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Gastric Bypass VRS. Lap Band



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Howdy,

This thread is more for my mom then myself, I've been banded since 1/24/07 and lost 28lbs so far. I feel so great and would do it all over again in a heart beat. My mom who is also over weight went to a lapband/gastric bypass seminar tonight. The doc she went to said that people benefit more form GB then from LB. He told her that only 36% of people w/ LB maintain their goal weight where as 70% of people w/ GB maintain their goal weight. The doc I went to use to do GB and now only does LB bc he said GB has so many problems and people stretch out their stomach's and then gain weight back bc you can't go in and make your tummy smaller again. My mom now isn't sure if she wants LB and she's leaning more towards GB. I'm not really sure what all I can tell her. She see's how happy I am w/ my band but, now she thinks that once she looses her weight she'll gain 64% of it back eventually. I've heard so many horror stories about GB but, don' personally know anyone who's had it done. I really want my mom to make the right choice. She's going to be self pay and the doc she went to charges $18,000 for GB and for LB so that money isn't an issue when trying to decide which procedure is right for them. Any advice/thoughts would be so helpful.

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There is no perfect weight loss surgery. With bypass you lose lots of weight and you lose it rapidly, but there are trade-offs. And it's much riskier, of course.

Every single person I know who had gastric bypass (except for the one that died) regained a significant portion of their weight within 2 or 3 years. But I know some Bandsters who have, too.

The stoma will stretch. The pouch will stretch. And the patient will begin consuming more and more food. Then it comes down to that D word (diet) and exercise.

The band limits what you can eat, and people sometimes hate that, or just get tired of it after awhile. You can eat around the band easier than you can the bypass, if you are one of the "lucky" ones who experience dumping syndrome.

I guess what I'm trying to say is that it's a personal choice. I'd encourage my mom to attend another seminar - presented by a more open-minded doctor. My doctor does both procedures, but he chose the band for himself.

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I'll try to find the study abstract I posted a while ago. The gist of it was that both RNY weight loss is superior in the first couple of years, but lap-band catches up after that, with the two procedures having statistically equal weight loss about 3+ years post-op. There wasn't enough follow-up data to make a conclusion about long term weight loss (10+ years post-op), but it looked like lap-band might be superior to RNY, since the lap-band's 8-year average weight loss was statistically equal to the 10-year average weight loss for RNY. Makes you wonder what the results will be when there is enough data to compare the 10-years post-op data. The authors of the study analyzed all previous studies that were published in English-language journals and had at least 3 years follow up and 100 participants.

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Here is is:

Systematic review of medium-term weight loss after bariatric operations.

Obes Surg. 2006; 16(8):1032-40 (ISSN: 0960-8923)

O'Brien PE; McPhail T; Chaston TB; Dixon JB

The Centre for Obesity Research and Education, Monash University, Melbourne, Victoria, Australia. paul.obrien@med.monash.edu.au

BACKGROUND: Although bariatric surgery is known to be effective in the short term, the durability of that effect has not been convincingly demonstrated over the medium term (> 3 years) and the long term (> 10 years). The authors studied the durability of weight loss after bariatric surgery based on a systematic review of the published literature. METHODS: All reports published up to September, 2005 were included if they were full papers in refereed journals published in English, of outcomes after Roux-en-Y gastric bypass (RYGBP), and its hybrid procedures of banded bypass (Banded RYGBP) and longlimb bypass (LL-RYGBP), biliopancreatic diversion with or without duodenal switch (BPD+/-DS) or laparoscopic adjustable gastric banding (LAGB). All reports that had at least 100 patients at commencement, and provided > or = 3 years of follow-up data were included. RESULTS: From a total of 1,703 reports extracted, 43 reports fulfilled the entry criteria (18 RYGBP; 18 LAGB; 7 BPD). Pooled data from all the bariatric operations showed effective and durable weight loss to 10 years. Mean %EWL for standard RYGBP was higher than for LAGB at years 1 and 2 (67 vs 42; 67 vs 53) but not different at 3, 4, 5, 6 or 7 years (62 vs 55; 58 vs 55; 58 vs 55; 53 vs 50; and 55 vs 51). There was 59 %EWL for LAGB at 8 years, and 52 %EWL for RYGBP at 10 years. Both the BPD+/-DS and the Banded RYGBP appeared to show better weight loss than standard RYGBP and LAGB, but with statistically significant differences present at year 5 alone. The LL-RYGBP was not associated with improved %EWL. Important limitations include lack of data on loss to follow-up, failure to identify numbers of patients measured at each data point and lack of data beyond 10 years. CONCLUSIONS: All current bariatric operations lead to major weight loss in the medium term. BPD and Banded RYGBP appear to be more effective than both RYGBP and LAGB which are equal in the medium term.

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My two best RL friends have had the bypass........ both did great, both started out over 300 lbs and both lost over 120 lbs. One is 4 years out, and she has regained a significant amount of weight back. One is two years out and just had a Tummy Tuck and booblift. BOTH are still well under their original weight, but my friend who is 4 years out was one of those people who NEVER dumped, so she could get away with eating and drinking everything and size 28 to 10 up to 16 right now... she is extremely depressed and I am worried about her... she has stretched out her pouch and now is thinking about having the band placed on her existing pouch. Both say it is the best they have ever done for themselves.

I guess what swayed me is that the band is NOT rerouting my PARTS! and I can be back to work in a few days vs a few weeks, and any general surgeon can remove it IF needed.

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I am pre-op, but I asked doc if a patient is a candidate for either surgery what would he pick? Doc said " if a patient has the ability to be at least, somewhat active, and health allows some time to slower/safer lose weight Lap Band is THE way to go! If a patient has lost the ability to be active or due to health does not have the "time to lose" then he might pick GBypass."

If it is necessary Lap Band can be fixed, adjusted, or removed at any time for life. GBypass can never be "fixed" adjusted or reversed even if "necessary". You also have restriction without adjustability and malabsorbtion to deal with for life. And that is, wether or not you re-gain. With Lap Band even 5-10-20 years along if you need to combat gains, you can get adjustment.

I was leaning to GBypass for myself until my research steered me far from it!!!! You can not go from BPass to Band, but you could go from Band to BPass if required!

To me, for myself, I'm still in control of my body and my options with Band-----with BPass I'm out of options!

I do hope what ever "mom" decides to do, you are supportive of her and her decisions--we all need that to feel successful!!! Good luck and good research!!

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Hi Laurend, Professor Paul O Brien is the head of my clinical surgical practice CBS (Centre for Bariatric Surgery). He actually helped design one of the original bands and has published lot of papers on the efficacy etc of the band. I feel in very safe hands being a patient of this practice.

www.lapbandaustralia.com

Susannah

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Hi Laurend, Professor Paul O Brien is the head of my clinical surgical practice CBS (Centre for Bariatric Surgery). He actually helped design one of the original bands and has published lot of papers on the efficacy etc of the band. I feel in very safe hands being a patient of this practice.

www.lapbandaustralia.com

Susannah

That's very cool! I think you are in very good hands!

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I too explored both options. I chose the band, based mainly on future health issues. I am a cancer survivor. I felt that if I were to have similar health issues in the future, I could better handle them with the band than I could with RNY. With the band, I will not have malnourishment issues, if I maintain a good restriction, and eat appropriately. Also, if I were to need additional nutrition during treatment, an unfill is possible. If I should need to for any health reason, my band could even be removed. Once you make the decision for RNY---that is IT! No second chances, regardless what life hands you!

I agree with the poster that suggested another seminar, with a more open minded Dr. She needs to be given honest, up to date information, and if she chooses banding, she needs a Dr. who will support that, not be there to belittle her decision.

Glad she has you to help her along---good luck on your journey as well!

Kat

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Hello, Can someone please explain what the dumping syndrome is and how from what i have read it is a good thing?

Thanks Lea:confused:

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Hey Ryan

I have a RL friend that just had a GB...she is an awesome person and I know that she would be willing to email you or your mom and tell the ins and outs of why and how she is doing. She had her GB about 8 weeks ago and I am thinking she is down around 50lbs. GB is a quicker loss I know that, but I also think that there is a higher regain average to go with it from what I understand. Good luck and I can set you up if you like.

POPT

Tracey

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dumping is when you eat something that has sugar or other trigger and it causes you INSTANT (and I mean INSTANT) crap your pants syndrome, or over all nautious.... you will learn your lesson after a dump...... most try to avoid it at all costs....

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hi i just wanted to give some info my mother had the GB done about 5 years ago and she is still thin she had a very hard time and she has to take B12 shots every month along with other vits. as we all should be with GB you have to because your body is not asorbing all the nut. she has said she wish she would have had the band because it is ajustable but it takes alot more will power and drive as we all know. my mother lost lots of weight fast and got to me grossly thin now she looks great. my doctor told me at my first consult that GB can mess with hormones and was true for my mom. so i guess the thing you have to do is look at the whole picture everyone is different my uncle is extermely over weight and myself having teh lapband and my mom having the bypass i know he needs the bypass he is way to large and has no idea of healthy eating or self control, he would not be able to do the liquid dites after a fill not and expecially before and after the surgery and he would not be able to own the fact that if you eat bad stuff you will not lose weight it would always be someone elses fault not his. i dont mean to sound mean but i am being honest so i hope he dont let his fear of the GB stop him becaues he is going to die if he dont do something.

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