andyisbanned

In his research at the University of Texas-Houston Medical Center, Brad Snyder, MD, reviews data on weight loss surgery outcomes every day. When he wanted to isolate the factors leading to success or failure after bariatric surgery, the data led him to an intriguing conclusion. Dr. Snyder recently shared his findings about starting BMIs with OH Magazine. What sparked your interest in considering starting BMIs in weight loss surgery outcomes, and what did your research uncover? I wanted to define what might predict a person’s outcome after weight loss surgery. When I looked at the gastric banding patients, one significant difference between those who failed and those who succeeded was their starting BMI. The people who failed to lose more than 15 percent of their excess weight had an average BMI of 49. The people who lost more than 30 percent of their excessive weight at a year out had an average BMI of about 43. I looked at about 600 gastric band patients a year out from surgery. I stratified their BMIs, charting patients with BMIs in the 30s, the 40s and the 50s while noting their excessive weight loss over a year. It was very clear that people with a BMI of 30 lost considerably more weight over that year than people with BMIs in the 50s. Were you able to pinpoint a BMI range or a specific BMI in this study? I was able to be specific to a degree. In extrapolating the data backwards, I came up with a BMI of 46—that is where patients started deviating above or below the mean with respect to their BMI. I then re-assessed the data with this BMI of 46 in mind. I separated the 600 people into two groups: 300 with BMIs less than 46, and 300 with BMIs greater than 46. In comparing the two groups, patients with BMIs less than 46 lost significantly more weight after one month, three months, six months, nine months, and 12 months than all those patients with BMIs greater than 46. Considering your findings, do you recommend that patients with a BMI over 46 try to get down to that prior to surgery? No, that might be a lot of weight they would have to lose. At this point in time, if a patient with a BMI of 52 comes in and wants a gastric banding procedure, I’m not going to tell them no. This study does not give us enough information. It’s only a year’s worth of data, so I can only [say] what I found is true up to 12 months. In these types of studies, it’s important to remember that we’re dealing with averages, not individuals. There are many factors at play—how educated the patient is, how well they understand how the band functions, how motivated they are to embrace proper diet and exercise programs, etc. In the future, do you expect a patient’s placement in the BMI spectrum to become the primary indicator for success after their specific surgery? Yes, I do think so. But it’s not going to be just BMI. The goal is to get people healthier. If a patient comes in with a BMI of 60, and I place a gastric band in them and their BMI drops to 50, they might be on significantly less hypertension medication, or may be able to cut back on their diabetic medications. Even by losing that much weight, even though it’s not 50 percent of their excessive weight, it remains a significant amount, and has clinical impact on their comorbidities. I don’t think we’ll get to a point where we say “OK, your BMI is 47 so we can’t do a band on you.” I don’t think that’s where this is headed. This is just starting to give us some insight into how the gastric band works. So patients should always have the ability to decide between their surgical options? Yes, definitely. My job as a physician is not to talk a patient into a particular procedure. As a bariatric surgeon, I will offer all procedures available that the FDA has approved for weight loss surgery. That being said, I want to make sure that my patients have realistic expectations for what each procedure will mean for them. If a patient comes in with a BMI of 65 and tells me that they want a gastric band, I want to make sure that I have made it very clear that they should not expect to lose more than 50 percent of their excessive weight. They might, but they shouldn’t expect it. Are there other notable findings in this paper that you would like to point out? I stress that what this paper does is examine averages and numbers, not patients. Certainly, highly motivated patients with realistic expectations and good mental and social support are the most successful patients, no matter what their BMI is. Brad Snyder, MD, is a minimally invasive surgery fellow at University of Texas-Houston Medical Center. July 2008 Interesting article. I just thought this was a good read.

Lesile: I was going to request to be added to your friends on myspace but your profile is set to private and requires knowing your last name or email. Therefore, I would like to ask be your friend, so please go to http:www.myspace.comcrowbuy to make a request to me, which I will gladly accept. Thank you.

Sunny; you do deserve this surgery. I am not a girl nor do I know about the doctors you mentiond, but I use Dr. Britt. I really believe in him and his staff. They have worked with me and been very supportive to me. I think you should check them out. http://www.samc.stirsite.com/home.html I have BCBS of Alabama and my insurance paid to use Dr. Britt/Dr. Groves. They do have surgery rights at Madison Outpatient Center in Madison, Crestwood in Huntsville, Marshall Medical Center North in Guntersville, and Marshall Medical Center South in Albertville or Boaz. I went to Marshall North and had a very good experience. I hope you will give them a look. They are the best.

Enough with this poll. It should be shut down. This thread has generated alot of chatter and it has offended alot of folks. I know Froggi did not mean this poll to be hurtful, but it has stirred up a lot of emotion. Everyone should just do what makes them happy. If you want to get the lap-band, then I say go for it. If you do not want the band, then don't get it. It is that simply. You are responsible for your happiness. Don't let others dictate to you how to live.

:biggrin2: when.....you go to Denny's and order a grand slam breakfast only to share it with two of your children and all 3 of you get full from it! :biggrin2:

Karly1: The first fill is to just get you started and usually does not provide any restriction. It took 3 fills before I really got any restriction. You are at the stage that you need to work on portion size and control. Start getting into a habit or routine of planning and eating healthy meals. Get your Protein in 1st then add the other foods. Try to stay away from fried foods. Get into the habit of eating with a small plate, fork, and/or spoon. Really work on not drinking with your meals. You need to not drink any liquids at least 30 minutes prior and 30 minutes after a meal. Learning to not drink with a meal is hard, but it is necessary. Drinking with a meal will only wash you food out of your stomach, which will mean you still can eat more than you need too. Of course, you know all of this from the class with Amy. Dr. Britt and staff is just simply the best! You should be ready for a fill by July 9th, which is this coming Thursday. He is in the Guntersville office on Thursday. You should call Monday and see if you can get in on Thursday. I am sure he could work you in.

Just because you can eat a whole hamburger and fries, doesn't mean you should. You need to make good food choices. No fried foods, no bread, and watch your carbs. You really need to work on portion size and control, because when restriction comes, and it will, you will need to be familiar with the correct portion sizes and foods you need to eat. Do you drink with meals? I can tell you this is a big no-no and you should not drink with meals. It takes practice and time to get use to no drinks with meals, but it is important. You should be waiting at least 30 minute prior and 30 minutes after a meal to drink. Drinking with a meal only washes the food thru your smaller stomach more quickly which means you can eat more at one sitting. The goal is to reduce your portions and intake to help you lose the weight. You must remember the band is a tool and you have to work with this tool to get the best benefits and weight loss.

Karly1: That is great. I love Dr. Britt and his staff. I will get my 4th fill on July 24th. I have 6cc in my 14cc band. Do you know what size band you have? How many fills have you received? How much is in your band? My 4th of July was very nice. I grilled out Hamburgers and hot dogs. We stayed home and did some fireworks here with the children. We had some sparklers, poppers, and some roman candles. Nothing big, but our neighbors all around us had lots of pretty fireworks we could enjoy too for free. How was your 4th?

Hi Karly, Welcome to the Alabama thread. I live in Hartselle and work in Madison. I was banded on 2/14/2008 by Dr. Stephen Britt in Guntersville. I have lost 34 lbs so far. Tell us a little about you. I look forward to seeing you post some more threads.

This is not an offensive poll. It is just asking your opinion. Weight and height play a role in determining your BMI. My doctor will not do surgery if you do not meet the over 35 BMI standard even on a self-pay patient. I think it depends if your BMI is 35 or higher. The company and doctor that invented the Lap-Band never intended it to be used for someone under a BMI of 35. I am sure you can find a doctor to take your money and do the surgery when you do not meet the BMI standard. Just like should age play a role in who gets WLS. I say it does. I think that only those under 18 with extreme cases should be considered for WLS. This surgery is not a quick fix and it takes a strong will & mental attitude to change your eating habits and work your band. The band is still a tool that has to be used properly. This is not some fade diet, but a life style change.

There is a social group for those banded and on myspace. Lap Band Surgery and Lap Band Discussion Forum - Banded MySpace Anyone that is banded and on myspace, I would love to meet you here or on myspace. You can view myspace profile at MySpace.com - Andy C - 42 - Male - Hartselle, Alabama - www.myspace.com/crowbuy . I look forward to meeting you all.

Join the social group. Lap Band Surgery and Lap Band Discussion Forum - Banded MySpace Myspace is: http://www.myspace.com/crowbuy

I have sent you a friend request on myspace. Also come join the banded myspace social group. Lap Band Surgery and Lap Band Discussion Forum - Banded MySpace

....when you go on vacation and your family finishes their meal long before you and you are the only one that brings food back to the room, which you eat for lunch the next day.