Bypass Bias

[TSB 1]

So, my surgeon is dedicated solely to bariatric surgery. Has 2 nutritionists on staff, a PA and an NP. He seems much more pro bypass vs. band. His stated reasons were that most patients undergoing bariatric surgery lose most of their weight during the first year and since bypass patients lose more in the first year than band patients, it is a better remedy for obesity.

I am firm on my decision for the band. I am just a little frustrated with all of the services/advice at my surgeon's practice being geared toward by pass patients. I have been told that the instructions for post band patients vs. post by pass patients are virtually the same. The only exception being that as a band patient I can start on solid food 1 week sooner than the by pass patient.

If I had an astronomically high BMI and/or had extremly severe health problems OTHER than being overweight, I think I would go with the by pass to acheive immediate and dramatic results. I just feel that since I am still in relatively good healthand I only have to lose between 72 & 87 lbs (haven't decided on a specific goal weight yet), that the less invasive procedure makes sense.

Has anyone else had this experience w/ a surgeon? If so, how did you stand your ground with them? I feel a little inferior when I explain why I prefer the band as the surgeon and his staff can always come back with reasons why bypass is a superior method for addressing obesity and its related health problems. I feel as if "the professionals" think I am making a bad decision. It is subtle and ever so slightly condescending, but it annoys me. Anyone have good ideas for "talking points" if/when I have to have this discussion w/ my surgeon or is staff? Thanks.:biggrin:

Edited April 29, 2009 by TSB
Typo

[HeatherO 7]

Some doctors are biased towards a particular surgery whether it be bypass, band or another option. Since you have less than 100 pounds to lose, I don't see any reasons why banding would not be a good option.

Some of it has to do with the reasons why you are obese in the first place. Do you overeat at every meal . . . then either option is good and lapband works great because you will no longer have that option. Do you eat a lot of sweets and tend to graze all day long, then maybe the bypass is a better option with the dumping syndrome.

If I were in your shoes, I would start listing out pros and cons for each surgery based on your lifestyle. Once you have gathered your thoughts, take this information to the doctor and have a heart-to-heart discussion on which options suits you best and why. If the doctor still strongly feels that there is only one option but it does not sound like the reasoning is anything more than bias towards the bypass route . . . you can always see a different surgeon.

[2Flyguys 13]

my friend was all for the band!!!!!!!!!she went and saw a surgeon who refferred to the band as a waste of time...and if she really wanted to lose weight she would have the bypass....so she is now having bypass surgery...and has turned in2 a strict believer that the band doesnt work...he went on to say how much faster weight loss would b with the bypass...let me introduce myself....lol...i was banded on oct. 6th 2008...i have lost between 117-120 pounds...(i'll have an exact # after my dr. appt. today)....bypass results...but i'm banded and proud...lol...yes in less than 7 months i lost that much weight...and their r plenty of others that r banded with the same type of stories...yeah the band is not as easy...u will have to work hard...but i do believe harder work = long term success....the band will teach u to eat right and exercise...ive been around so many bypass patients how go through this very invasive surgery to lose weight real fast...just to gain it all back and then some....the bypass in my opinion is a quick fix....the lap band is a forever tool....

[Jaffa 5]

I think if your only reason for wanting band is less invasive, that they might be right.

Personally, I don't buy into the less invasive thing so much. Have you ever watch a lapband surgery? Have you ever watched a video of them removing a lapband? It really isn't non invasive so much as it is non altering.

Now, having said that, my regular doctor was exactly the same.

I didn't want bypass, because I didn't want to worry about dumping syndrome, or taking supplements for malabsorption. I also didn't feel like I needed something that drastic.

I have the band so instead I worry about getting stuck, slips, erosion, leaking band or port, port flipping, and eventually paying for fills. I would rather worry about those things, then the Gastric Bypass complications.

Well, I don't really worry about those things so much anymore, because I would get gastric sleeve if I had any problem requiring me to have my band removed.

If I was selfpay and could get gastric sleeve, that is really the best of both worlds in my mind.

You still have complications, but they are usually just in the beginning, and then you go on with your life. You get rid of all the band complications and hassles, but don't get the hassles of Bypass. The reason, they don't offer it, is because most places don't do it. Why? Because Insurance won't pay for it. I would go so far to say, that even if Insurance would pay for Gastric Bypass, but I could afford to self pay for Gastric Sleeve, I would go with the sleeve.

I love my band, just dread anything ever going wrong with it, and yes, I do deal with changing restriction level as the day goes on.

[2Flyguys 13]

u dont find some1 tampering with ur intestines to b invasive?????????????? wow!!!!!!!!!!!!

[Libbyjane1976 1]

The whole cutting and rerouting thing doesn't sit well with me. Also they are finding alot of GP patients are gaining their weight back. At least with the band you can always tighten it to lose the few lbs you may gain back. you don't have that much to lose. I would go with the lapband.

[Jaffa 5]

u dont find some1 tampering with ur intestines to b invasive?????????????? wow!!!!!!!!!!!!

Yes, I do as a matter of fact. But, I also don't think invasive is really a good argument on its own.

You see, if she is using that one point to argue with doctors who know all of the stats and complication rates, and taken in balance and side by side, they don't think the band being less invasive is worth the trouble. I agree, it just isn't a good enough reason all by itself, but the other reasons are good enough in my opinion.

I would never get the GB, and I think a lot of people feel the same way, so along came the lapband. When in reality, maybe the best solution is neither.

[2Flyguys 13]

the band has been nothing but a solution 4 me...a solution..a god send...an awesome tool...it gave me my life back...im able to do soooooooo much more physical activity with my son....the band is...was...and will always be my solution....:ohmy:

[Jaffa 5]

The whole cutting and rerouting thing doesn't sit well with me. Also they are finding alot of GP patients are gaining their weight back. At least with the band you can always tighten it to lose the few lbs you may gain back. you don't have that much to lose. I would go with the lapband.

Ok, that is somewhat true, but may be a bit misleading. You can't just infinitely keep tightening up the band to lose more weight. You will eventually, get too tight and not be able to eat solids.

Hey, I like the lapband way over GB. But I think people are being misled by a lot of these doctors who are giving the choice of either the Lapband or GB. It's like going to a car dealer that sells both Honda and Suzuki, and comparing the two. Well, if you don't know or talk about Toyota, then you don't even consider it an option.

[circa 0]

There may be reasons to believe that GB is the most effective but to say that because its faster is really a flawed argument. Irregardless of which method is chosen, if its not properly maintained and used, its like putting a band-aid on a gushing wound. Getting to the root cause of the problem is the most effective way. But just like anything where there are choices, people will have their preferred method - even, and especially doctors.

[karen_karen 0]

I think the doctor don't understand your needs and not very supportive I believe it's better for u to find a new surgeon

[TSB 1]

Thanks for the response Heather & 2 Fly. I can see you have both had great success! I have weighed out the pros and cons. And the surgeon actually said on my 1st visit that those who are relatively young, goal oriented and have not yet had their mobilitiy impacted by obesity are ideal candidates for the band. He said it would seem that I meet that criteria. He is not refusing to do the band on me, it just has felt at times like they were trying to sway me. Good thing I am stubborn :ohmy: I guess at this point, for LB specific support this is the place to be and I will just have to be determined to be sucess story :thumbup: I did say to him (and please don't anyone take offense) If I weight 400 pounds, I could see going with the bypass. His response was that obesity is obesity. But to me there are certainly degrees of obesity -- just as there are "stages" of many diseases, KWIM?

[Jaffa 5]

the band has been nothing but a solution 4 me...a solution..a god send...an awesome tool...it gave me my life back...im able to do soooooooo much more physical activity with my son....the band is...was...and will always be my solution....:ohmy:

Oh man, I'm not sure what kind of response that is really suppose to be? If you could only hear how it reads to someone else. I'm going to give it a try for you.

Ok analogy time.

The only car I have ever owned is a honda, it is a great solution....a god send....an awesome way to get places....I don't have to walk anymore!!!!! I will never own any other kind of car. The honda is....was....and will always be my car.

Well OK....that doesn't really help the person argue about which procedure they want and why? I simply don't get the post.

[Jaffa 5]

Your doctors are right. Obesity is obesity. You want to differentiate in an area that really hasn't proved to be all that helpful.

You have obviously already made up your mind. So quit arguing with them and just tell them, it is the only surgery you want.

Then they will collect their money and you will collect your band and everyone will be happy.

I know I did that and I'm very happy with my band. But, if I ever have a complication down the road and have to pay for the sleeve, I will be very unhappy.

Edited April 29, 2009 by Jaffa

[circa 0]

Oh man, I'm not sure what kind of response that is really suppose to be? If you could only hear how it reads to someone else. I'm going to give it a try for you.

Ok analogy time.

The only car I have ever owned is a honda, it is a great solution....a god send....an awesome way to get places....I don't have to walk anymore!!!!! I will never own any other kind of car. The honda is....was....and will always be my car.

Well OK....that doesn't really help the person argue about which procedure they want and why? I simply don't get the post.

I think that's a flawed argument. Comparing cars to potentially life saving, and definitely life-changing surgery. Sure in the literal term it might hold Water, but let's look at the real picture. Its more like comparing oral to IV treatments. One might be more comfortable with one over the other