did anyone have a difficult time choosing between bypass and lapband surgery ? Why? i'm caught between the 2.my doctor says bypass is more effect long term.but the risk is more...not high,but more.:smile:

absolutely no problem deciding, zip,nada, no. Bypass has never been an option. Too many complications. Plus, I'm not on the higher end of the weight scale. 37 BMI but lots of medical issues. Plus my daughter has had and her best friend had bypass. World of difference, Plus being off work 6 weeks was not an option.

Trisha

That's funny--my doctor said that while the studies comparing the long term effectiveness between the two procedures are still fairly new since the band hasn't been around as long, that iit looks as though the band is more effective 5 years or more out. He says it's because people who have the bypass tend to rely on the surgery to lose weight--their bodies stop absorbing nutrients so they lose weight no matter what. Eventually their bodies adapt and learn how to be more efficient. However, since the band forces you to learn behavior modification there is a better long term success rate.

Also, the band has so many more complications and is irreversible. It can't be adjusted like the band can. The only reason I could see for going for the bypass is if someone has already been unsuccessful with the band or if they are so heavy it is life threatening and they need to lose weight much moe rapidly. Also, it seems that people with diabetes who have the bypass can often stop or greatly reduce their medications almost immediately, so if you have severe diabetes that might be another reason to opt for the bypass.

Okay, here's the summary of a journal article that reviewed data from studies that compared the "medium" term effectivness of the two procedures. For those of you who don't speak medical-ese like me, here's what it says--

In the short term (1 year out a 2 years out) there is a higher percentage of loss of extra weight (67 vs 42% and 67 vs 53% respecitvely--notice that the bypass number remains the same while the band number continues to increase) however from 3-7 years out the numbers are comparable. at 8 years (probably the longest out any band studies go) the percentage of extra weight lost is 59% in the band, At 10 years out the percent of extra weight lost is 52%.

Basically, it takes longer to lose the weight with the band but it tends to stay off more than it does with the bypass.

BACKGROUND: Although bariatric surgery is known to be effective in the short term, the durability of that effect has not been convincingly demonstrated over the medium term (> 3 years) and the long term (> 10 years). The authors studied the durability of weight loss after bariatric surgery based on a systematic review of the published literature. METHODS: All reports published up to September, 2005 were included if they were full papers in refereed journals published in English, of outcomes after Roux-en-Y gastric bypass (RYGBP), and its hybrid procedures of banded bypass (Banded RYGBP) and longlimb bypass (LL-RYGBP), biliopancreatic diversion with or without duodenal switch (BPD+/-DS) or laparoscopic adjustable gastric banding (LAGB). All reports that had at least 100 patients at commencement, and provided > or = 3 years of follow-up data were included. RESULTS: From a total of 1,703 reports extracted, 43 reports fulfilled the entry criteria (18 RYGBP; 18 LAGB; 7 BPD). Pooled data from all the bariatric operations showed effective and durable weight loss to 10 years. Mean %EWL for standard RYGBP was higher than for LAGB at years 1 and 2 (67 vs 42; 67 vs 53) but not different at 3, 4, 5, 6 or 7 years (62 vs 55; 58 vs 55; 58 vs 55; 53 vs 50; and 55 vs 51). There was 59 %EWL for LAGB at 8 years, and 52 %EWL for RYGBP at 10 years. Both the BPD+/-DS and the Banded RYGBP appeared to show better weight loss than standard RYGBP and LAGB, but with statistically significant differences present at year 5 alone. The LL-RYGBP was not associated with improved %EWL. Important limitations include lack of data on loss to follow-up, failure to identify numbers of patients measured at each data point and lack of data beyond 10 years. CONCLUSIONS: All current bariatric operations lead to major weight loss in the medium term. BPD and Banded RYGBP appear to be more effective than both RYGBP and LAGB which are equal in the medium term.