Band to Bypass with low BMI - what are the real risks?

[Melificent 0]

Hi all

I'm in the UK. I had a gastric band in 2009. I did lose weight but had constant vomiting, reflux, heartburn, etc. Only when it was too tight did I manage to get to nearly my goal weight. I have had it checked under x-ray to rule out complications. I have around 11 kilos to go. According to NHS guidelines I am overweight. However, my BMI is 26 and no-one in the UK will touch me. There are a few places outside the UK that offer the sleeve but I can see from this forum that people are starting to need revision from this. The bypass is the gold standard and this is what I would aim for. To undergo the cost, worry and hassle of a second bariatric surgery means I want to get it right this time and not be looking at a third surgery several years down the line. Hindsight is a wonderful thing and I wish I'd had the bypass in the first place. Anyway - I have found somewhere that will do the bypass but I am very concerned. No-one can seem to tell me what the real risks are of bypass with a BMI of 26. Guidelines seem to talk about cost effectiveness. So why is it you can't have a bypass at BMI of 34 and with one additional point, at 35 - hey presto it's ok. Can anyone advise please?

Edited April 20, 2016 by Melificent

[daizymom 62]

I don't really have any advice for you. It's not usually presto at 35- at least not in Canada- to have gastric bypass with a 35 BMI in Canada, you have to have at least 1 co-morbidity. Good luck! I hope you find what you're looking for.

[KristenLe 5,979]

Most Bariatric Programs in the States require you to be obese (35 + BMI) with comorbities or morbidly obese (40+) in order to "qualify" for WLS. I honestly can't imagine going through major surgery and modifying my internal organs with a BMI of 26. WLS was not intended for people who need to lose 30-50lbs unless there was a medical reason to do so. With WLS at a 26 BMI - you risk losing too much weight and having complications with nutrients/malnutrition. Just my fat girl opinion. :-).

[James Marusek 5,244]

In general, RNY gastric bypass is recommended over sleeve for patients suffering from severe acid reflux. This is because the sleeve will only make the condition worse.

I knew one person personally who went from band to bypass. In his case the band was wearing into his stomach and his stomach was about to rupture. I don't think you will incur any more risk because you have a low BMI in getting a revision from band to bypass. I suspect that in reality, the risk will be much less. In the case of the individual that I mentioned, because there was scare tissue from the band removal, then they rerouted his stomach, his pouch was a little smaller than most operations. But he was fine with that. It just meant that he had to consume a little less food during his meals.

[NewAngela 60]

After the first few months, or after, you can always take supplements to get more calories. At the end of it all, I would think you have a better chance of maintaining a "normal" BMI as opposed to the average weight loss of 60% or so excess weight. The main risk would be loosing to much fat and then loosing muscle as well, but gastric bypass patients intentionally don't have excess calories. High calorie supplements may be needed if you loose to much weight. Definitely better to do it at the time of band removal or soon after. I had the band removed due to slippage and complete obstruction and I gained over 100 pounds over 5 years or so. I just had bypass 6 weeks ago.

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