Why is banding so frowned upon?

[WASaBubbleButt 41]

I think Australia has had the band longer, so surgeons are more experienced. They also stress eating a 'normal diet' after healing from the surgery. That takes away a lot of that food obsession, which may make it more viable for a lot of patients long term...

Australia has half the slip stats of the US. I personally think it is a combination of skill/experience and the post op diet. Not sure we will ever know one way or another.

[WASaBubbleButt 41]

The support group I attend at my surgeon's office is filled with RNY grads and potentials. One of the members has no problem challenging people who have chosen the band about their choice. She regularly says that banders can lose only 50% of their excess weight and she can't understand why anyone would choose that over bypass. <o:p></o:p>

<o:p></o:p>

I complained that people who chose or were choosing the band may not feel welcome in the group and that it was reprehensible that the facilitator allowed members to ask other members to defend themselves. I told her that I was sick of defending myself and wasn't about to do it with a bunch of people dealing with the same thing I was. <o:p></o:p>

<o:p></o:p>

It was obvious to me that many people in the group gravitated toward RNY because they thought it was an "easy" way for them to kick their sugar addictions. Apparently, many of them appreciate getting sick when they eat something sweet. It was bizarre to me, but it seems to work for them.<o:p></o:p>

I wouldn't want to dump either but you know, I think there is a time when it is appropriate for someone to get bypass in hopes that they dump on sweets.

I have a friend that weighs more now than she did when she was banded. It's not the band, it's her. She cannot give up sweets. Can't do it. She started out at about a 60BMI, she's up to about a 70BMI now two years later. She is just getting bigger and bigger. Again, it isn't the band it's HER. She can't give up the sugar. She should have had bypass to begin with. She used to eat cakes, pies, brownies, etc. She can't eat those foods with a band so now she's eating chocolate bars, M&Ms, etc.

It's really very sad.

[RestlessMonkey 7]

WasABubble...I stand by my post. To have a surgeon try to force one elective surgery over another is filling that surgeon's agenda, not the patients'. If there is a sound medical reason one should'nt have a procedure, then give it. Otherwise, let the patient decide.

AND I said question...but never doubt. Maybe you do doubt yourself, and if so, I feel for you. That's no way to live.

On the plus side, open debate is always good. If our stances and beliefs can't hold up to scrutiny and questions, then maybe it's time to revamp.

[Jachut 487]

Being from Australia, I have an opinion about why the band works so well here - and that's all it is, an opinion.

I think its the diet. The emphasis is on a normal diet here, not Protein first. Protein first has several disadvantages to my way of thinking. Firstly, we dont all get 80 to 100 grams of protein a day and we're not all losing our hair and failing to lose weight and ending up all fat no muscle, so that debunks that theory completely.

Secondly, I dont believe protein DOES fill the stomach like the doctors say it does. I have had this discussion on Australian boards and there's general consensus that its the fibrous foods that fill the band and make you very satisfied - fruit, vegetables and grain foods (not WHITE carbs mind you). Eat a meal of mainly protein and you ingest a LOT more calories than a meal spaced out with plenty of salad and some bread!). Also it will be a much higher fat meal.

Now mind you, I am not saying that the old traditional food pyramid is the way to go. I think reducing carbs from a ridiculously carb overload diet is a sensible thing for weight loss and I agree our bodies need protein. But cutting out carbs and fruit and veg to the extent that many Americans do is also detrimental - you only need read the What Did You Eat today threads to realise that people are woefully falling short of healthy levels of fresh food, and living on protein foods.

To keep your calories low enough to be happy with 800 to 1000 calories of mainly protein foods a day (something no Australian doctor would recommend) you need a TIGHT band. Which in turn often leads to ingestion of slider foods not the healthy foods it was intended to encourage. And of course it leads to far more problems with the band.

In addition, Australians in general simply do not eat the amount of processed foods that Americans do. Protein shakes and bars are not food, they are processed, full of artificial sweetener and more designed to supplement athletes trying to build muscle, not the average person trying to lose weight. I cant for the life of me understand why you would have surgery to improve your health and then live on stuff like that.

And of course, like a previous poster mentioned, eating normally like that (well its normal to Australians) blows that whole diet mentality away. I dont know ANYONE here who thinks so much about what they eat, weighs, counts and measures it like Americans do. It really is just eat normally but less and to my mind, that works. Our surgeons dont give us rules and regulations, and we dont fear going back for fills and having to present food diaries or report that we've eaten bread once or any of that.

That's why the band is the gold standard WLS here. When you approach it from that perspective, its actually a very easy, non problematic surgery to live with, of COURSE people have problems here too, I met a lady the other day who's had since her surgery a flipped port, an infection at the port, port replacement of course, and no fill for 12 weeks while all that is worked out, and I know people who've slipped etc.

The PRIME reason for the success with the band here though is our medical system. Medical care is much more easily accessed, unless you live in a very isolated place, the idea of having to fly in for your fills is patently ridiculous here, as is leaving the country for surgery. You drive a few suburbs to your surgeon, that's all. Most people pay a once off fee of a few thousand prior to surgery and all their aftercare is bulk billed so no out of pocket expenses for your fills etc. Putting off a fill or an unfill because its going to cost several hundred dollars just doesnt really happen here.

I dont think the follow up with the band is disadvantage, I think its one of the keys to why it works well! Interestingly they're doing more sleeves in Perth now, for the simple reason that Western Australia is much more rural, and people are coming from isolated areas for WLS and the sleeve doesnt have the follow ups.

Now, those are all just opinions. I'm not stating them as fact. That's how I've worked my band, and its been hugely successful for me and that's the only authority I feel I have to say what I just did. I'm not suggesting I'm 100% right or that everyone should do it my way, and I'm not wanting to start a fight about it as everyone defends their high protein diet so vehemently. Those are the culture differences beween the US and Australia and how I interpret them, that's all.

Edited December 14, 2008 by Jachut

[redmom 0]

Jachut, I've been reading your posts for several months now, and I've got to say your approach makes the most sense to me. I'm still on my post-op diet, but as soon as I'm cleared for real food again, I hope to never see another Protein Shake in my life. I've got three little girls that I'm hoping to teach how to maintain a healthy lifestyle. For us that means exercise regularly and eating the colors of the rainbow. We'll also be making Christmas Cookies and enjoying them as a "sometimes treat". I'm hoping to teach them and myself, all things in moderation, not how to obsess about food. I can't justify buying them organic milk and hormone free chicken and then drinking a Protein shake made of who knows what chemicals. Thanks for the common sense approach.

[jillsart 0]

The following are typical results for WLS at the end of 5 years:

DS: About 85-90% of your excess weight (but a horror of a procedure IMHO)

Bypass: About 80%

Sleeves: About 80%

Banding: 50-70% (depending on starting BMI)

MGB: Not sure, nobody with any skill or positive reputation does this procedure, only the doctors who can't make it in the real world do it. ;o)

Gastric Ball: Only used for temporary use, not designed for long term use so there are no 5 year stats.

These are different statistics than my surgeon quoted me. Can you tell me where you got these statistics!

[Great2BThin 5]

The following are typical results for WLS at the end of 5 years:

DS: About 85-90% of your excess weight (but a horror of a procedure IMHO)

Bypass: About 80%

Sleeves: About 80%

Banding: 50-70% (depending on starting BMI)

MGB: Not sure, nobody with any skill or positive reputation does this procedure, only the doctors who can't make it in the real world do it. ;o)

Gastric Ball: Only used for temporary use, not designed for long term use so there are no 5 year stats.

These are different statistics than my surgeon quoted me. Can you tell me where you got these statistics!

My starting

BMI was about 44, I am down 90 lbs, total of 66% of my excess body weight and 6 mos out from surgery.

Statistics are just averages. And averages include all types of folks, they don't account for those that don't follow the rules, think the band will do all the work for them, etc. I intend to be 'above average'! :tongue2:

[Bea1128 1]

Being from Australia, I have an opinion about why the band works so well here - and that's all it is, an opinion.

I think its the diet. The emphasis is on a normal diet here, not Protein first. Protein first has several disadvantages to my way of thinking. Firstly, we dont all get 80 to 100 grams of protein a day and we're not all losing our hair and failing to lose weight and ending up all fat no muscle, so that debunks that theory completely.

Secondly, I dont believe protein DOES fill the stomach like the doctors say it does. I have had this discussion on Australian boards and there's general consensus that its the fibrous foods that fill the band and make you very satisfied - fruit, vegetables and grain foods (not WHITE carbs mind you). Eat a meal of mainly protein and you ingest a LOT more calories than a meal spaced out with plenty of salad and some bread!). Also it will be a much higher fat meal.

Now mind you, I am not saying that the old traditional food pyramid is the way to go. I think reducing carbs from a ridiculously carb overload diet is a sensible thing for weight loss and I agree our bodies need protein. But cutting out carbs and fruit and veg to the extent that many Americans do is also detrimental - you only need read the What Did You Eat today threads to realise that people are woefully falling short of healthy levels of fresh food, and living on protein foods.

To keep your calories low enough to be happy with 800 to 1000 calories of mainly protein foods a day (something no Australian doctor would recommend) you need a TIGHT band. Which in turn often leads to ingestion of slider foods not the healthy foods it was intended to encourage. And of course it leads to far more problems with the band.

In addition, Australians in general simply do not eat the amount of processed foods that Americans do. Protein Shakes and bars are not food, they are processed, full of artificial sweetener and more designed to supplement athletes trying to build muscle, not the average person trying to lose weight. I cant for the life of me understand why you would have surgery to improve your health and then live on stuff like that.

And of course, like a previous poster mentioned, eating normally like that (well its normal to Australians) blows that whole diet mentality away. I dont know ANYONE here who thinks so much about what they eat, weighs, counts and measures it like Americans do. It really is just eat normally but less and to my mind, that works. Our surgeons dont give us rules and regulations, and we dont fear going back for fills and having to present food diaries or report that we've eaten bread once or any of that.

That's why the band is the gold standard WLS here. When you approach it from that perspective, its actually a very easy, non problematic surgery to live with, of COURSE people have problems here too, I met a lady the other day who's had since her surgery a flipped port, an infection at the port, port replacement of course, and no fill for 12 weeks while all that is worked out, and I know people who've slipped etc.

The PRIME reason for the success with the band here though is our medical system. Medical care is much more easily accessed, unless you live in a very isolated place, the idea of having to fly in for your fills is patently ridiculous here, as is leaving the country for surgery. You drive a few suburbs to your surgeon, that's all. Most people pay a once off fee of a few thousand prior to surgery and all their aftercare is bulk billed so no out of pocket expenses for your fills etc. Putting off a fill or an unfill because its going to cost several hundred dollars just doesnt really happen here.

I dont think the follow up with the band is disadvantage, I think its one of the keys to why it works well! Interestingly they're doing more sleeves in Perth now, for the simple reason that Western Australia is much more rural, and people are coming from isolated areas for WLS and the sleeve doesnt have the follow ups.

Now, those are all just opinions. I'm not stating them as fact. That's how I've worked my band, and its been hugely successful for me and that's the only authority I feel I have to say what I just did. I'm not suggesting I'm 100% right or that everyone should do it my way, and I'm not wanting to start a fight about it as everyone defends their high protein diet so vehemently. Those are the culture differences beween the US and Australia and how I interpret them, that's all.

Jachut, I agree with you totally. I don't do the "band diet" either. I eat good, wholesome foods in all food groups. I don't do protein overload and I'm doing just fine; however, I am in no way suggesting anyone should deviate from their surgeon's advice, this is my choice. I'm loosing at a rate that I'm happy with, but more importantly I feel great! I'm exercising and am very active. My skin and hair are healthy too. I did give up all white foods except for the occasional indulgence. I eat whole grains, fruits, veggies, and lean protein. I decided when I got my band that I wasn't going to diet anymore. I eat what I want, but I have it in moderation. I do log my food most days, but that's just something I like to do so I can see what I've been doing. Especially around the holidays as there is so much mindless eating. Also I tend to get very busy and believe it or not I sometimes forget to eat and tracking allows me to make sure I'm getting in enough veggies, etc. The good news is that I don't stress about food anymore. This past Thanksgiving was the first holiday I can remember not feeling guilt. I had what I wanted in small amounts and had a great day. No guilt!!! That, IMHO, is the best thing about the band. I eat like a normal person and I don't worry about it every day, all day.

And also, I haven't had a fill in about 4 months. I have good restriction, but am not overly tight. I know everyone is different. And just like Jachut, there is no judgement in my comments. This is just my experience and my preference. I'm enjoying life like never before and the band is the tool I use to do that.

Edited December 14, 2008 by Bea1128
forgot a word

[WASaBubbleButt 41]

WasABubble...I stand by my post. To have a surgeon try to force one elective surgery over another is filling that surgeon's agenda, not the patients'. If there is a sound medical reason one should'nt have a procedure, then give it. Otherwise, let the patient decide.

AND I said question...but never doubt. Maybe you do doubt yourself, and if so, I feel for you. That's no way to live.

On the plus side, open debate is always good. If our stances and beliefs can't hold up to scrutiny and questions, then maybe it's time to revamp.

I didn't read it as the surgeon was forcing the OP into anything. He was telling her the options and the stats. I didn't see where he was refusing to do her band, perhaps I misread. The patient can't decide about surgery types unless they know all the details of each surgery type. The best way to get that information is from your doctor. I applaud a doctor who will take the time to draw diagrams and explain each surgery type in detail. I don't like doctors who hide information or fail to take the time to explain. That is what we pay them for.

I disagree about doubting the procedure type. Doubt it and question it to the minute they put you to sleep. I don't see anything wrong with changing your mind about any elective procedure. Many people start off wanting one procedure and they change their mind. You really feel sorry for people like this? Why? This is a huge and life changing decision and every single person should continue to research their options right up to the night before surgery to be sure it is the right procedure type for them. If they change their mind that's okay, it's not a failure.

I never claimed to doubt myself. I wrote absolutely nothing that would lead you to that unusual and bizarre conclusion. I wrote to doubt the surgery type and keep researching, make sure you choose the right surgery type for you. That isn't doubting one's own self. Two different animals here but I kinda think you know that. ;o)

[WASaBubbleButt 41]

The following are typical results for WLS at the end of 5 years:

DS: About 85-90% of your excess weight (but a horror of a procedure IMHO)

Bypass: About 80%

Sleeves: About 80%

Banding: 50-70% (depending on starting BMI)

MGB: Not sure, nobody with any skill or positive reputation does this procedure, only the doctors who can't make it in the real world do it. ;o)

Gastric Ball: Only used for temporary use, not designed for long term use so there are no 5 year stats.

These are different statistics than my surgeon quoted me. Can you tell me where you got these statistics!

Most come from Cirangle. Keep in mind, the first five year stats for the sleeve just came out this last summer. So many are still hanging on to the old stats that are from a totally different procedure and technique. The non sleeve stats from from the ABA medical journals.

[WASaBubbleButt 41]

My starting

BMI was about 44, I am down 90 lbs, total of 66% of my excess body weight and 6 mos out from surgery.

Statistics are just averages. And averages include all types of folks, they don't account for those that don't follow the rules, think the band will do all the work for them, etc. I intend to be 'above average'! :tongue2:

I beat the stats too, all of them. None of the procedures show that the average person loses 100% of their excess weight but I did it. In a million years I never thought I'd be close to that.

Any of the procedure types can work, you just have to find the one that is right for you.

[lellow 1,713]

Another Australian bander here and I have to admit, I also don't count calories. I eat whatever I want, just a lot less. I eat all foods, including bread and Pasta. I don't do the 'protein, veg, then carbs' things at all.

I have lost all cravings for ice-cream, cola and other fattening slider foods, but I do occasionally have highg calorie foods like fried chicken and fries (small portions as my band dictates) so I generally don't feel like I'm ever on a diet.

Australian surgeons are always available to you. My fills are largely covered my Medicare and I don't worry about calling my Dr for a fill/unfill. I call when I need to see him and he books me an appointment, period.

Australian generally have great after-surgery care. They don't feel deprived, they don't feel like they're dieting. Many of us exercise, because it's made clear to us early on that the band will help you lose 60% of your excess weight on average, but the other 40% is up to you.

And it seems like that approach works for Australian patients, with approx 85% of Australian banders losing a minimum of 60% of their excess weight.

[WASaBubbleButt 41]

And it seems like that approach works for Australian patients, with approx 85% of Australian banders losing a minimum of 60% of their excess weight.

Those stats are quite similar to the US as well. Where you guys difffer is in complications, you have half the slips we do in the US. Not sure about other complications.

[lellow 1,713]

There you go! If 85% of all patients are losing 60% of their excess weight at a minimum, that's some success rate for WLS if you ask me,

I think the slippage rates here are 1%, and erosion less than 1% here in Australia. I wonder if it's to do with surgeon skill.

Edited December 15, 2008 by lellow

[Jachut 487]

Well by and large, with the exception of the sleeve one day taking off, banding is really the only surgery available here these days. So surgeons do many more of them.

The stats are similar in both countries, but Australia has a WAY smaller population, I wonder if that's relevant? Less slippages because less people overall. it would be interesting to compare numbers, not percentages.

Like I said, I also think the slippage rate is to do with the fact that Australians generally continue to eat their grain foods - Pasta, rice, bread and cereals. those foods fill you a lot very quickly and most people still want to eat them becuase they dont have the stigma attached to them here, nobody believes that moderate carbs makes you fat. So on the whole, people dont need to be as tight - because for the same calories, a bread roll of a piece of chicken are VERY different in size and to be full on 200 calories of a Protein like chicken you need to be TIGHT.