I had stage 4 endometriosis and had a total hyst 1 year prior to my lapband. Unfortunately there was so many lesions they were not all removed at the time of surgery and I continued to have pain. After I lost weight - a total of 56lbs after the band, my pain is mostly gone. I am an RN and have talked to my doctor about this. It seems that our fat cells secrete estrogen along with our ovaries. Therefore, the more fat you have, the more estrogen you produce which activates existing endometriosis. Losing weight reduces the amount of estrogen, which reduces the activation of endometrial lesions. I hope this helps. Wendy