeeded was their starting BMI. The people who failed to lose more than 15 percent of their excess weight had an average BMI of 49. The people who lost more than 30 percent of their excessive weight at a year out had an average BMI of about 43.

I looked at about 600 gastric band patients a year out from surgery. I stratified their BMIs, charting patients with BMIs in the 30s, the 40s and the 50s while noting their excessive weight loss over a year. It was very clear that people with a BMI of 30 lost considerably more weight over that year than people with BMIs in the 50s.

Were you able to pinpoint a BMI range or a specific BMI in this study?

I was able to be specific to a degree. In extrapolating the data backwards, I came up with a BMI of 46—that is where patients started deviating above or below the mean with respect to their BMI. I then re-assessed the data with this BMI of 46 in mind. I separated the 600 people into two groups: 300 with BMIs less than 46, and 300 with BMIs greater than 46. In comparing the two groups, patients with BMIs less than 46 lost significantly more weight after one month, three months, six months, nine months, and 12 months than all those patients with BMIs greater than 46.

Considering your findings, do you recommend that patients with a BMI over 46 try to get down to that prior to surgery?

No, that might be a lot of weight they would have to lose. At this point in time, if a patient with a BMI of 52 comes in and wants a gastric banding procedure, I’m not going to tell them no. This study does not give us enough information. It’s only a year’s worth of data, so I can only [say] what I found is true up to 12 months.

In these types of studies, it’s important to remember that we’re dealing with averages, not individuals. There are many factors at play—how educated the patient is, how well they understand how the band functions, how motivated they are to embrace proper diet and exercise programs, etc.

In the future, do you expect a patient’s placement in the BMI spectrum to become the primary indicator for success after their specific surgery?

Yes, I do think so. But it’s not going to be just BMI. The goal is to get people healthier. If a patient comes in with a BMI of 60, and I place a gastric band in them and their BMI drops to 50, they might be on significantly less hypertension medication, or may be able to cut back on their diabetic medications. Even by losing that much weight, even though it’s not 50 percent of their excessive weight, it remains a significant amount, and has clinical impact on their comorbidities. I don’t think we’ll get to a point where we say “OK, your BMI is 47 so we can’t do a band on you.” I don’t think that’s where this is headed. This is just starting to give us some insight into how the gastric band works.

So patients should always have the ability to decide between their surgical options?

Yes, definitely. My job as a physician is not to talk a patient into a particular procedure. As a bariatric surgeon, I will offer all procedures available that the FDA has approved for weight loss surgery. That being said, I want to make sure that my patients have realistic expectations for what each procedure will mean for them. If a patient comes in with a BMI of 65 and tells me that they want a gastric band, I want to make sure that I have made it very clear that they should not expect to lose more than 50 percent of their excessive weight. They might, but they shouldn’t expect it.

Are there other notable findings in this paper that you would like to point out?

I stress that what this paper does is examine averages and numbers, not patients. Certainly, highly motivated patients with realistic expectations and good mental and social support are the most successful patients, no matter what their BMI is.

Brad Snyder, MD, is a minimally invasive surgery fellow at University of Texas-Houston Medical Center.

July 2008

Interesting article. I just thought this was a good read.

yet his research seems to be backwards...from what I've seen on here people with higher BMI's lose more faster...but yeah I guess it depends really lol

You know I may be to late to make a comment but I am 5'5" I weigh 235 I have struggled with my weight and been embarrassed by my weight for years. I have high blood pressure and thyroid issues however that isn't my reason.. As all of you want to I want to look good too. I want to be able to climb stairs with out feeling like I am dieing I want walk with out my knees killing me and I want to ride roller coasters again.. Your weight problem and my weight problem may not be the same however our goal is.. Good luck and God Bless

yet his research seems to be backwards...from what I've seen on here people with higher BMI's lose more faster...

Absolute weight maybe, but % of EWL is a different animal. What I see is that WLS helps most people lose about 100-150 lb. A LOT of people just can't lose past that. So if I have 100 lb. to lose, and someone else has 250 lb. to lose, and we both lose 100 lb., I've lost 100% of my EW and gotten to goal and they've lost 40% of their EW and not gotten to goal.

Note: that doesn't mean it's hopeless for anyone with the higher BMIs. My surgeon has a patient who lost 250 lb. with a band!

But this is another reason why I think it's great for people to have WLS once they realize they have a problem and not wait until their problem is even worse and why I think the NIH recommendation of waiting until morbidly obese is totally bogus.

Absolute weight maybe, but % of EWL is a different animal. What I see is that WLS helps most people lose about 100-150 lb. A LOT of people just can't lose past that. So if I have 100 lb. to lose, and someone else has 250 lb. to lose, and we both lose 100 lb., I've lost 100% of my EW and gotten to goal and they've lost 40% of their EW and not gotten to goal.

If I'm reading this correctly, he studied people up to one year after surgery. It isn't realistic to expect a 50+ BMI to be at goal after a year. I'd like to see numbers 2 years, or better, 5 years out. How many are at goal then? If you are looking at % of EW lost, that study is flawed IMO. You cannot compare that in higher BMI patients at just a year out because they will continue to lose for longer periods of time. How do the higher BMI patients compare to the lower BMI patients at 5 years out? That would be much more telling IMO.

I started at a BMI of 56.8. I didn't go into this with an expectation or desire to get to my "ideal body weight" which is 131 lbs, according to my surgeon. My goal is 160, which is a BMI of about 26 or 27, and I may adjust my goal at some point. I want to be under 200 and after that, I'll decide where I want to be based on how I feel, my health, and my clothing size. I'll probably be "overweight" based on the BMI at that point and I won't be one of those "lost 100% of EW" statistics. That's ok with me. Maybe I'll prove myself wrong on that. Either way, it is a hell of a lot better than where I was, which is probably what a lot of high BMI'ers think.

yes I am 224 and going in for mine on Aug 5th...I have medical reasons also. I have been though all the tests and my ins company has approved me with my medical history...so yes diff

I am having mine on Aug 5th. I have the same problem as you, but I am 224 lbs. I also now have health issues. Please if you could let me know how your first days were when you came home from the hospital. i need to talk to someone I just want to know what it is like afterwards. I am so excited. Thank you Lisa

Prof O'Brien has found in Australia there's considerable success with lower BMI patients. Of course you cant equate that with pounds lost, but with percentage of total body weight, low BMI patients tend to do very well.

In layman's terms I look at myself. I simply didnt have the "issues" to overcome that many heavier people had. As a lower BMI you are likely to have been fat for less time, not to have been so fat in the first place, not to have developed as dysfunctional eating habits and issues. The stories people tell about what they used to eat, including entire bottles of soda in a day, well I never DID that in the first place, so I didnt have to overcome it. I'd never eaten two big macs in one sitting or entire cakes, or six ice creams, I didnt eat three plates full of dinner. I may well have gotten to that point. Now I'm not saying by a long shot that all people with a bmi of 50 indulge in those behaviours but its a fair call to say they probably eat a lot more than I did at a BMI of 35. So it was way easier for me to change, I probably had a much milder form of the disorde4r.

I also hadnt got so fat that I couldnt exercise or hadnt exercised in years. I was still able to be active and if there's one thing I could say is the secret of weight loss its hard exercise. If youre so big you can barely more, its much much more of a challenge.

All those are reasons why that study found the results it did and they're all compelling reasons why you should be able to tackle a weight problem seriously before it becomes really difficult.

And of course that's just generalising because there are indeed people on this board and out there in the world who HAVE gone from BMI's of 50 down to 20 through sheer guts and determination.