Why the Lap Band is No Longer the Favored Option.

When considering gastric surgery for weight loss, one must factor in effectiveness, maintenance, and longevity. Seeing as there are several options available in bariatric surgery, one has to think about what would be most suitable for his or her individual needs and concerns.

There are two main categories of weight-loss surgeries; restrictive and malabsorptive. Restrictive procedures limit the amount of food one can eat by making the stomach smaller, while malabsorptive procedures, such as the Roux-en-Y Gastric Bypass, also reduce the body’s ability to absorb calories by circumventing part of the small intestine (combined with the restrictive intervention). This article will focus on the simpler and more common of the two, restrictive surgeries. These include the Adjustable Gastric Band (Lap Band) and the Vertical Sleeve Gastrectomy (Gastric Sleeve).

Gastric Surgery Options

When the Lap Band was first introduced, it quickly became the go-to solution for people who couldn’t lose weight no matter what they tried to do in terms of diet, exercise, and other lifestyle modifications. It works by reducing the stomach’s volume by placing a ring around it, slowing and limiting the amount of food a patient is able to consume at a time. While its results are undeniable, the test of time has revealed some of its shortcomings.

Regular "Fills"

Firstly, it requires regular tune-ups known as “fills” where liquid is injected into the ring to modulate how much of the stomach is being restricted. This adjustability is sensible in theory, but at the tune of around $200 every month or two, this extra cost takes a considerable bite out of the monthly budget. 

Lap Band Migration

Secondly, while the band’s biggest supporters laud its non-invasiveness, it is a foreign body that is not always as sturdy as one would hope. Many patients have had to undergo revision surgery due to its unintended slippage (migration). Any time a second surgery becomes necessary on the same site, it becomes a more invasive procedure.

The Gastric Sleeve surgery, on the other hand, has become the new favorite, and will likely keep that title for the long haul. It limits the amount of food one can consume, much like the Lap Band, but once it is set into place there are no adjustments or maintenance measures with which to be concerned. Rather than placing a ring around the organ, a portion of its volume is simply removed and the stomach stapled together, never needing to be altered again. In addition, the portion removed includes the gland that secretes grehlin, a hunger stimulant, which makes eating sensible portions much easier and more satisfying.

An astoundingly positive set of side-effects of both surgeries includes the reversal of several co-morbidities such as high cholesterol, hypertension, type-II diabetes, and sleep apnea. The Gastric Sleeve, however, is more effective on all counts.

Support Following Weight Loss Surgery

You’ve had weight loss surgery, now the work begins. Here are some tips to help you find support.

While weight-loss surgery affords a newfound freedom to people seeking a final solution to obesity, it comes with its own unique set of responsibilities and challenges for which patients will want to be prepared. Namely, being required to observe a dietary lifestyle that's in accord with your new anatomy is a discipline that may not immediately register for those with whom you share meals, and it's important that you feel a solid sense of support during this transitional period into the new life you're claiming for yourself.

Because of your restricted food intake and inability to absorb as many calories, it's vital that you stay on top of your diet and make sure you are consistently getting all the essential nutrition that your body truly needs. This plan is initially set-up with your surgeon and dietician when you undergo your weight-loss procedure*, but you may also find it helpful to consult with a local nutritionist when you get home...someone with whom you can track your experience, make whatever subtle changes may help you stay most in-tune, and to help keep yourself accountable until your new habit patterns become seamlessly integrated into your life's rhythm.

Fear not! Even if it sometimes seems like everybody around you is consuming food no longer in your diet and you feel alone or unsupported, there are a lot of amazing people like yourself who are taking it in stride and are readily available for sharing, reflection, mutual celebration and assistance. Here are just a few of the many resources available to help you embrace and nourish your new way of healthy living!

Post-Bariatric Surgery Support Forums:

http://www.bariatricpal.com

http://www.3fatchicks.com/forum/

ttp://www.thinnertimesforum.com

http://www.obesityhelp.com

*And remember, the MedToGo team and your personal surgeon are always available as a resource for more information. Each doctor has a dietician on their staff who is available by email or phone for post-op advice.