Gastric Bypass or Lap Band - can't decide

[Bella 0]

Hey all,

Yep - can't decide.

If I get the Gastric I'll have to deal with maybe major complications, losing it too fast (loose skin) etc BUT it sounds like I WILL lose it.

The Lap Band makes more sense .. but I see some people are having trouble losing because of their diet/exercise. I'm afraid I'll be one of those!!!

If I'm going go under the knife - I only want to do this once and I want it to work.

Any thoughts?

Bella

[Dody 0]

Personally I would never consider gastric bypass, because of the dumping syndrome and malabsorbtion issues, but it has to be your choice what you want. I don't want my intestines re-routed and the band gives me that option. This is a very personal decision you have to make for yourself. No one else can do it for you. Read all you can on both procedures, but I think in the long run you will choose the safest one which is the band. Everyone doesn't have more than one surgery. A lot of people never come to the forum and are out there very contently living life with their bands. Others like to keep in touch with one another how they are doing, and yes those that have problems come here to ask questions and get answers. It is a support forum as well as just general talk about the band. There are issues with the band of course. There is always port infection, slippage, or erosion, but I think the majority of people would tell you if they had to do it again they would choose the band. Maybe I'm wrong, but I think most people would....anyway best of luck to you whatever you choose.

[nicolejunior 0]

hello Bella, if you asked for my opinion, go for the la-band, i also want to have it, i hope in the next weeks i will be a new lap-banded. I think the lap-band is more secure than the gastric by-pass, and don-t worry about not loosing weight, i think with the minimum effort, we will loose weight.better have some walks in the park, than risking your life, because in the gastric by-pass, the risks are bigger, an the operation is irreversible......compared to the lap-band, which you can remove any time.

[GeezerSue 7]

First...the need for plastic surgery has WAY more to do with how overweight someone is and how LONG that condition lasted than it does with how fast someone loses weight. I lost slowly with the band and needed PS. I REGAINED and am losing quickly with DS and may need more PS...not because I'm losing quickly, but because the skin is stretched beyond its capacity to return to normal. Most doctors will tell you that if you have been 100 pounds overweight for any period of time, you WILL need plastic surgery.

Then...the band is a safer SURGERY. And a shorter SURGERY. But, for me, for the surgery to be successful, I have to be NOT morbily obese when it's all said and done. To have ANY wls--even a "safe" one--and still be very obese or morbidly obese is NOT--to me--"safe." I got the band, went from MO to just O, started having complications and regained most of the weight. I had the band removed during a revision to DS and have NEVER been happier with a decision...except, maybe, that I waited so long to do it.

About the "rerouted" comments...my band--and I am the exception, not the rule, to be sure--was rearranging my innards and causing them to malfunction. My esophagus worked only intermittently. It recovered, about 2.5 months after having the band removed, but it was miserable to live that way. Also--and again, I may be the exception--I can eat most foods now and I had a VERY limited diet while banded.

I have to take lifelong supplements. Because I will have lifetime malabsorption. Which means that, for the rest of my life, a certain percentage of the foods I eat won't "count." Not for good (nutrients), not for bad (fats and cholesterol.)

Good luck with your decision. But there are more than two wls's out there, so don't forget to consider the DS as well. Good luck.

[princess_n_thep 2]

I definitely think the band is the safer surgery and you do lose the weight much more slowly and healthily. However, I don't think the band is the "life long" surgery it was told it was to me. And is definitely a lot more work personally.

So many people need corrections, revisions and work that it requires more surgeries. One of my main issues is that I only wanted to have ONE surgery. And I am possibly looking at more now if I were to erode, slip, port replacement, etc... I didn't really get told that was a large possibility. Even Inamed says that it is not a lifetime surgery and the chances are high for additional surgeries needed with the band. Had I known that, I don't know if I would have gotten the band. If I had to do it all over again, I would just take the plunge into RNY rather than the band. But I have my band now, so I am trying to not worry about "what if's" and just deal with it while I have it. But I do feel that it isn't a case of IF I lose the band, but WHEN.

Both my sister and mother have RNY bypass. They do look great and have lost A LOT of weight and are maintaining (sister for about 6 years, mom for about 3). They don't struggle too much with their diet as they are now in a routine. The dumping or vomiting is very minimal. And it is usually when they eat something that they didn't know what was in it or it was a funky type of food that just didn't agree with them. Neither of them have any other issues that make life unbearable. I ask my mom if she would do it again or would she try my lap band first, and she would go the RNY route. She likes that it is forever and that it is permanant. She said that I can eat "around" my band and "pack" my pouch and she would have done that, therefore not being successful at the surgery.

Good luck with your choices!

[NewSho 20]

My question to you would be: Are you more concerned with losing a portion of your excess weight 'safely' and slowly or are you more focused on seeing all or most of that excess weight get off, no matter what.

Will you be happy if you only lose 50% of the 100# you hope to lose?

Answering that question will help you to keep weighing your options.

Like you I had a (relatively) lower start weight. I was only aiming to lose 70-80# overall so I thought the LapBand had a chance to get me there.

I preferred to have the LapBand although I had a full approval for either WLS. I did not consider the DS (which is popular with some) as it was not a good fit for my lifestyle, start weight, weight loss goals or as a good option for a surgery that local doctors in my area were very familiar with.

• The positives for the LapBand were exactly what you mentioned: the less intestinal rerouting, shorter/less complex surgery, adjustability, lack of malabsorption, lack of 'dumping', the fact that it is not permanent, etc. I saw the LapBand in Europe where it has some real success. But European LapBanders tend to be a bit smaller when they get the surgery than we are here in the US. (Yes, statistics back this up. It's almost done as an obesity preventative outside of the US, where here we sometimes view WLS as a sort of last resort.)

• The downsides of the LapBand were the slower rate of loss, the possibility of little/no loss and the possibility of GERD-type symptoms after banding.

So I know the same stats you know, but honestly since you're trying to lose 100# with the LapBand I would caution you to keep weighing your options carefully.

ALL (yes, all) of the many RnY bypass patients I know that needed to lose 100# or more - have lost the weight. They've had ups and downs but of the 11 or 12 people I personally know with RnY they *all* lost nearly all of their excess weight. Yes, every single one of them lost 100# and only one has 10-20# more to lose.

Now of my friends with LapBands, the stats aren't as high. I know 18 to 20 friends who have tried to lose 100# with the band. So far, of those (counting friends, acquaintances, and etc) I can count 7 who have lost 100# with the LapBand. Unfortunately 2 of them need to lose another 50-100# so they lost "that magic 100" but they are no where near being at/near their goal. You know what's so funny - of those 7 people, now 5 of them work in the weight loss surgery field. They're such exceptions that they are literally employed in the industry now. That's how rare they are.

Again, this is my perspective - but that said, I am admittedly waiting to hear if I am going to have to

1) get another LapBand or get this one repaired or put back in place

2) just get the band removed and get revised to another surgery (an RnY)

Well, now I speak as someone who never, not in five years of diet, exercise and trying to be a good LapBand citizen - has come close to goal.

Forget the life-threatening complications (we know RnY bypass patients sometimes suffer those but no RnY patient I know has ever been as sick as I was after I had the LapBand. Seriously. But then I'm an exception.)

the thing to me is - I'm still fat. It's just not that I suffered complications that would have killed other people - it's the irony that I had an operation that was supposedly 'safer' yet ended up been hospitalized anyway - and even after I fully recovered, I *STILL* can't get the weight off. That really gets me - not to mention it's frustrating to still be obese (at a BMI of 30) after a 5-year "Battle of the Band." So I'm like - gee, even with the RnY I'd still be closer to my goal weight.

Now as for the dumping thing. Bandsters love to point at dumping as another reason they'd never have RnY.

Guess what.

I've suffered (as has every other long term banded patient) "stuck food" or "PB" incidents that rival the dumping syndrome that RnY patients experience and it ain't pretty. When Bandsters say "oh I'd never want dumping" I can understand it. But we do get things feeling a bit stuck, we do occasionally experience "the golf ball" syndrome and yes some of us suffer from "PB's" or sliming.

Why we like to feel these incidents are better than dumping, I don't know.

So always consider that there are consequences to any WLS and sometimes these incidents happen at work, restaurants or in public. It does happen. Not always, not daily, not frequently - but it does happen.

If I had it to do all over again and I was told " you won't lose more than XXX pounds with the LapBand" then I would have had the RnY with only minimal reservations.

I need to get the weight off - so all of this, "Oh I'd have the Band or nothing" was not the approach I took. I needed a tool to help me lose weight and so far, the band hasn't gotten there. Check me in a few months, maybe things will change and my view will change too. But I am happy to see people give great consideration to finding the right tool for them - no matter which one they picked.

So I often feel like my banded friends who are trying to lose 100# plus are struggling more, working harder and not seeing the same success. Seriously. All Bandsters who don't lose all their weight are NOT lazy. We like to say that as banded patients because it makes us feel better about our potential to succeed. But my most successful banded pals who are aiming to lose 50-60# are doing much better. They are seeing much better success. The LapBand is a great tool for losing a portion of your excess weight.

I realize many successful Bandsters will chime in and refute my opinions (that's what they are, although stats do back up the LapBand success rate) but those LapBanders who lose almost all of the excess weight are the exceptions to the rule - not the norm. This really is a fact. Period.

So if you were hoping to lose 50#, 60#, 70# - it might be different. I think LapBands is a wonderful weight loss option. It really can be life improving, life changing and such a positive tool.

But for the magic "century" mark I hope you please consider that for the VERY unscientific sample of people I know, the RnY bypass patients did it across the board. It doesn't mean this is a reason to go with the RnY but if you are concerned about the overall success rate, just please consider your options carefully.

Thanks for sticking with this little novel of a post and good look with your decision either way.

Happy Banded (and Non-Banded) Journeys to everyone...

[*susan* 1,709]

Wow, this is an interesting thread. I have about 140 pounds to lose and am just now researching lab-banding. Of all the WLS out there, this seemed the least scary with the fewest side effects. Now I am curious to hear from other members of the board who have over 100 pounds to lose their opinions of the band. I am going tomorrow night to an informational seminar at St. Vincent's hospital and hoping to have many questions answered there. Right now, I see my biggest optical as being insurance. If BC/BS won't approve me, there is no way I could afford to go private pay.

[GeezerSue 7]

NewSho...

I've been on the "band boards" for four years, and I think yours is the best answer I've read on this topic.

Sue

[mrycrltn 2]

I like NewSho's answer also. Very good points.

[NaturalBeauty 2]

Great topic!

I think it's an individual choice. Please do the research because for me RnY Open or Laperscopic(sp?) was not an option. When I found out about the band I was so delighted. I may not lose the weight based on the governments chart but I will lose based on what I want and I am happy about that.

All I can say is research, research and more research.

Good luck!

[Alexandra 55]

If I had it to do all over again and I was told " you won't lose more than XXX pounds with the LapBand" then I would have had the RnY with only minimal reservations.

This is just such a personal decision I don't know what anyone else can say that will help. For example, NewSho's comment above doesn't ring at ALL true for me, since all I wanted was to lose XXX pounds as safely as humanly possible. That number, XXX, is equal to whatever I could lose that would leave me lighter than the 340 I started with. That was my priority.

Keeping the weight off was priority # 2 for me. (Losing it quickly wasn't even on the list. See how our priorities differ?) And I felt that banding, with its longer-term action of behavior modification, stood me a better chance of that over RNY. The fact that RNY guarantees weight loss almost in spite of what the patient eats seems to me a lose-lose situation, so to speak. Once that malapsorptive action lessens, after 12-18 months or so, unless I'd learned a whole new way to eat the weight would just come back on. And I know I couldn't be sure of learning a whole new way to eat unless there were significant negative repercussions to overeating. Dumping isn't something to count on--it only happens on certain foods and to certain people; it's by no means a sure thing.

[NewSho 20]

Thanks for your comments.

I do agree that RnY bypass stomach pouches can eventually (and sometimes should) increase in size. One of the downsides has alway been that this pouch increase can not be fixed without some re-surgery.

Well, now more and more RnY surgeons have started outfitted these increased pouches with a... LapBand. Ironic, eh? Sometimes the surgeons put a new LapBand on top of bypass patients' pouches.

But even more progressive surgeons now outfit their RnY bypass surgeons with a LapBand *at the time* of their original surgery. This has most of the benefits of the RnY bypass and the benefits of LapBanding. In fact, early research does show that these dual-form patients (I call them 'hybrids' but some docs call them RnY/LapBand patients) who get both from the start - have a higher loss rate than either RnY alone or LapBand alone. It might literally be the best of both worlds.

There are some surgeons (like some in Florida) who give all their RnY patients a LapBand from the beginning and although this operation costs more - the long term loss rate is higher and they can have the benefits of adjusting the pouch size with the LapBand. It really does seem like a great solution for some patients. I know a patient with a hybrid and she's lost 90 lbs in 10 months - but the best thing is that she can have adjustments if she ever gets needs them after her 'active RnY losing period' slows down.

Hopefully this procedure will catch on as an option for those who feel they may want the adjustability of the LapBand plus the malabsorptive aspects of the RnY .

Happy Banded (and Non-Banded) Journeys to everyone...