DON'T Have Band Surgery If....

No, I haven’t lost my mind. I still think the band is grand and I still wish I still had mine, but because I want everybody to succeed at weight loss, I feel duty-bound to tell you some reasons not to have adjustable gastric band surgery.

So here goes, in no particular order.

Don’t have band surgery if…

You’re phobic about needles. Right now, a needle is the only way to get fluid into the band. The fill needle is not a big, scary one, and you don’t have to look at it at all if you prefer, but it’s still a needle.

You believe that band surgery cures obesity. Obesity is an incurable, chronic disease with the very real potential for recurrence. Weight regain can happen to anyone.

You think that once you get to your goal weight, your weight loss journey stops. Nope. It’s only just begun. Next you’ll have to maintain that weight loss for the rest of your life, and that takes vigilance and hard work.

You’re a self-pay planning on having surgery in Mexico or elsewhere out of country. What are you going to do if you have a problem or complication or just need another fill or unfill? Travel back to the Mexican clinic? Try to get help locally? Finding a US-based bariatric clinic that will accept patients who had surgery overseas is not easy, and once you do find one, you’re probably going to have to pay a non-refundable program fee, from $200 to $2000.

You can’t afford the time and expense for frequent follow up visits for fills, unfills, and other medical care. Even if your insurance covers those visits, you’ll have to take time off work, arrange for child care or pet care, fill your car’s gas tank, and shell out a co-pay.

You're a self-pay and don't have money or plans for dealing with fills, unfills, and possible complications. See above.

You hope to lose weight without getting any fills. Sorry, but it probably won’t work that way. See above.

You expect to lose a pound+ a day. Average weight loss with the band is 1-2 pounds/week. That average includes people who lost weight faster as well as people who lost no weight at all. Rapid initial weight loss is usually related to fluid retention, not fat loss.

You believe that slow weight loss with the band will prevent sagging skin. According to several plastic surgeons I’ve asked about this, your age and genetics have the most influence on how your skin will respond to massive weight loss. The rate of weight loss has little or anything to do with it.

You expect to experience restriction and lose weight steadily from the moment you wake up after surgery. Most band patients need several fills to achieve optimal restriction, plus more fills and unfills (or adjustments) to maintain that restriction, and virtually no one loses weight at a steady rate. My weight loss was extremely uneven – down 1#, down .5#, up .75#, down 1.75#, down 0/up 0, down .25#, and so on.

You believe in the sweet spot or perfect restriction. Restriction is constantly changing, just like our bodies, because of dozens of quite ordinary factors (food choices, eating and drinking habits, weight loss, time of day or month, illness, medications, stress, etc.). If you think you’ll lose weight only at the mythical sweet spot, you’re going to spend energy on frustration that could be better applied to changing your eating behavior.

You’re not willing to follow pre- and post-op liquid and puree diets. No, liquid and puree diets are not fun, but they’re short-term. When I was banded, I had 36 years ahead of me, assuming that I live as long as my mother did. That’s 12,672 days. My pre- and post-op liquid diets used up a whopping 17 days. Do the math. Even if you add in post-fill liquids and purees, those liquid and puree days represent a teeny, tiny fraction of my life.

You believe you’ll never be hungry again. Maybe, maybe not. The fact that you feel hungry 5 hours after a meal doesn’t mean your band isn’t working. It just means that your body needs fuel. And part of your ongoing work as a bandster is going to be figuring out whether you’re feeling physical hunger or “head” hunger.

You think the band is going to do all the work for you. The band has no magic ingredient that triggers weight loss once it’s wrapped around your stomach. All it does is affect your hunger and appetite. The band is not going to make good food choices, practice portion control or banish the demons who make you eat when you’re stressed or bored. Nor is it going to exercise for you. Success with the band is the result of a joint effort between you, your band, your surgeon and dietitian.

Have a don't-have-band-surgery reason to add to this list? Post it in the comment section!