Would you get lap band?

[annanyc 33]

I need to decide by tomorrow whether to get banded on September 12th or not. Obviously, I could do this at some future date, but realistically, I don't see another window, since insurance doesn't cover my surgery, and I'm quitting my well-paying, stable job for my own business. I'm super excited about the opportunity, but having the time and finances to take off just isn't something I can count on for the foreseeable future.

I didn't really consider lap band, because I didn't think it was an option until recently. I didn't know you could get a lap band at my weight, or that it was financially practicable. I'm currently 31 and healthy, with very low blood sugar, great cholesterol and other blood work. I've been a vegan for two years. I jog 15 miles per week without a problem in addition to walking my dogs for 90 minutes each day. I use fitbit and over the last 6 months, I've averaged almost 15,000 steps per day, so objectively, I'm pretty active. My resting heart rate reflects this. Though I'm obese, most of it is "healthy fat" carried in my hips and thighs. My waist circumference is under 35". No obesity-related illnesses run in my family. My BMI is 30, has never gone higher than 32.5, but has never stayed the same in one month either. I'm an awful yo-yo dieter. Great at losing the weight through every method, sane and insane. Terrible at keeping it off. And it's drastically affected the way I live my life. I know that a lot of it is mental. But I have so little confidence. I've been fighting my weight since I was 12 years old. I don't date. I don't put myself out there. I avoid family events and socialization when I'm heavier... I look at the world completely differently. I'm a binge eater.

I have my life together in other ways. But I also think this would make a huge difference professionally. I'm a corporate lawyer, and I work in an office with over 500 attorneys. I'm one of three obese female attorneys at the firm. A few carry some extra pounds. But most are noticeably slim. As much as I hate the observation, perception matters an insane amount here. I have to think all the moreso when I go into business for myself.

Overall, I do realize that my problem is not really my weight, but the obstacle I've let my weight become to living my life. I don't want to do something rash- I've never needed any type of surgical intervention before, and this is one- one that comes with complications, and doesn't even always work. One that, no matter how minimally invasive, does result in scar tissue, and diligent upkeep over the years, and in all likelihood, will require future surgery to remove/adjust/replace. To do this for pure vanity reasons seems potentially unwise. I'm pretty sure I'd probably tell a friend not to go through with it. Except it's not just vanity, you know? Mental health counts for something. Confidence. And I've already gained and lost over 50 pounds five times in my life. I'm so sick of trying the same thing and expecting different results. I think lap band, combined with some therapy and a little inner work, could really work great things in my life.

I guess I'm just looking for feedback from anyone else who's gotten this done. Whether they would if they were in my position- if it wasn't a physical health risk- because I just can't bring myself to believe that mine is. Should I just try to lose weight again and keep it off? I need to be objective about cost-benefit here and whether this is really worth it.

[DELETE THIS ACCOUNT! 12,703]

Let me preface my response by saying this is strictly my opinion. I'm no expert nor am I a doctor.

If I were in your shoes, with your BMI and medical history, I wouldn't get WLS.

For one thing, the maker of the Lap Band only recommends it for those who have BMI's over 40 or over 35 with co-morbidities. With your BMI being only around 30, you don't fit their FDA approved criteria.

The other part is, judging only by what I read here, it seems to me your issues are much more mental than they are physical. We have a saying around here- the band goes around your stomach not your brain. It can't and won't fix our mental issues with food. If I were in your shoes, I'd seek out a good therapist to help me work through the food issues. I'm guessing if you did that, you wouldn't need the band anyway.

Just my personal opinion. You need to do what is best for you, though.

Best wishes on whatever you decide.

[annanyc 33]

Hi- thanks a lot for your response, and for your responses generally. I've found them really helpful and informative. I did think that the FDA lowered their recommendation and now approved lap band for BMIs above 30. They still want a comborbidity though. And I don't have that.

Honestly, I've been toying with the idea of using it off-label anyway. Losing most or all of my weight without restriction and then using restrictions as that extra help to aid maintenance. If I could learn how to maintain my weight, I'd be set. (I'm pretty sure most other dieters' if onlys are the same as mine

But yes, I agree with you that a lot of my most handicapping issues right now are mental ones. And I'm not sure getting lap band is appropriate for that even in conjunction with therapy to address the bingeing and self confidence issues at play. Thanks for giving me your honest opinion.

[☠carolinagirl☠ 18,721]

i will risk (any scar tissue and any additional surgeries (if/when it does happen) just to have what i have now.....a better life, better mobility and better health..i was told any WLS won't help unless i help myself...only you can make that decision for yourself.....if you get it, go for it.....if not, make better food choices/exercise and try to get healthy regardless.

[kazjim98 618]

I completely agree with Missy ~ while the band can help control how much you eat, it cannot control head hunger and binge issues. I wish you well in what ever you decide, Best Wishes

[2muchfun 8,927]

I agree with Missy. If you do go for WLS it would seem like plication would be a smarter move than the band since you're a vegan? We rely heavily on animal Proteins to give us the satiety we need to avoid overeating. I'm sure as a vegan you could be successful with the band but it does require a lot of focus and commitment. At 30 BMI I sense this may not be the right step for you.

Wise of you to seek the opinions of those who have gone before.

tmf

[GoingforGoal 1,734]

Greetings.

I know this post will be contradictory to everything you just read. So bare with me...

Here in the US, the band is typical for BMI 40 and higher (35 w/ comorbidities) However, this can be circumvented if you are self pay as there are no insurance hoops to jump through. Our peers in other countries (Europe and Australia specifically) have been doing this much longer and many of their participants are lower in BMI. I would be assumptive to believe their average 'obese' person in their population is not the same as ours. I am not sure at what your height is, but for me 195-200 would be a BMI of 30 for me. And for me, that is obese an unacceptable standard. And despite differing opinions, if you were to ask bandsters if they would find it acceptable to remove the band at BMI 30 because they are not fat enough anymore, they would all balk.

I get peeved when I hear others state whom they feel is an appropriate candidate for the procedure. It is likened to family and friends discouraging someone from the band because they deem it drastic. Because hey, all you have to do is eat less right? But in reality, you are suffering like the rest of us. You can mask it with all the positives you want, but in reality, you are out of control and struggle with maintenance like the rest of us. We just managed to gain more. I am certain you can find others here who have the same habits (ie binging etc) and ended up in the yo-yo effect you are living out. Whether you are 300, 250 or 200 the lifestyle, the habits are the same. The negative effects you are having on your body are not mitigated by the 'healthy cholesterol and low sugar' bit. Your playing havoc on your metabolism, wasting muscle weight with fat and setting yourself up for easier weight gain each and every time you reattempt to lose. This is the bodies natural response to this kind of loss-gain-loss-gain cycle.

So let's talk mental for a minute. You avoid life as a consequence of being overweight. You feel devalued at work. You feed the emotions etc. This is more of a burden than the weight itself wouldn't you agree? It's the impact fat has on your life, your decisions and your relationships that create this vicious cycle. If all your efforts are unsuccessful, or temporary, you need another solution. We all sat at this intersection and had to determine if the band was that solution. Sure you and I have different circumstances, but our needs are the same.

Being vegan you should already be savvy on how to achieve minimum Protein levels through your current diet. I personally find vegan Proteins (ie tofu, Beans etc) much easier to digest than meat Proteins so, in reality, you may have a head start on us. Can you achieve 80g min of healthy Protein daily in your current diet? Recognize you will be limited to about 1c of food per serving. If so, than you'll be like the rest of us calculating protein levels and finding creative solutions to achieve those numbers.

As for the longevity/success of the band. If you want a guarantee, you won't get one...that's true for any diet or wls procedure. However, the band is designed to be placed once and for the life of the patient. True, some need revisions, repairs, replacements or removals for various reasons. But this is still the minority statistic. Much of the success is up to the patient to be compliant.

But side note, specific to maintenance.

I too was easy at losing weight initally. My issue was always maintenance as I reverted back to old habits. And this is where the band saved me personally. After getting banded I lost 50 lbs easy. THan got pregnant, than had a bad accident that put me into rehab for ovr 8 months. That's 18 months of not dieting. But unlike my 1st pregnancy where I gained 50 lbs, I only gained 20 w/ the band which I readily lost after the pregnancy. And because I am horrible stress eater, I ate poorly the entire 8 months I was in rehab. I would equate it to preop eating but the trick was..I couldnt eat as much. Would you believe I didnt gain weight?!?!?! And in January when symptoms got better I decided it was time to start again and I lost another 50 lbs. There is no way I could have done it w/out the band. Even today, I have a +3lb rule. Where when I go easy on myself and eat more freely, I will go back to strict eating if I gain more than 3 lbs to maintain. It's harder to gain 3+ lbs as it was before and thus I find maintenance to be a cinch. This is how the band can help someone like you. I know that if I did not have the band, not only would I gain weight back readily, but I would find maintenance an impossibility long term. And that's how the band serves me.

Just my personal take on it.

[MammaJamma42 106]

I'm only 4 weeks post-op, so I'm definitely not an expert, but I gotta agree with Hazel on this one. Her logic makes sense to me. If you can afford it, and if it will make you healthier (mentally and physically), and help you maintain long-term weight loss, then go for it, and finally feel good about yourself!

[lellow 1,713]

Australian doctors actually advocate the band for low BMI banders. The prognosis for banders with low BMIs are very good indeed. As long as a bander shows a history of trying to lose and being active already, they're actually the best candidates for lapband wls, because they already have a lot of the lifestyle elements that assist with losing weight, so the transition is easier.

My BMI was 35 at surgery and I'd already lost about 30lbs on my own by my estimate before deciding on getting a lapband. I walked a lot, and I was strong, if not fit. And had lost and gained many times previously and I was looking for something that would keep it off. What I needed was something that would help with my hunger.

Even before I got the green zone where the band eradicated most of my hunger, I was working out, sticking to band sized portions and in fact, I lost the majority of my excess weight before finding that perfect restriction. I believed that once I got there, the band would help me keep it off so this wasn't a diet where I could 'fall off the wagon'. If I hung in there, it would eventually kick in and would make it easier. And it did.

I won't say it wasn't a learning curve in identifying what the band helped me with as opposed to what I thought it would do, but in the end, what I REALLY needed it to do was control my hunger, and that's just what it did. For the rest of it, I put in the work, and I lost all of my excess weight and more as a result.

I also believe that had I not gotten the band, I probably would have gotten less active as I got older, would have continued to gain (as I had slowly but surely all my life) and eventually gotten to the point of being at a BMI that was much, much higher with possible co-morbs that would have made the surgery more dangerous. I'm glad I did something about it early, because I honestly don't think I could have done this by myself otherwise.

[Cocoabean 430]

The band does control my head hunger, at least most of it. By controling my physical hunger, I find myself thinking of food lest often. If I do eat out of boredom or stress, I eat less food. I started with a BMI of 36. I'd have done at a lower BMI if I could have. The FDA did lower the BMI to 30. The insurance companies still say 35 with co-morbidities. And if a surgeon will do it off-label at a lower BMI and you are willing and able to pay, and feel it will help--that is your decision. Be certain that your expectations are not too high, though.

If you are determined to eat around a band, you can do it. Junk food goes down oh, so easily. Milk shakes? yep. chocolate...oh yeah..all day if I wanted to. Eating healthful foods can be difficult, and it is easy to go with the comfort foods.

I was a grazer, I'd snack all day long, my surgeon warned me that the band doesn't always work for grazers. Turns out I am one of his most successful band patients. I listen to my band, I follow what it says. You have to get your head around that.

[annanyc 33]

I wanted to thank everyone for their thoughtful replies to my post. All the responses were sincerely appreciated. I decided to go ahead and schedule the surgery. I am aware that most of my problems with food are in my head. But I don't think that separates me too much from most other people who are considering WLS. The majority of us eat emotionally, binge or have other unhealthy relationships with food. Many of us let our weights hold us back from taking non-weight related steps in life, like going for promotions or pursuing romantic relationships or social engagements.

Regarding my weight not being as high as many surgery candidates, well, it's high enough that it's drastically affecting my ability to live my life the way I want to, much like any of us and high enough that lap band has been done, and to good effect. So I'm going to take this step. Exciting? Yes. Terrifying? Totally. Life changing? I'm going to do everything I can to ensure it is

I can't believe it's in just a few weeks!

[PrettyThick1 1,860]

Honestly, you just need a social life - get out there and have fun girl. You need to date, you need to travel and just find people with similar interests. I wouldn't advise you get WLS.

[MammaJamma42 106]

I'm so happy for you, Anna!! I think you'll be happy with your decision. I'm so glad I did it! Only wish I'd done it much sooner and at a much lower weight!!

[Cocoabean 430]

I wish you all the best with your decision!! Keep us posted as to how your journey progresses.

[lellow 1,713]

Good luck. It sounds like you're going into this with your eyes open and I think that's a great start. At a BMI of 35, which others may not think was that heavy, I felt heavy. And in hindsight I never realised how much it impacted on my life. As long as you have realisitic goals, understand the fight you will have with your food demons and are prepared for them, I expect you will be successful where you haven't been able to be before. Isn't that all that every bander wants?