questions?

[neworleanslady 0]

It seems like you have a lot of info on the sleeve. Do you know if people just don't lose weight with the sleeve like sometimes happens with the lap band? Is the lap band a safer procedure than the sleeve? Thanks.

[MacMadame 81]

With EVERY wls, there are some people who don't lose much or who gain every drop back. Just like there are people who get to goal and beat their surgery type's average EWL.

But the average EWL for the sleeve is about the same as the bypass, which is better than the band.

There are a number of reasons for this, but I think the main one is hunger control.

Hunger control with the band works by giving you proper restriction. If you don't have enough restriction, you will be hungry and if you are hungry, you won't stay on your diet. Some people have found getting to the "sweet spot" to be elusive inspite of their best efforts. They get restriction and then lose some weight and lose that restriction. Or they never get true restriction and are doing it all by willpower -- the same method that we've all tried before and failed.

Hunger control with the sleeve, OTOH, comes from removing the part of the stomach that produces ghrelin, the hormone that stimulates the appetite. While some people still experience hunger, it's nothing like before (and often not real hunger). So it's a more sure thing.

As for complications, the sleeve is a more serious operation upfront. There is the possibility of a leak which can be very serious as people die from them if not detected in time. But once you pass the 1 month mark, you are pretty much home-free. So the long-term complication rate is very low, much lower than with a band.

With a band, the short-term complication rate is excellent. It's pretty rare to die from a band -- and usually going to a butcher is involved, though of course there are also freak accidents. But the long-term complication rate is not good. The longer you have the band, the more likely it is that something will go wrong that will lead to a re-operation including slippage, erosion, port flips, band leaking, esophegal spasms, uncontrollable acid reflux, etc.

One hospital reported a 40% complication rate by 10 years out. My surgeon says it's more like 25% in his experience. Yeah, 25% is a lot less than 40% but it's still ASTRONOMICALLY high. It was too high for me and that's at least one reason why I got the sleeve.