Roux-En-Y or Lap Band

[seattle_homme 1]

I started thinking about bariatric surgery a few months ago, and of course after hearing about, thought that Lap Band was the only way to go (less cutting (of organs), no malnutrition issues, and (bad word here, I know) reversible.

I attended a intro session the other night at Northwest Hospital (Northwest Hospital & Medical Center - Bariatric Surgery: Surgical Options)

The surgeon seemed to really think it made more sense (for more people) to really consider Roux-En-Y even though most of us favor the Lap-Band.

The bottom line was weight loss 70% vs 50% of excess body weight (in favor of Roux-en-y). Not to mention the better effects on diseases.

My initial reaction to Roux-En-Y is pretty repulsive (out of fear). It seemed so permanent, and so many hoops to jump through. But his perspective was that this really is a life long change, the more weight you can loose the better. Dumping is a good thing (conditions us to eat properly), and the only issue becomes malabsorption (i.e. taking vitamins).

What do you all think? Has anyone else struggled with the choice? Any positive or negative feedback on the Roux-En-Y? (I know this is supposed to be lap band only

Thanks.

[Chickie 15]

Honestly, I have made a life long change, and I ended up doing better than the RNY stats quoted. So if you are looking at this in terms of a total lifestyle change, and a commitment to said change, there is no reason that 100% EWL cannot be achieved.

That all said, if I lost my band for some reason, and was unable to be re-banded, I would look at my other options (RNY, DS and VSG)

[babygrl1234 6]

My take on the situation is that a roux en y will give you your results much faster but a lapband will help you to maintain your results longer. Not to knock anyone who get a roux en y but to me it is a lazy man's surgery. You can sit on your ass all day for the first 12-18 months and your weight melts off. However, if you don't change your eating habits you will eventually gain your weight back. You get dumping which will deter you from eating sugary foods but that does not alway last forever and is not always the case. With a band you have to eat better because every calorie you put in your mouth counts, you have no intestinal rerouting so you absorb everything from your food. You have to work out. You have to change your lifestyle. But once you get there your band will help you to maintain your loss. You still have to take small bites and small portions, where as roux en y people can stretch their pouch to eat like they could before.

Like I said I am not trying to offend anyone who may have had a rny I just know it would not work for me in the long run. And that is the most important thing to decided, what works for YOU.

[OH Juli 15]

I don't typically answer these posts because they've been discussed to death on here but today I will.

It's my opinon that the surgeries are for very different types of people. The only thing they have in common are that they are surgeries for weight loss and they are done by surgeons who specialize in that part of the body.

The lapband is for people who have one last good effort to give to weightloss. Bypass is for people who are just done fighting and want to give the burden over to someone (the surgeon) or something (the process) else. They've run out of steam or they are too far away from being able to take responsibility for their actions.

That's not to say that one person is more committed than the other, it's what they are committed to. A successful lapbanded person (successful is the key word) is committed to making life long changes in how they eat AND how they move their bodies. The band gives them a tool to catch their breath, get their footing while they learn to behave and think differently. It also keeps them from falling too far when they break from the weight loss fight.

Bypass are commit 100% with their physiology with the hope that their behaviors will change during the 18-24 month window of opportunity.

However both can fail and do. I feel it's because the person doesn't want to do the work of rewiring their brains and his or her committment to the process/promise to him or herself of a better way of living is not sincere and life long lasting.

So if you were my friend sitting across the table having coffee with me I'd ask you if you had one last fat beat down left in you immediately or if you felt like you couldn't even think about exercising until you got under a certain weight...

[Skinny_Jill 36]

Many people gain their weight back after RNY and the lap band. The good thing about the band is that it can be adjusted to help you lose the weight again if you stick to the band rules. I work with a girl that had RNY and she lost 80 pounds. She has gained back 50 pounds because she did not learn to eat properly after surgery. Now she can eat all the foods she couldn't eat at the beginning.

Both require hard work and determination to lose the weight and keep it off.

Good luck with your decision.

[seattle_homme 1]

Wow, I am certainly learning a lot.

I guess I didn't realize how much work was required after surgery. I just assumed that once I had the surgery, life would be easy. All of the weight would come off from the lack of food, not exercise. Although I am fairly active, when I think of exercise, I think of five to six days a week, 60-90 minutes a day. I hope this isn't a requirement for the rest of my life. (If I kept up 5-6 days a week of this exerciese, I wouldn't need surgery to begin with!

I find this fascinating:

The lapband is for people who have one last good effort to give to weightloss. Bypass is for people who are just done fighting and want to give the burden over to someone (the surgeon) or something (the process) else. They've run out of steam or they are too far away from being able to take responsibility for their actions.

A successful lapbanded person (successful is the key word) is committed to making life long changes in how they eat AND how they move their bodies

So, a couple of questions :

1. Why does a lapband person need to exercise more than bypass?

2. How much more excercise do Lap Banders need?

3. What are typical exercise programs for Lap-Banders, during loss, and in maintenance.

[Chickie 15]

Wow, I am certainly learning a lot.

I guess I didn't realize how much work was required after surgery. I just assumed that once I had the surgery, life would be easy. All of the weight would come off from the lack of food, not exercise. Although I am fairly active, when I think of exercise, I think of five to six days a week, 60-90 minutes a day. I hope this isn't a requirement for the rest of my life. (If I kept up 5-6 days a week of this exerciese, I wouldn't need surgery to begin with!

You can just eat less and lose weight, but you won't just be loosing fat, you will lose muscle too. And then, there is no guarantee that you will keep the weight off without exercise.

And really, for optimum health, people should be doing around an hours exercise a day.

So, a couple of questions :

1. Why does a lapband person need to exercise more than bypass?

2. How much more excercise do Lap Banders need?

3. What are typical exercise programs for Lap-Banders, during loss, and in maintenance.

1. Because there is no malabsorption. Ever calorie we eat we absorb.

2. That's up to the individual. I exercise daily for anywhere up to 90 minutes (most days I average about an hour)

3. I can only speek for myself here, but pretty early on in the picture I started running. And I still run now, over a year into my maintenance. I actually run more now than I did while I was losing. I also do some resistance training 3 times a week on top of my cardio.

[anonemouse 1]

I started thinking about bariatric surgery a few months ago, and of course after hearing about, thought that Lap Band was the only way to go (less cutting (of organs), no malnutrition issues, and (bad word here, I know) reversible.

I attended a intro session the other night at Northwest Hospital (Northwest Hospital & Medical Center - Bariatric Surgery: Surgical Options)

The surgeon seemed to really think it made more sense (for more people) to really consider Roux-En-Y even though most of us favor the Lap-Band.

The bottom line was weight loss 70% vs 50% of excess body weight (in favor of Roux-en-y). Not to mention the better effects on diseases.

My initial reaction to Roux-En-Y is pretty repulsive (out of fear). It seemed so permanent, and so many hoops to jump through. But his perspective was that this really is a life long change, the more weight you can loose the better. Dumping is a good thing (conditions us to eat properly), and the only issue becomes malabsorption (i.e. taking vitamins).

What do you all think? Has anyone else struggled with the choice? Any positive or negative feedback on the Roux-En-Y? (I know this is supposed to be lap band only

Thanks.

My first thought when I read that was that your surgeon isn't up to date on the most current statistics. The most current ones say that the lap-band and RNY have equivalent results about 5 years out from surgery. Now, RNYers will lose weight faster for the first year or two, but then their bodies adjust to the surgery. They start losing weight more slowly, in some cases start regaining, and their bodies adjust to the surgery and start absorbing more calories. Lap-band patients, though, can lose weight for however long they have their bands. They don't depend on the same "window of opportunity" that RNY patients have to.

Personally, I think RNY should only be a realistic choice for people that are completely immobile or have seriously life-threatening obesity or conditions caused by obesity (in other words, are in severe danger of dying if they don't lose weight very quicky). I just think that it is too extreme for the average bariatric patient. Yes, it may take longer with banding to get to goal weight, but it is very possible to get there. There are just so many severe complications that can occur with RNY, and the procedure itself is so drastic, that I honestly never considered it for a moment when I was first looking into surgery. If I, for some reason, lost my band, the first bariatric surgery I would look at is VSG.

[GayleTX 1]

The most successful losers I know are the ones who had the lapband surgery and then ate and lived as if they had the gastric bypass. It's a great combination.

The bypass is only effective for about 18-24 months....after that you're on your own...the hope is that you will have learned new eating habits by then.

The band is good for life....can be adjusted as your needs change.

Many doctors and infomercials say that with the band you can eat what you want, just less of it, and lose weight. Well, maybe a few people can but nobody I know. And even if you did you probably would not improve your health much (we didn't eat healthy before wls or we wouldn't be fat). So getting a lifetime tool like the band and then eating right (lots of Protein, a few good carbs, very little refined/white/starchy carbs), lots of water/tea, don't drink with or right after meals, good regular exercise (you don't have to become a marathon runner...just move your body like healthy active people do). And keeping a good fill in your band as you lose is very important so you don't overeat.

[KarenG. 0]

This is such a favorite topic on this board! I don't think that there is a right or wrong answer. For me, I have known people with bypass who regained. My doctor liked the band for me because of my age, my BMI and because I would like to have kids in the future. Personally, I liked the fact that it is adjustable and less invasive. I understood that there is a small percentage of people that it does not work for but I figured I could always try another surgery if this less invasive one did not work for me. My doctor described it as a tool but one that is less powerful then the other options. I was ok with that because I wanted to try to change eating and exercise on my own - I have found it to be very powerful and I don't really even have great restriction yet. Good luck!

[OH Juli 15]

I find this fascinating:

So, a couple of questions :

1. Why does a lapband person need to exercise more than bypass?

2. How much more excercise do Lap Banders need?

3. What are typical exercise programs for Lap-Banders, during loss, and in maintenance.

1. We absorb our calories. To lose weight the idea is to have a deficit between how many you eat and how many you burn. Excersice burns calories. Bodies are healthier if you exercise them.

2. How much do you want to eat? How quickly do you want to lose? What's your objective? You adjust your exercise as part of that equation. An hour a day most days isn't unreasonable.

3. My exercise program has changed as my abilities have grown and boredom set in. I see me continuing exercising at the same level when I get to maintenannce and increasing the calories.

HTH

[seattle_homme 1]

Can someone point me to the study for long term lap-band vs bypass patients? Even just a reference, if the full article is not out for public consumption. I am interested in the 5-8-10 year comparisons.

I have hear something about 8 year loss in lap-band is comprable to 10 year loss in bypass? but I have also heard that bypass patients gain most of their weight back after 2-3 years? I want to find some hard data if you have it. Thanks!

[cathgr8 1]

I don't think the idea that you should exercise for the band to work well should scare you off the surgery. Frankly, though I'm 52 years old, I have had no regular exercise program at all until the last 6 weeks, and lost over 100 pounds in 14 months anyway. If you follow the food rules stringently, you can still lose rapidly. And as you slim down, you will feel more energy and will become more active. I love my walks now, becasue my knees don't hurt and I don't feel like I'm struggling for breath. It feels good. I don't work out an hour or more a day, I just walk for 40 minutes 5 days a week, and now am incorporating some mild strength exercising 3 times a week. It's what every healthy person should do, even bypass patients, that's all. The beauty of the band is most people can lose the weight by doing what works for them, as long as they follow the basic rules for eating.

[seattle_homme 1]

Thanks Cathy!

I guess I was hoping for a "thin person fix". Many thin people don't need to exercise (agreed, many do, but many DONT). I tend to go through spurts of exercise. I am 250lbs, on 5'11 frame. I can run 2 miles at any time with a 12 min/mile pace. After training for a few weeks, I can easily run 5 miles, and bring the pace down to 10 min/mile. I run triathlons every other year, and am in general pretty active.

The problem is (as with most people) I sit at a desk 10+ hours a day, and I simply have very little time for exercise during the week. 9 hours of work, 2 hours of commute, 2 hours with my family before my son goes to bed, and then (during winter in seattle) a dark and rainy night from 8-10pm before bed. My gym is 40 minutes away. It just isn't convenient.

And so my hope is to have a lifestyle like a thin person. Not even like a crazy thin person (who can eat anything and not exercise). But like a sane thin person, who, with the help of the band, will keep calories at bay and just loose weight! And when summer comes, and I *want* to run and swim and bike, I can, but when winter is here, and I don't want to, I don't need to!

Can I get more people like Cathy who can say this works?

Also, what is your diet like (when you are not working out?)

[cathgr8 1]

I think the most important part of the diet is making sure you always start with hard Protein. When my BF asks what I want for Breakfast, or lunch or dinner, I always say anything with protein. The other day, he said, I'm starting to think that what you really mean is "meat." He's right. The only protein I eat which is not meat is nonfat milk, usually once a day, cottage cheese, and sometimes eggs. That goes in first, then maybe a little pita bread or crackers, veggies or fruit. For treats, I stick almost religiously to sugar free, fat free pudding (3 g of protein too) with a squirt of fat free ReddiWhip (the banana fudge is to die for, with a couple of slices of banana on top). My calories are never under 1000, but since it's mostly lean protein, I still lose. And I still do go out to restaurants, drink alcohol a couple of times a week, and will have occasional taboo treats, like a small slice of birthday cake or split a pastry or a potato with the BF, but rarely. I have certain foods at the fast food places I have learned fill me up, and have lower calories and lots of protein, and that's what I usually have for lunch. And I have started bringing low heeled shoes to work, and walk at lunch or on break, usually to Starbucks for my latte. You can have a few minutes here and there rather than a long bout of exercise too.