Lap Band vs. the Sleeve

[DELETE THIS ACCOUNT! 12,703]

So all of these real people's experiences are discredited because they've posted them on Facebook?

As far as the two stage VSG/DS point. It was that way early on and still is for super MO folks in some situations. What they found doing the 2 stage DS is that many people lost successfully on the first surgery' date=' VSG, and there was no need to do the second, malabsorptive procedure to revise to DS. Also, partial gastrectomy has been done since the late 1800's to treat cancer, ulcers etc and those people have lived normal lives with just part of their stomach.

Bear in mind, I'm not "anti-band", I have one and have lost 90 lbs. BUT, as a person with a pre-existing inflammatory GI disease aggravated by the band and facing removal/revision, I would not make the decision to get one today. I love that my band has helped me to lose and maintain the loss, restored my mobility and improved my overall quality of life, but my GI tract is truly not functioning as it should and this makes life pretty miserable a lot of the time.[/quote']

See I think there is a huge difference between your situation and situations like you speak of on Facebook. You have a medical condition that is causing problems with your band by no fault of your own. Most of the horror stories you hear aren't like yours because unlike you, they have no one to blame for their band issues but themselves.

Your situation is very different than the majority of people having band problems. Really, trying to compare yours to them or lump you in the same boat would be quite the injustice towards you and very unfair.

Now, as for all the people on the internet whining because they caused their own band complications? I put zero merit in them or their stories.

[Frederic 500]

To clarify I'm not discrediting stories because they appear on Facebook I'm just pointing out Facebook aggregates anecdotal evidence which makes it less objectives. It would be like trying to study worldwide weather patterns by only talking to people who live within 100 miles of each other or trying to learn about sexual disorders by only speaking to women in their 20s.

The Internet puts huge amounts of information at our fingertips but unfortunately many of the systems intended to make it easier to review that information either intentionally or accidentally reinforce our own subtle biases.

Also as humans we're predisposed to believe our personal experiences are more common than they actually are since we often surround ourselves with people who have had similar experiences.

[Lori123 170]

I chose the lap band because I especially needed assistance with appetite control, and it has definitely done that. How can cutting half of your stomach off or re-routing body parts work on appetite control? The band sits on the receptors at the top of the stomach therefore decreasing appetite. It decreases your appetite allowing you to think about better choices. Most people with an increased appetite and increased hunger tend to eat too much of the wrong thing. They confuse hunger with appetite. I know I did. The band won't let you overheat (without unpleasant effects) and also decreases your appetite, correcting the hard part of eating right. With this help/assistance, I am able to choose the right items and amount of food to eat.

[tamarlarae 11]

Oh believe me, I plan on making the necessary lifestyle and mental changes. I have tried everything else, idk what else I can do. I'd like to take my life back and be healthy for myself, husband, and future children.

[Bibliophile 2]

That is a horrible misconception rooted in our poor understanding of how human nutrition works.

I agree with what you're saying but we're talking about the focus on diet *with* weight loss surgery and the idea of how important diet is to WLS "success." Other than making changes to adapt to the band, I am not sure it's appropriate to evaluate the success or failure of gastric banding with that confounder. Almost anyone who expends more calories than they're taking in will lose weight -- and they'll do that without going through a 12K+ risky procedure that's beginning to show an unexpectedly high complication rate 5-10 yrs out.

Almost anyone can lose 1-3 pounds a week if they restrict their caloric intake and "follow" a diet. The issue is - if the band is a tool, how well does this tool really work and can that efficacy be evaluated independant of issues like individual willpower, etc.?

[Sharpie 3,306]

I have to wonder why sleeve people are on a lapband chat forum... my dr. told me about the sleeve, did not recommend it for me.. said it's still relatively new and like the bypass it has dumping issues and is not reversible... I know a lady who got cancer after being banded thank God she did not have a sleeve or bypass, the band was unfilled , she got her chemo and did not have to worry about losing too much weight during the process.. I have another friend who had bypass, had years of malnutrition and was hospitalized at deaths door a few times.. he has never looked healthy and I wish he had a band....

[Frederic 500]

I agree with what you're saying but we're talking about the focus on diet *with* weight loss surgery and the idea of how important diet is to WLS "success." Other than making changes to adapt to the band' date=' I am not sure it's appropriate to evaluate the success or failure of gastric banding with that confounder. Almost anyone who expends more calories than they're taking in will lose weight -- and they'll do that without going through a 12K+ risky procedure that's beginning to show an unexpectedly high complication rate 5-10 yrs out.

Almost anyone can lose 1-3 pounds a week if they restrict their caloric intake and "follow" a diet. The issue is - if the band is a tool, how well does this tool really work and can that efficacy be evaluated independant of issues like individual willpower, etc.?[/quote']

I don't know where you're getting your data but it doesn't match mine. Australia has the most published data on long term lap band procedures and it comes out as consistently having fewer complications than other WLS while maintaining similar levels of weight loss success after 3 yrs.

And as for your statement "Almost anyone can lose 1-3 pounds a week if they restrict their caloric intake and "follow" a diet. " I will say almost no one needs WLS. We're not talking about the average person we're talking about long term obesity sufferers who generally have to show they were unable to lose weight despite restricting caloric intake and exercise. Saying everyone can lose weight by cutting their calories and exercising more is like saying tall people can get shorter by cutting off their legs both statements are true but they harbor an unrealistic expectation of a certain demographic.

Even before my WLS I ate healthier and exercised more than all of my thinner friends. Should I quit my job so i can work out even more and only drink nutrition shakes to lose weight. The calories in vs calories burned model is great short hand for 90% of the population but WLS and medical intervention are the only realistic option for the percentage of the population with metabolisms outside the standard deviation.

[Bibliophile 2]

I don't know where you're getting your data but it doesn't match mine.

I am looking at peer reviewed studies published in major research journals. I posted some abstracts earlier in this thread. Unfortunately, the long term data on lapband is not as promising as once thought.

And as for your statement "Almost anyone can lose 1-3 pounds a week if they restrict their caloric intake and "follow" a diet. " I will say almost no one needs WLS. We're not talking about the average person we're talking about long term obesity sufferers who generally have to show they were unable to lose weight despite restricting caloric intake and exercise. Saying everyone can lose weight by cutting their calories and exercising more is like saying tall people can get shorter by cutting off their legs both statements are true but they harbor an unrealistic expectation of a certain demographic.

We may have to agree to disagree here but I stand by my statement that anyone can lose 1-2 pounds per week with the right combination of diet and exercise. That's a basic truth. However, there are physical and mental factors which in reality influence individual ability to *follow* a prescribed diet, cope with severe caloric restriction and/or exercise. For example, I overeat and under-exercise. I am not someone who could realistically follow a 1200 calorie diet for the long term without a serious intervention. I chose lapband as an intervention and am not yet sure if it was the right or best choice.

My concern is that we have a demographic (and I include myself in this ) that historically doesn't do well with a program of diet and exercise yet we're insisting that for lapband to be successful, they have to follow a program of diet and exercise. This is precisely why I think we need to evaluate various types of weight loss surgery independently of whether we think someone followed the proper "program" or not.

[Frederic 500]

All weight loss surgeries require dietary and exercise changes. If a person cannot make those long term changes they simply shouldn't get WLS of any kind. That's why the psych and nutritionist evals are necessary.

WLS isn't for people who can't diet or exercise it's for people who diet and exercise weren't enough. Missy just recently posted a long term evaluation of lap band procedures in Australia and it seemed to point at some pretty solid results in reduction of co-morbidity factors.

I guess my problem is you seem to be coming down pretty hard on lap-band when your arguments would generally apply to any WLS. Meanwhile the original poster was comparing 2 specific WLS options.

[d9leigh 31]

How did this thread take a left turn lol

[d9leigh 31]

How did this thread take a left turn lol

[Frederic 500]

Oh and to bring in personal stories I had no problem eating 1200 calories and doing 500-600 calories worth of exercise. At my weight I should have been losing dozens of pounds a week but I'd only average 1 or 2 lbs a week at other times I'd change absolutely nothing about my diet or exercise but I'd get a new diabetic medication and I'd lose (if my blood sugar started dropping into normal range) or gain 5 lbs in the matter of a few days.

[DELETE THIS ACCOUNT! 12,703]

I am looking at peer reviewed studies published in major research journals. I posted some abstracts earlier in this thread. Unfortunately, the long term data on lapband is not as promising as once thought.

Actually, that's not true. Long term data is promising, in fact there was a very large study that took place over 15 years. The results are very promising:

http://www.futurity.org/health-medicine/weight-stays-off-long-after-lap-band-surgery/

[morelgirl 177]

My concern is that we have a demographic (and I include myself in this ) that historically doesn't do well with a program of diet and exercise yet we're insisting that for lapband to be successful, they have to follow a program of diet and exercise. This is precisely why I think we need to evaluate various types of weight loss surgery independently of whether we think someone followed the proper "program" or not.

I have to say that I also believe it would be impossible to evaluate the efficacy of any WLS without taking into account the factor of patient compliance/non-compliance. Even when examining the failure and success rates of the more invasive surgical procedures (Roux-en-Y, BPD, DS, sleeve, etc.) results are always skewed by the inclusion of non-compliant patients in the data sets. Every single form of weight loss surgery can be made unsuccessful by the patient refusing to follow the prescribed diet plan. Patients with malabsorptive surgery may face different side effects and complications (dumping syndrome, for example) from non-compliance, but weight regain and lack of weight loss can occur following any current WLS procedure if the patient refuses to follow a post surgery diet. A patient with LAGB can regain weight if not eating small portions, not eating only when physically hungry, not eating lean Protein as the largest component of the diet, eating high-calorie/low satiety (slider) foods, or by consuming large amounts of liquid calories. A gastric bypass patient can regain by doing the very same things. The GBP surgery may make this unpleasant by causing dumping syndrome, and the initial restriction of amount eaten may work for a while, but continual overeating can stretch gastric tissues to nullify the original restrictive effect.

In my mind, this means that ALL types of WLS must be evaluated using all the available data, including that on non-compliant patients.

Now, I say that mainly based on issues surrounding diet. As far as prescribed exercise goes, I have known several successful band patients who did not include exercise as part of their post-surgery program, or who only added it after a great deal of initial weight loss that was not aided by exercise. For some of them, it slowed their losses, but for some their loss was quick enough that I can't image what would have happened if exercise had sped it up. I'm not suggesting that exercise is not a key component to anyone's trying to lose weight, but in my mind it is not AS key as the diet changes that consequently limit calories and therefore result in weight loss.

Every WLS surgery patent has a diet to follow after their surgery and in the words of my surgical team, the diet is at least, if not more important, in determining final weight lost than the initial surgery itself.

After all, the point of weight loss surgery is not to reduce weight--if it were, the procedures we choose to undergo would have us all waking up in the surgical recovery room at our normal BMI goal weight. Rather, the point of surgery is to aid in patient weight loss by helping to limit the amount of calories consumed, the number of calories absorbed, or both. I don't see, knowing this, how you can possible expect to separate patient compliance from long term success rates.

But that's just me.

[Bibliophile 2]

I guess my problem is you seem to be coming down pretty hard on lap-band when your arguments would generally apply to any WLS. Meanwhile the original poster was comparing 2 specific WLS options.

As I said in my first post, I am still on the fence about the lap band. I've looked at lots of studies and some of the current data is indicating that it is not as quite as complication free nor as successful long term, as it is being purported to be.