undecided

[schulbaby 0]

OK, I have been to the doctors informational meeting, so I am reading all of their papers again, and I keep going back and forth on deciding do I want to do lap band or the gastric bypass. Both of them would be laparoscopic they say. after reading the lap band clinical studies they list it says about 52% only lose 33% of their excess weight. I am about 90 lbs overweight.

I thought it is best to ask the ones that have had this done to find out if you are happy with your decision:smile: Learning to adjust to your new eating restrictions and so on.....Let me know.

[ParrotheadCathy 0]

I'm surprised that with only 90 pounds to lose you'd be qualified for gastric bypass. That aside, you are the one who has to live with your choice. Either one, you can make bad choices with your eating and "eat around" the procedure and fail to lose. MANY people lose 100 pounds or more with lap band. There are plenty of them on here. And is a growing percentage oef GB patients who "eat around" their surgery and later get the lap band.

I've already lost 53 pounds and I don't seem to be skidding to a halt, and I know of many, many other patients who have lost at least this much and are still steadily losing...and many of them want to lose more than 90 pounds.

There are complications with both procedures. Gastric bypass has more deaths immediately following surgery (apparently leaks of the surgically reduced pouch can be a serious problem if that happens) and there is a fairly common occurrence of malnutrion because of the malabsorption GB causes(that's what the "bypass" part is -- they reduce the length of your intestine to reduce how much you absorb from the food you eat). Lap bands can erode into the stomach (pretty rare) and the band can slip (you will read some here who have had this experience but not very common) and I have read where some have problems with their port being tilted, though I've never read any explanation of why that might have happened.

Gastric bypass has one "side effect" that I wasn't willing to accept. It's called dumping syndrome. From what I understand, if you eat sweets or very fatty food, it can cause something akin to the worst diahhrea you could imagine and you dump everything in your digestive tract .... undigested food, partially digested food and whatever else is in your colon at the time. I also got the impression that you have very little warning that this is about to happen. I didn't want that as even a possibility. I can see where if you weiged 400 pounds or even more than it would seem less of an issue.

What it comes down to, bottom line, is are you willing to make the changes either procedure requires? They are not all the same. With the LB you can pretty much eat normally, just in much smaller quantities. GB may cause faster weight loss in the beginning, but everything I've read says that at the 3 year mark, the loss percentages are pretty even.

I gave up fried foods (not that I ate a lot of fried stuff because the grease upset my stomach). I don't eat much bread and then it's in the form of whole grain crackers. Once a month, I do eat a small slice of the birthday cake at work. The main adjustment (which would be the same with GB) is reduced quantity. With GB, that inability to eat larger amounts is there from the start; with LB you'll need to get a few fills before you truly feel the kind of restriction you want.

GB has a much longer recovery time. Most (not all) LB patients need only a few days to return to their routines and LB is outpatient surgery almost all the time. GB requires a hospital stay.

If you choose the GB route, be 100% sure because it is NOT reversible. LB is as the band can be removed if need be. This is a big deal breaker for indecisive people.

I'll admit, it would have been nice to lose faster like the GB patients, but I'm more than satisfied with what I chose.

[WASaBubbleButt 41]

OK, I have been to the doctors informational meeting, so I am reading all of their papers again, and I keep going back and forth on deciding do I want to do lap band or the gastric bypass. Both of them would be laparoscopic they say. after reading the lap band clinical studies they list it says about 52% only lose 33% of their excess weight. I am about 90 lbs overweight.

I thought it is best to ask the ones that have had this done to find out if you are happy with your decision:smile: Learning to adjust to your new eating restrictions and so on.....Let me know.

Well... there is also the sleeve procedure. It has fewer long term risks than banding or bypass. No malabsorption, no aftercare either. The weight loss is better and faster than banding and slower than bypass.

Know all your options and choose the one that is best for you whatever that may end up being.

[essence08 0]

OK, I have been to the doctors informational meeting, so I am reading all of their papers again, and I keep going back and forth on deciding do I want to do lap band or the gastric bypass. Both of them would be laparoscopic they say. after reading the lap band clinical studies they list it says about 52% only lose 33% of their excess weight. I am about 90 lbs overweight.

I thought it is best to ask the ones that have had this done to find out if you are happy with your decision:smile: Learning to adjust to your new eating restrictions and so on.....Let me know.

I agree it is a personal decision. I researched both surgeries for about a year and decided that the lap band would be the best procedure for me. I am four months post surgery. I am happy with the choice I made.

[ljv52 2]

I am happy that I chose to have lap band surgery. As you can see, I'm down 61 lbs. since I started the pre-surgical diet on Jan. 13, 2009. The key is that none of these procedures are a "magic cure all" -- you still have to work hard -- to change your relationship to food (we are addicts) and you must make a conscious decision to add exercise to your life (not just briefly, but for the rest of your life). Otherwise, none of the procedures will keep the weight off forever, only WE can do that by what we eat and how we move our bodies. Good luck to you. Linda

[Libbyjane1976 1]

For only 90 lbs overweight I definitely say lapband. You don't want some doc in there permanently slicing and dicing your insides. At least the lapband there's no cutting involved except for your incisions and there's definitely no rerouting going on.

[Jeni 85 0]

lets see i dont really believe thse statistics

so my starting weight was 295

and normal bmi for my height is 24.9 (152lbs)

Need to lose 143lbs

ive lost 125lbs so far so that is about 88% of my excess weight... and i aint finished yet....

as log as you follow the plan and dont slack off you will be successful!!!

But this is a decision you have to make an your own.. and plus every one has something different thas right for them and thier lifestyle.. just do your research!!

go to obesityhelp.com there your can speak to people who have had the various weight loss surgeries and they would be willing to share thier expiriences with you.. that may help

also plenty of info online..

and weightloss surgeries for dummies is pretty good with lots of info

good luck!!!

[jimdd810 0]

I have never heard of gastric bypass surgery being laproscopic (or however you spell it.). Gastric bypass is a more invasive surgery that my Doctor said is used for the more extream people who have more serious health risk. If you are only 90 lbs over weight will your insurance cover either proceedure?

The lap band seems the way to go for you. You could lose all 90 lbs with the lap band Ive lost 40 lbs in one month and thats nearley 50% of what I want to lose. You will feel much better faster with the band than by-pass.

Edited May 4, 2009 by jimdd810

[SuzanneG 1]

I had 90 pounds to lose and I've lost almost 80 of it so far. I can run 3 miles now and I feel fit and happy. I'm in a size 6, so truth be told, if I never lost another pound, I think I could be OK with that.

The others have already posted about the pros and cons of each surgery. Choose what you think will work for you. For me, without question, it was the lapband.

[schulbaby 0]

Thanks everyone for the great info. You have given me good points. I have looked into this for quite a while but finally went to the info meeting the doctors had. Their practice has been in place for 6 years and associtated with the hospital I work. I know my insurance pays for both surgeries but not sure if I will be approved yet. They are looking into that now. All of you proved the lapband is successful if you work hard enough and want it bad enough:smile2:

Thanks again and have a great weekend:tt1:

[WASaBubbleButt 41]

I have never heard of gastric bypass surgery being laproscopic (or however you spell it.). Gastric bypass is a more invasive surgery that my Doctor said is used for the more extream people who have more serious health risk. If you are only 90 lbs over weight will your insurance cover either proceedure?

The lap band seems the way to go for you. You could lose all 90 lbs with the lap band Ive lost 40 lbs in one month and thats nearley 50% of what I want to lose. You will feel much better faster with the band than by-pass.

The preferred method of bypass is by lap. It's safer and an easier recovery. They can't do it by lap if there are lots of previous abdominal surgeries causing lots of scar tissue or sometimes people are so big the lap instruments are not long enough to reach the intestines. So, they do a full open.

[Oregondaisy 2,021]

I had the lap band and had revision to a sleeve.

Before you make your decision, read the complications

section of this board. You can also read the stories of

why people got revision to a sleeve on the sleeve section

of the board.

The band can slip, erode, the port can flip, some people do not have good weight loss with the band, some people get horrible reflux, some people can't seem to get the right fill. that means a lot of fills and unfills.

With the sleeve, they make you a smaller stomach and you have restriction right from surgery. It's a big decision so you should know everything there is to know about all weight loss surgeries.

[keithf 2]

lets see i dont really believe thse statistics

You must always be cognizant of the population over which statistics were gathered. One counter-example does not invalidate statistics. Nor even a forum full of examples.

From what I can tell, many people go into WLS with expectations that it's magic, and that they can go willy-nilly at the Krispy Kreme and have perfect figures every time.

Many of those same people don't have any sort of support or accountability structure. The folks here do. We know we have to change, and that it really isn't some magic wand, and I haven't even had my surgery yet.

There's a strong selection bias if you try to poll any focussed group: people here are more concerned with being knowledgable about the procedure and how to succeed with it. Are more apt to confess their weight loss sins, and are more apt to repent and get back together. Those that fall off the wagon tend to fall off the forums.

I finally had my orientation class yesterday (required by my bariatric program, as is the year-long nutritional counselling). We had a former bariatric patient as guest speaker, who declared that she didn't go to support group meetings anymore. Reason: sheer frustration at the number of people gloating that they ate an entire cheeseburger, and the equally large number of people whining that they had an adverse reacting attempting to do so. She, on the other hand, was eating healthily, and had lost 160#. She had the same good attitude you can associate with other successful patients here and elsewhere.

With the dramatic increase in surgeries, how many patients getting the procedure are *not* following the rules? That's where the statistics are getting pulled toward.

But back to the OP's question:

Based on my surgeon's experience, lap band produces the least complications in the short term, but about the same rate of re-operations as bypass. It produces somewhat less weight loss, and is somewhat easier to cheat although, as he points out, the bypass can also be cheated (insert anecdote about the bypass patient feeling so proud she had worked up piece-by-piece to an entire chocolate bar).

If you get the bypass, you will probably become a cheap drunk -- the alcohol goes right to the intestine, since the pylorus is no longer in the way. For this reason, if you have any alcohol issues, you *MUST* have a long, meaningful conversation with your surgeon. I would probably opt for the band in that case.

Dumping, as described by the guest speaker, nurse, and surgeon, is different for everybody -- sometimes they vomit, sometimes they get diahrrea, sometimes they just have to lie down and be miserable for half an hour. The guest speaker cannot have milk for this reason.

Banding has similar vomit-producing issues, but for different reasons.

If you were diabetic, my surgeon would recommend a bypass. Of that I'm certain: the statistics he's gathered show a dramatically higher incidence of remission from diabetes than with the band. Still less than duodenal switch, but he doesn't perform those. (Nor will he convert a band surgery from laporascopic to open -- he doesn't feel comfortable compounding the risk of band infection with the risk of an open procedure. He will simply back out in that case unless instructions to convert to a bypass were filed.)

Overall, my surgeon, is more *comfortable* with the bypass, but he's also performed about 10x as many bypasses as bands over the past 15 years. However, he doesn't exhibit any strong, long-term preference between the two for the non-diabetic case.

Edited May 9, 2009 by keithf
clarification

[Oregondaisy 2,021]

There is no dumping with the sleeve. You have a smaller stomach made out of the part of the stomach that isn't stretchy. People think having their stomach made smaller is drastic. But that is exactly what they are trying to achieve by wrapping a piece of silicone their stomach. The thing is, some stomachs won't tolerate it at all, and some will only tolerate it for a period of time.

I like to think of it as wrapping a tight rubber band around my finger and seening how it feels after a period of time.

[WASaBubbleButt 41]

You must always be cognizant of the population over which statistics were gathered. One counter-example does not invalidate statistics. Nor even a forum full of examples.

From what I can tell, many people go into WLS with expectations that it's magic, and that they can go willy-nilly at the Krispy Kreme and have perfect figures every time.

Many of those same people don't have any sort of support or accountability structure. The folks here do. We know we have to change, and that it really isn't some magic wand, and I haven't even had my surgery yet.

There's a strong selection bias if you try to poll any focussed group: people here are more concerned with being knowledgable about the procedure and how to succeed with it. Are more apt to confess their weight loss sins, and are more apt to repent and get back together. Those that fall off the wagon tend to fall off the forums.

Thing is... we all have food issues or we wouldn't have gotten fat. So while it is true that some target groups will try harder and put forth more effort, I don't think anyone goes into this thinking that they aren't going to put some effort into it.

Most people I have seen fail any WLS type goes into this determined to change their eating habits and food choices just to discover that maybe they can't do it afterall. The band or sleeve or any other WLS type doesn't do a thing to fix your head. It seems so easy on some levels, get surgery and darn well just change head stuff. It doesn't work that way. You really don't discover just how many food issues you have until AFTER surgery and then you also discover the severity of these food issues.

Before my surgery I kinda didn't believe it was going to work. I knew I was going to try very hard to do it but I really didn't think I could change my food choices and habits. I shocked myself when I did it. Today I prefer healthy foods and getting back to basics. I won't eat a burger from Mickey D's, you couldn't pay me to do it. I never thought I could give up fast food but I did. I'm lucky, a lot of people try their best and have the best of intentions and they discover they just can't do it.

So you can't really take just those that are able to change food habits and use that as a target group for average bandsters because they aren't average, they are above average. The average bandster will lose about 55% of their excess weight (considering loss and the well known regain for all procedures) by 5 years time. That includes people like me that really seriously changed diets, added exercise, etc. AND it includes those that just can't hack it.

Then there are issues of another nature. One problem with banding is that each time you have a complication the fill is removed and you are put on liquids for a time and then solids but with no fill. Esophageal dilation, pouch dilation, slip, etc., it's an unfill. That puts a dead stop to weight loss and actually turns into weight gain for most. Then the problem is resolved and you are back to getting fills again and finding a sweet spot. This is one reason banded folks have slower weight loss on average.

Then you have mechanical failure. Leaks in the tubing, port, or band itself. You lose restriction and quite frankly if we could do this without restriction we wouldn't have had surgery to begin with. Without restriction weight gain happens again until surgical repair.

I guess my point is that you can't just take successful bandsters and use that target group as the average WLS person. They aren't average, not in the least. We all make all sorts of plans and promises to ourselves that we will do this or that but the true test is when it's time to do it. Then we discover it wasn't as easy as we thought.

With the dramatic increase in surgeries, how many patients getting the procedure are *not* following the rules? That's where the statistics are getting pulled toward.

My guess is 100%. Nobody is perfect with food issues all the time. Some do a better job than others.

If you get the bypass, you will probably become a cheap drunk -- the alcohol goes right to the intestine, since the pylorus is no longer in the way. For this reason, if you have any alcohol issues, you *MUST* have a long, meaningful conversation with your surgeon. I would probably opt for the band in that case.

LOL! You are in for a big surprise. Banded and sleeved people make cheap dates too. ;o) It's also a matter of less food in your body to slow down absorption of alcohol.