Interesting journal article about banding in the long term

[Dune 2]

Here is a quote from an abstract of a study i found investigating the long term success rates of banding.

The mean EWL at 5 years was 58.5% in patients with the band still in place. The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years. Conclusions: LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%)

SpringerLink - Obesity Surgery, Volume 16, Number 7

First, i just want to say that i am neither 100% for or against banding. I am considering getting banded and am trying to find out from as many sources as possible what i can so that i can make a sound decision. I am interested in the positive stories, which most of you have, but i am also interested in the rarer but just as real negative stories.

The above is a link to an abstract from a study i have found in a journal, about the long term impacts of banding. Unfortunately you have to pay to see the full study, but the abstract contains a detailed summery of the way the study was carried out and its results. The actual article will probably just contain jargon and tables so i am not going to bother paying to read it, the abstract will do.

Anyway, i am interested on your thoughts about this. My first thoughts are that the sample population used are people that were banded in the 90's which was when the procedure was less advanced as far as types of bands used etc (i am sure some of you know the technical details better than i but bands in those days did not have a lifetime guarantee as they do today) are concerned.

However, i do find the results compelling. As i said, late complications would probably be less of an issue today with the bands being more advanced, but the study identifies a trend in gradual failure to maintain excess weight loss which i find worrying. Its not saying that it doesnt work, its just saying that for a large percentage of people it is not a long term solution. If i do have it, i hope i dont become part of this number. I am interested to hear your opinions, thoughts and feelings in response to this.

Many thanks,

Love Dune

[elcee 3,341]

Why don't you read the complications thread - you will get a good idea there of some of the complications people experience.

No surgery is perfect but the band has proved to be a pretty good option.But I think you should go and investigate bypass and the sleeve as well. That is once you have decided that you actually think WLS is for you.

You have to remember as well that the problem is that humans are not perfect. Often the reason the "band failed" is because the person was not ready to change. A band does not shop, cook and put food in your mouth and it can't stop you from making poor choices.

If you decide to spend your time sitting on the couch eating candy then the band won't stop you.

[Dune 2]

Why don't you read the complications thread - you will get a good idea there of some of the complications people experience.

No surgery is perfect but the band has proved to be a pretty good option.But I think you should go and investigate bypass and the sleeve as well. That is once you have decided that you actually think WLS is for you.

You have to remember as well that the problem is that humans are not perfect. Often the reason the "band failed" is because the person was not ready to change. A band does not shop, cook and put food in your mouth and it can't stop you from making poor choices.

If you decide to spend your time sitting on the couch eating candy then the band won't stop you.

Thanks for this advice Elcee, i have read a few of the threads there and i'll probably go back there again to have a look at some more.

If a band does not do any of these things (choose to live healthily, shop cook and put food in your mouth) then why is it needed?

On the one hand people seem to go for this option because they feel they have no choice, they wont be able to do it any other way, but then if it is all down to the way we shop, cook and put food in our mouth (as many post banders say) why do we need it?

I propose that it is more complicated than that and we should be careful before reducing and judging it and people in this way. However, I agree with you 100% that choosing to change the way you live your life is fundamentally important.

However, change is continuous. You never know what is going to happen. Do you think that the large trend of people in this study that were not able to maintain the excess weight loss were not able to maintain it because they were not able to change in the very beginning?

What the study seemed to indicate was that while they did change for the first 3-5 years, making them success stories, people who would say that it is all about lifestyle changes, people like myself (except without the band) in a way, just 4 months ago when things were still going well for me, as time passes it says that the excess weight loss is not maintained. I wonder what the reason for this is? What may have happened in their situation? If (whatever it was) it were something that we were faced with would we cope in the same way? Or, did they just get back into bad habits very gradually? I guess we have to cross bridges of difficulties as we come to them.

Perhaps it is not only about change, but also continuous adaption.

Wow, thanks, this has really helped me!

I'd be interested to see the results of a more modern study because i think that this one is weakened by the fact that it only represents people who had the old fashioned bands.

Anyway, many thanks,

Love Dune.

[LeighaMason 19]

Dune, go to WWW.PUBMED.GOV for studies on the band, search for adjustable gastric band.

The band helps me by making me full after a small amount of food. That is why I needed it, I ate the proper foods before banding but I ate too much because it took a lot of food to trigger the "I'm full" feeling. So now I eat 2-3oz steak, a new potato the size of a golf ball, and maybe 10 green Beans when before I would eat a 16oz steak, a potato the size of my two fists together, a 2 cup salad with dressing, a mound of green Beans and a couple of rolls.

[Dune 2]

Dune, go to WWW.PUBMED.GOV for studies on the band, search for adjustable gastric band.

The band helps me by making me full after a small amount of food. That is why I needed it, I ate the proper foods before banding but I ate too much because it took a lot of food to trigger the "I'm full" feeling. So now I eat 2-3oz steak, a new potato the size of a golf ball, and maybe 10 green Beans when before I would eat a 16oz steak, a potato the size of my two fists together, a 2 cup salad with dressing, a mound of green Beans and a couple of rolls.

Thanks Leigha!!! what a cool site, loads of good stuff there! NICE ONE!!

Dune

[CurvyCat 0]

The stats you quote in your initial post are about right, but I don't think it's the fault of the band or complications with it that results in the success rate not being higher. I think that complications are only a small portion of the failure rate. Physical hunger is only one thing of many that contributes to someone who is chronically obese. Head hunger and other emotional/psychological issues are a HUGE part of our problem, and the band doesn't fix those, of course.

Perhaps looking at those numbers from a glass-half-full perspective is in order. 95% of people who lose weight through diet alone gain it back. 50% of bandsters gain it back. Personally, I like the odds WITH the band (or other WLS) a whole lot better than those without it.

[Dune 2]

The stats you quote in your initial post are about right, but I don't think it's the fault of the band or complications with it that results in the success rate not being higher. I think that complications are only a small portion of the failure rate. Physical hunger is only one thing of many that contributes to someone who is chronically obese. Head hunger and other emotional/psychological issues are a HUGE part of our problem, and the band doesn't fix those, of course.

Perhaps looking at those numbers from a glass-half-full perspective is in order. 95% of people who lose weight through diet alone gain it back. 50% of bandsters gain it back. Personally, I like the odds WITH the band (or other WLS) a whole lot better than those without it.

yes yes, at the moment i am thinking, from what i am reading on the boards, that at least with the band, if you do have some problems, once you get back on the horse (recover your motivation to eat healthily and exercise) the weight will come off at a gallop rather than a trot.

Many thanks for your response,

Dune.

[Cocoabean 430]

Here is a study published in 2010:

Long-term results and complications following adju... [Obes Surg. 2010] - PubMed result

Abstract

This study was performed to assess our long-term results with laparoscopic gastric banding in patients with an observation period of at least 9 years calculated from the date of operation. Between January 1996 and December 2000, a total of 276 patients (83% female) underwent laparoscopic gastric banding at our institution. Mean preoperative body mass index (BMI) was 44 +/- 6 kg/m(2). BMI after 1, 5, 7, 9, and 10 years was 33 +/- 6, 30 +/- 6, 31 +/- 6, 32 +/- 7, and 31 +/- 7 kg/m(2), respectively. Mean excess weight loss after 1 year was 57.1 +/- 23.0% and after 5, 7, 9, and 10 years 73.2 +/- 29.6%, 65.9 +/- 29.3%, 61.8 +/- 32.8%, and 64.0 +/- 32.1%, respectively. Median completeness of follow-up was 80%. Of the study population, 146 (52.9%) patients had at least one complication requiring reoperation. Presently, only 148 (53.6%) patients still have their original band, 49 (17.8%) had their original band replaced with a new one, and 79 (28.6%) had their band removed. Thirty-three patients had no second bariatric operation, a Roux-en-Y gastric bypass was done in 39 patients, and six patients underwent sleeve gastrectomy. Our long-term results are good with regard to weight loss in those patients who still have their band in situ. This is accompanied by a high complication rate and a 29% band loss rate.

It does not say the volume of the bands that were studied, or what placement technique was used.

You will not lose weight fast with a band, it is restrictive only. 1-2 pounds per week is expected. You can totally undo that with highly processed slider-type foods, for which there always seems to be room.

If you want rapid loss, bypass is the way to go. With bypass also, 30% of patients experience dumping sydrome when they eat surgary foods. It is a great aversion therapy to stop you from eating those kinds of foods if they are a problem for you.