Is the sleeve more effective than the band at forcing compliance?

[mandi78 3]

I was banded 11 months ago and here I sit, only about 4 pounds lighter than I was a year ago. I have nobody to blame but myself. I know the band is just a tool, it's up to me, etc, etc. I was hoping the band would force me to not eat the way I was eating but it really hasn't. I can't stand the way it feels when my pouch is "full". Its uncomfortable in my chest and makes me want to gag. It feels like I can't breath and I panic so I drink to wash the food down. Then, I eat more. They've done x-rays and say my band is in proper position. Those who have the sleeve, is this how it feels when you are "full" or is a more normal feeling of being full in your stomach? I'm looking into my options of having the band removed and trying something else but I don't want it to just be another failure. I want something that will force me into compliance and the band has not done that. I have been in therapy for over 3 years and seen a few different therapists and have worked on the emotional part of my eating/food addiction but can't seem to move past it. Thanks for any advice.

Edited August 21, 2008 by mandi78

[SpecialK 22]

Mandi, I don't know alot about Vertical Sleeve but I've tried to get educated about it and it looked to me like they took the stomach and cut a vertical tube shaped pouch maybe the diameter of a hotdog (picture that size in your mind), and then stapled off the whole long side of that pouch away from the rest of the stomach (which I've been told to picture it the size of a Nerf football), and then they REMOVE the entire rest of the stomach so there is no going back. That non-reversible factor was a major reason I went with the lapband. I am concerned for you that if you are forcing food with your egg shaped stomach pouch formed from your lapband, that you may still be a eater that forces food in your new tube shaped pouch and you could break open the incision line if that is the abuse situation you can't stay away from. Also, given that RNY or gastric bypass patients can stretch out their new smaller pouch, I have to believe its possible to stretch out a vertical pouch too which would lead to regaining. With your lapband, you can continue to get adjustments even if you have been unfilled and want to then start over and try again. Please discuss your eating habits and your past experience with your surgeon and see what he recommends. If you haven't considered counseling, I would do it and I have and it helps. I wish you all the best.

Edited August 21, 2008 by SpecialK

[MacMadame 81]

The sleeve stomach is more the size of a man's index finger. It holds about 4-5 oz. by year end. It doesn't stretch out more than that because it's made from the more muscly part of the stomach, not the stretchy part. [in the early days, they used a bigger size and those stomachs did sometimes stretch out, but the new smaller size doesn't.]

As for what it feels like to be full, it's a normal functioning stomach, just smaller. So, for example, you can wash food out of it with liquids about as well as you can with a regular stomach. (Which is to say, you can a little, but not really, not like with a band.) You still aren't supposed to drink while eating because of the size -- you can't get in all your nutrients if you fill up your sleeve with Water.

I think if you weren't able to make the lifestyle changes necessary with a band, then you might want to look at the DS as well as the sleeve. Both surgeries cut out the portion of the stomach that produces ghrelin, the hormone that stimulates your appetite, so hunger control is a more sure thing than it is with a band. However, the DS also has a malabsorption component that allows people to continue to eat similar types of food to what they ate before -- it's more Atkins based than South Beach diet -- which the sleeve (and the band and RnY, for that matter) work best with. Which is not to say there aren't food restrictions -- too many carbs make some DS patients have smelly farts and diarrhea.

As far as being reversible is concerned, the only reason to remove a band is that it's causing health problems. A VS isn't going to do that because it's a real stomach, just smaller. It turns out you don't even need a stomach to live (my aunt lost hers to cancer) so you shouldn't be having health problems just by having a little one. Most of the sleeve complications come early on and are fixable -- over production of acid, strictures, etc. Other complications are the sort of things that can happen to anyone and are extremely rare.

The only serious complication is a leak and that generally isn't an issue after two weeks. Your stomach heals around the staple line and then you can't "bust a gut" any more than you will bust your current stomach if you eat too much.

The DS does sometimes come with health problems because of the malabsorption. In that case, the intestinal switch part can be reversed but not the stomach part. RnY can technically be reversed but it's a big scary operation and is usually only done if your RnY is killing you. Even then, you may have an atrophied pylorus value and scar tissue that keeps you from having a real stomach like you had before.

The band is easier to reverse but it sometimes causes permanent problems, too, because of scar tissue that forms around it. You need to accept that if you get/have one, your stomach may never go back to the way it is before if it has to be removed.

In the end, being reversible doesn't seem like a big deal to me. If you aren't willing to commit to WLS because it's not reversible, then they shouldn't have a band either IMO. WLS is a big commitment and you need to go into it thinking it's for life, because it almost always is.

But the big thing you need to think about if you want to revise your surgery is why exactly did it fail... if it didn't fail mechanically, if your head is the problem, then whatever you revise to will fail as well IMO. You can eat around any WLS even the a bazooka surgery like the DS. If you didn't like the full feeling of the band, maybe you'll find something to not like about another WLS and you'll eat around that too.

The surgery only works on your guts... the head work needs to come from somewhere else.

Edited August 21, 2008 by MacMadame

[SpecialK 22]

Thanks MacMadame for the info to help me learn more about it.

[LavenderRose 0]

SpecialK,

I have the band and I am having it removed due to complications. I seen my dietician and asked her what the differece was with feeling full with the band and feeling full with the sleeve. She explained to me that once the hunger hormone (Ghrelin) is removed then I will feel less hungery all the time and I won't have those dramatic peaks of starvation. I will also not get that chest pain anymore. The sleeve has no device to make things get stuck to feel that pain. You will just feel "normal" with the sleeve since it operates like a regular stomach. The best thing I like is I won't be able to eat more and drink with my meals (you are NOT supposed to do this with the band anyway) bad me..., so with the sleeve if you try to eat too much or drink with it you will end up in pain and throwing up..I do not want that. There is no other part of your stomach to force food into with the sleeve like it is with the band.

I do not drink with my meals anymore now, so that is a wonderful thing for me and it was hard for me to train myself to do. I don't even allow a drink on the table when I am eating. I make sure my hubby keeps his close to him and not near my side where I could just pick it up unconsciously and drink it.

If you are having problems with head hunger...don't beat yourself up about it. You need to work hard with your counselor and try getting a book called "The food & Feelings workbook" It is very good and I used it and am using it to help battle my addiction. Also joining groups for food addicts can be very helpful for some. The reason we are all obese or morbidly obese is because we didn't or couldn't control how much we ate. I have never seen a obese person eat 2-3 oz at each meal, exercise 4-5 days a week and say I don't know why I am not thin. If we could control how much we ate we wouldn't need surgery as a tool to help us out. Head hunger won't go away overnight and you will have to work on this addiction for life, as well as any alcoholic or drug addict works on their addiction and staying clean life long. You can still get surgery, but don't expect the surgical TOOL to work if you are not doing your part. I just feel you can keep working on this one day at a time, but you must be committed. That is also why they have surgical support groups. People don't cure their head hunger and get surgery, though that would always be best. But in reality, it isn't like that 95% of the time. We need a tool to help us along. You can make the band work for you if you want to. But it will mean working hard with getting counseling, exercise, going to support groups, and taking it one day at a time. If your band is causing you pain in your chest, first try and eat smaller bites and chew very well. If this doesn't work then maybe you need a slight unfill. Sometimes just .2 cc's is enough to help.

Good luck with your weight loss journey whether you keep your band or get another surgery.

[MacMadame 81]

Thanks MacMadame for the info to help me learn more about it.

Your welcome.

And I just want to clarify that I wasn't saying the OP should get her head shrunk because she's nuts and would clearly mess up a sleeve too. I edited a few times to make it clearer I wasn't saying that, but tone can be so hard to convey online.

But not all WLS fails because of physiological reasons so it's good to examine that part of it if you are in the position of not having lost a lot with your surgery. So it was more of a general statement than a specific one.

[LavenderRose 0]

Your welcome.

And I just want to clarify that I wasn't saying the OP should get her head shrunk because she's nuts and would clearly mess up a sleeve too. I edited a few times to make it clearer I wasn't saying that, but tone can be so hard to convey online.

But not all WLS fails because of physiological reasons so it's good to examine that part of it if you are in the position of not having lost a lot with your surgery. So it was more of a general statement than a specific one.

I am trying to look through the posts to see who made you think anyone thught you said that. I don't see that in your post at all MacMadame. I just can't find anyone who said that you thought the OP was "nuts and needed her head shrunk". I agree with most of what you said. You basically said what I did, that we need to work at any weight loss surgery and that it is a tool and it isn't going to work by itself. We both just worded it differently and I just worded what my thoughts were in my posts. Maybe I am not seeing something. The only thing I think I added was how I just know by so many posts I have read over the past 3 years that people get the surgery THEN get counseling as oppossed to the other way around. A lot of people get surgery for health reasons first and deal with the head hunger later when they get their diabestes under control or what ever health issue needs attention. If you got this feeling from my post, then you are taking my post completely the wrong way. You know a good deal about the sleeve and I think you described it to her very well. But I am allowed to post my thoughts.

[LngRedRose 0]

Mandi,

The reason I choose the sleeve is because it is maintaince free and it is non reversible. There is no overeating because you will throw up if you do (and trust me.. after a couple of times.. you won't do it again). I had the sleeve on July 2nd... I have lost 51 lbs since then. I wish you luck in whatever decision you make...

[mandi78 3]

I don't disagree with what anyone has said. I started therapy 2 years before getting the band and I thought (and my therapist thought) I was prepared and could deal with the changes it would require. I was wrong. There really wasn't any way for me to know this prior to surgery. I thought it would be similar to how diet pills make you feel in that you just don't have an appetite or an interest in food. I was wrong. If I had known then what I know now, I would have chosen a different option. I know the band has helped many people and I'm happy for them and that they were able to make the changes and follow the band way of life. I'm sorry that I couldn't. I'm not blaming the band, I know the problem is with me. I just don't know where to go from there.

Seriously, after all the therapy I've had, changes I've made in my ways of thinking and seeing myself and others.....I just can't imagine myself ever having a normal relationship with food and not overeating. It's a very helpless and hopeless feeling. I don't know what to do. Nobody seems to be able to help me.

[solopoco 0]

I didn't realize just how severe my 'head hunger' was until I had the sleeve surgery - the first two weeks after surgery proved to be difficult for my head would say HUNGRY but my stomach would allow so little (and of course I was on liquids only). Nevertheless, i was forced to comply since there was no turning back - FOR ME, I needed the irreversibility thought process....I had surgery July 15 and have lost 30 pounds....my head hunger is gone, I'm incredibly pleased with the results and so grateful I chose the sleeve.

[MacMadame 81]

I am trying to look through the posts to see who made you think anyone thught you said that.

I didn't think anyone said that. I was worried the OP would think I meant that. So I was happy that no one was taking it that way.

[JaJeanne 1]

Mandi78,

Hey girl, keep your chin up, you are on the right path, you are trying to do something about your situation, just please think of the positive, at least you haven't gained anymore weight!!! I know exactly what you mean with the head hunger...I got the sleeve on July 30th and I stupidly found myself eating regular food, even when I was supposed to be on liquids, now why would I do that? Food addiction, hello how crazy is that? I can't seem to control my food choices if the bad food is around. The only thing is that I can only eat a small amount of it...but even though I've been eating small amounts my body is totally fighting weight loss. I've lost 18 lbs in 4 weeks tomorrow, which is great, but not as great as most that I've seen, soooo believe me I know about the head hunger. I'm starting a food journal to write down exactly what I eat to help me see what I'm doing...I am also focusing on trying to get my Water and Protein in... Don't worry, just try to do your best, that's all we can do right? I'm still worried that I've done damage to my new stomach and I hope it hasn't ripped, torn or burst, I guess I would have felt it if it did. But this head hunger is something else... I would try that Foodaholic program if we had it where I live, maybe they have an online support group kinda like this... but this works too... I feel ya Mandi, just keep trying day by day and hour by hour, I know what your going through...All the best, Jeanne

[jlweb55 0]

No you do not feel like you do with the band , I have the band and now I have the sleeve. I feel normal, just full with the sleeve, It did not force me to stop eating icecream and Cookies, I am having to work on my head hunger, I am not hungry at all now, just old habits. jlweb55

[mandi78 3]

What caused you to switch to the sleeve? Did you have complications from the band?

[jlweb55 0]

My head hunger is awful. I hope it subsides soon. I am at 3 weeks and eating everything in site, in small bites of course. judy