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Need advice--from band to bypass???



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Please, please give me any advice you might have. I am contemplating having my band removed and a bypass done. I am 19 months from banding and have not lost a single pound. I am the same weight I was when I left the hospital the day after surgery. I will be the first to admit that I have not followed all the lap band "rules". I've made poor food choices and haven't exercised like I should. However, my portions are decreased dramatically. The band is doing its job - I'm not doing mine. I feel like with the difference in portion sizes from what I used to eat til now - I should have lost SOME weight. I'm not expecting to be a big loser because I don't apply myself like I should. That being said, I am becoming very frustrated and depressed because of the lack of success. I'm wondering if maybe the band was not the right WLS for me. Has this happened to anyone else? I'm really thinking about the bypass - even though it is so risky, I'm wondering if that will work for me. I don't need criticism - just advice. Thanking you in advance.:wub:

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I am sorry you are going through this. But I wonder, if you could not follow the diet instructions for the band if you will be able to follow the diet instructions for the gastric bypass.

I would work with a therapist to see what is causing me to not follow the diet requirements. I have heard that the bypass can fail people too, just like the band can fail.

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I know that my daughter had by-pass 7 years ago and has done amazing with it. She lost her weight very quickly and has kept it off. Now she was only 19 when she had it done but it is a life changing alteration!! I nursed her back to help and went through every step of it with her. I chose not to have it done because I did not think I would be able to handle it. It just depends on you!! I had my Lapband done Nov 19 and have lost 44 pounds. Now some of that was pre-op weight loss but I have lost weight since my surgery. I got my first fill yesterday so I am hoping I will begin to loose more weight!! Good luck at whatever you decide!!:wub:

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I am sorry you are going through this. But I wonder, if you could not follow the diet instructions for the band if you will be able to follow the diet instructions for the gastric bypass.

I would work with a therapist to see what is causing me to not follow the diet requirements. I have heard that the bypass can fail people too, just like the band can fail.

I agree with this. If you can't follow the band rules and change your behavior, how will you keep it off after bypass and follow those rules? The bypass has a decently high failure rate and a lot of people regain the weight, with few alternatives afterward due to the alteration in their body anatomy.

Bypass might work for you, but I would not take another single drastic step without a good psychologist and some intensive therapy to help you identify and act on your goals. And if you are going to do that anyway, why not do it in terms of getting the weight loss surgery you have already had to work for you before considering another surgery?

I know you are hurting and I am so sorry. I hope you get the help you need and find answers.

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My opinion is like this. If you went for the bypass, you would likely lose a lot of weight the first year. That's because the part of the stomach they cut away produces the hunger hormones which drive you to eat - basically you'll have no hunger that year. However, the body is tricky and figures out a way to make you hungry again. That's why bypass patients regain 20-30% of what they lost at that point.

In your case, you might gain it all back because you're unable to make the dietary changes. (By the way, it's great that you're honest about it, because that's how you can get the help you need.)

If you're not planning to have children, and if you accept the nutritional risks involved, you could consider the Duodenal Switch. This is a surgery that lets you eat much more because so little gets absorbed - I've heard you can eat what you want. However, you have to work hard to get all your nutrients, and you cannot get pregnant because you can't absorb enough nutrients to support a fetus. It's worth looking into.

Other than that, you could do the bypass and take a risk that maybe if you can get it off you'll keep it off - but you have to have a serious plan, like you'll get into serious fitness like running once you've lost enough not to have to worry about injuries. Without a backup plan like that, you're likely to regain the weight

Good luck, and I hope you find the help you need!

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When talking with the PA at my surgeon's office last week, I brought up the theory that if I am having trouble following the band rules, what makes me think I will be able to follow the bypass rules. Her comment to me was "the bypass MAKES you follow the rules", as if there isn't much chance to "cheat". This is the exact though that I had, though I didn't know if it was true. If I am given an inch, I'll take a mile; however, if I'm not given an inch, I won't try anything. Make sense, or not? She made it sound like the bypass may be what I need, because of the trouble I'm having making the band work. I don't know - I'm still confused. But, she was gonna talk to my surgeon about me this past weekend, and she's supposed to call me today to let me know his suggestion. I'll keep you posted, if anyone's interested. Thanks to those of you that responded to my post.

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I would highly recommend the DS, even though the side effects are a lot more than with the bypass. If you are not a rules follower, you WILL regain after a certain time. Regain with bypass is very common. Good luck with your decision!

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That is what I was going to say too. Regain with the bypass really is quite common and devastating, as there's nowhere left to go after that. You've re-routed your insides.

I have always said if I fail the band I will likely go with the duodenal switch. Way more expensive, way more risky, but very high rate of weight loss success.

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Thank you so much for your responses. I have heard of the DS, but don't know anything about it. Could you tell me more?

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I'm not expert at this but I would think if you can't lose weight with the band, you will have a difficult time losing and/or keeping it off with any other procedure. The will to lose weight begins in the mind. That's the whole purpose of the Psy. evaluation prior to LB surgery to determine if you are ready for the changes necessary . If your thinking and way of eating doesn't change, surgery alone won't cause weight loss. If you watch the current season of The Biggest Loser, you will see there is a man on there who had the RouenY Gastric Bypass surgery and is close to 400 lbs. You absolutely 100% MUST make changes with any procedure or it won't work. I have looked at the lapband as a "tool" to assist me with my weight loss and trust me it's not easy. You must put forth an effort to change your diet and exercise and the lapband will work for you. The key is YOU got to work it for it to work for you. I hope this helps you with your thought process. You can still lose weight with the band but you must be willing to change your diet and get an exercise regimin going. You've heard the saying "Fail to Plan and you Plan to Fail". Good luck in your weight loss endeavors.

Frank Lloyd Wright:

I know the price of success: dedication, hard work, and a devotion to the things you want to see happen.

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Thank you so much for your responses. I have heard of the DS, but don't know anything about it. Could you tell me more?

If you do a Google search on duodenal switch you will find a lot of information.

There are a few points that stick with me:

It has the best weight loss success long-term of any of the surgeries.

It has the highest rate of complications as well, mainly due to nutritional deficiencies that can be severe. It also can make it difficult to stop losing weight when an appropriate weight is reached.

It is the most difficult of the bariactric surgeries to perform.

There are the fewest surgeons doing it and you will likely have to travel somewhat to get it done if you aren't in a major city.

It is the most expensive of all the bariatric surgeries.

Good luck with whatever you decide.

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I don't mean to "beat a dead horse", BUT... I cannot get the idea of revising to a bypass out of my head. I think about it all day, I go to sleep thinking about it, and I wake up thinking about it. I've called my insurance, and it looks like they will cover the surgery. I called a surgeon (different one than did my band-due to travel distance) and found out what they need from me. They need a referral - so I have an appointment with my PCP next Monday. I wish I knew if I was doing the right thing, or if I am making a big mistake. I know the decision of WLS is a very personal one, and one that shouldn't be taken lightly - but I really do value all opinions. Please let me know what you think?

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I think that you need to see a psych before you visit a doc about bypass. You need to figure out WHY you are sabotaging yourself. Until you do that, you are doing yourself a complete disservice by getting another procedure when you haven't figured out your 'issues.'

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When talking with the PA at my surgeon's office last week, I brought up the theory that if I am having trouble following the band rules, what makes me think I will be able to follow the bypass rules. Her comment to me was "the bypass MAKES you follow the rules", as if there isn't much chance to "cheat". This is the exact though that I had, though I didn't know if it was true. If I am given an inch, I'll take a mile; however, if I'm not given an inch, I won't try anything. Make sense, or not? She made it sound like the bypass may be what I need, because of the trouble I'm having making the band work. I don't know - I'm still confused. But, she was gonna talk to my surgeon about me this past weekend, and she's supposed to call me today to let me know his suggestion. I'll keep you posted, if anyone's interested. Thanks to those of you that responded to my post.

I'm not saying that your PA does not know what she is talking about, but people do fail with bypass. There is a way around any weight loss surgery if one really wants to. I mean with the band when you have the right restriction it forces you to make changes or at least it did for me. Both surgeries have consequence if you don't follow the rules. If you look at the statistics after 3-5 years, the results with both surgeries are comparable.

Maybe you don't have good restriction. Did you do after-care? How many fills did you have?

Oh and there is the guy on the Biggest Loser that had the bypass and look where he is at!

Edited by Kat225

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Sounds like you have made up your mind. I hear the desperation in your writing.

You have not responded to anyones suggestion about the mental health part of this equation.

Is it possible that you are also suffering from significant depression and anxiety - that is not a result of your weight? Meaning, it will be there regardless of which sugery you choose and how much wt you loose.

Just a thought. Good Luck with your endeavor!

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