Weight loss surgeries of the future?

angelarias · May 28, 2009

Hi All:

I was banded in July 2004 and will be banded 5 years. I check the board monthly and am so glad there is so much more information available today than there was when I was researching weight loss surgery.

I chose to be banded because it was a reversible procedure and I thought in 10 or 20 years, with medical technology as quickly as it is progressing, banding would no longer be done, RNY, DS and VSG would be long gone as viable surgical options and instead replaced with true, safe, non-invasive procedures. My band is just fine (Thank God) but I have never believed that it is a lifetime implant. For example, my dad's pacemaker has already been replaced and my mom's hip replacement from 10 years ago needs to be revised. These are lifetime implants. Hopefully, our bands will last 10-15 years-let us pray!

For newbies out there, no matter how good insurance you have, never asssume emergency surgery for you is going to be free or lowcost. For those of us thast have insurance (with a wls exclusion), an emergency medical fund is essential. I have been thrilled when I read about one you being able to save enough for plastics but I have never read anyone mention that they have money set aside just for a wls emergency. IT IS essential. I travel extensively for work and wherever I go, I have the name of the local band surgeon and where to go for a fill.

Here are my stats. I am 35 yrs. old, 5'5" and started at 260. I lost 10 pounds on the pre-op liquid diet which took me to 250. I lost another 30 pounds on the 6 week liquid diet which took me to 220. In the next 2 years I lost an additional 40 pounds which took me to 180 in 2006. I am now 200 so i have lost and maintained a 50% weight loss. Was weight loss surgery a good investment? I think so. I like to do a cost per pound analysis. I have currently spent $3500 for fills and $8500 for the surgery. $12000 for 60 pounds or $200 a pound. For those of you bandsters that paid out of pocket divide your pounds lost by your surgery and maintenance visit costs and you'll get a cost per pound.

I would love to see posts on this forum from patients 5-10 years out of surgery--what ever surgery type you had. Share with us what the "weight loss real world" is like.

More importantly, the questions I'd like to pose to everybody out there. What weight loss surgeries will we be discussing on this forum 10 years from now? Will our bands be still in place? Will the DSers have a modified new DS? Will the RNY still be the gold standard in the U.S. I'm not looking to start a debate about weight loss surgery methods or inspire negativity or drama.

Just posing a straight up question to look 10 years into the future. As you can imange 10 years ago, we were discussing phen-fen and had no idea what a RNY or a DS or a VSG or a gastric band was! So 10 years from now guys, what do ya think? Will peple have gastric stimulators, a revised TOGA procedure via endoscopy, biodegradable bands (yes, gastric bands that do their job and break down in the body with no surgery), brain electrodes to lose weight (like recently featured on Oprah), a weight loss pill.

I am not a medical person but I love to discuss technology. So chime in everyone. What new wl technolgy will we be discus sing 10 years from now on the boards?

By the way, I am filled to 6cc in a 4cc band and I have little restriction. I do like my band and am not thinking about a revision. I'm happy with my 60 pond weight loss and will try to lose 60 pounds in a year's time.

Athe best,

Angel

Banded July 2004

Drs. Ortiz/Martinez Tijuana, Mexico

band filled 6cc in 4cc (band still in good position but little restriction) cannot get any more fills--band full

260 starting weight

250 surgery weight

200 plus or minus 5 pounds current weight

50 percent weight loss

goal weight 135-140

ParrotheadCathy · May 28, 2009

I don't look at this as cost per pound at all! I was paying $175 per month for medication co-pays and my diabetes control was slipping a little and my doctor was talking about adding Byetta to my regimen (which would have been another $35 per month). I paid $5,000 in cash and financed $10,000, so I have a monthly payment of $187. So, let's see: Pay $175-$210 per month and it never ends, may increase OR pay $187 per month for 7 years (or sooner if I pay extra each month as I have been doing so far since there are no prepayment penalties on the financing). I saw a way to improve my health dramatically and put an end to those drug bills. In the interim I have replaced one expense with another and I'm good with that.

snzgetsfit · May 28, 2009

How do you have 6cc in a 4 cc band? I've herd something like that before but don't understand.

One thing as far as the future...this is out now I believe...it the single incision placement of the band. Wow..that must be nice.

Jaffa · May 28, 2009

I don't think you are going to hear from many people who have been banded 10 years?

But, I think the gastic sleeve in its new form, performed by the right people, using the right technique, is the future.

I don't think any real miracle is coming within the next 10 years. Just my opinion.

keithf · May 29, 2009

I saw a special about a month ago, hosted by Alan Alda, covering new WLS techniques.

One under research was a pacemaker for hunger. Basically, it manages to turn hunger on and off according to a schedule. It doesn't do anything for gorgers, but does help for grazers, as I recall.

wootsie73 · May 29, 2009

I'm not banded yet, but hope to be in the next few months. I'm disabled and have Medicare coverage, so at least I don't have to pay for all of it out of pocket.

I agree with the person who said the payments for the loan replaced the payment for medications. I currently take 15 prescription medications daily, and have almost every co morbidity there is.

With that said, I do think there will be significant changes in wls in the next 10 years. Hopefully, obesity will be a thing of the past in the future. They have isolated a gene that causes obesity, and should be able to correct the problem within 10 years. Of course, it will be very expensive initially, but the price should go down over time. They will also develop better and safer surgeries. Who knows what they will be, but the lap-band was initially inserted via an open surgery instead of laparoscopically. In fact, all wl surgeries were done that way.

The most important issue concerning obesity currently is our children. Kids spend to much time sitting around playing video games and watching TV instead of playing outside and getting lots of exercise. They are even taking PE out of our schools. We also live in a fast food era, so the kids are not eating healthy foods. I think this is where the future will be.

Joan

Edited May 29, 2009 by wootsie73

Jachut · May 29, 2009

I've been banded almost 4 years now. Like you, I've never really assumed this will be a lifetime thing, I really hope to get 10 years out of it, if nothing better's out there and my band wears out, I wouldnt hesitate to get another.

I'm intrigued by the sleeve and I do believe for a lot of people its a better surgery but I dont think I'd swap over, I think I'd get another band.

If I were so lucky as to get 20 years out of it, I dont know what I'd do then, whether I'd have any other WLS at all. I really think the longer this goes on, my habits are becoming more and more consolidated. I dont want to be so arrogant as to say that I could have done this without the band, but I am now maintaining my weight on about 1800 to 2000 calories a day which is quite a reasonable amount of food (I have to work REALLY hard to get it all in, but I need it) and I will never give up running, I love it. So I lost 120% of my excess weight and whilst I'm sure I'd have rebound weight gain if I lost my band in even 10 years, I dont think I'd really shoot up to my previous high, which was heavily influenced by being a stay at home mother of young children, something which no longer applies to me. Not sure there.

But I do think somewhere in the future they'll work out how to control our appetites, not restrict our stomachs!

i dont need an emergency fund, in Australia, if my band slips, wears out, or I just want it out, its pretty much free. Our health insurance covers it, no arguments, no pissfarting around. Its paid for. I paid a once only $3000 fee and I will never pay for any service from my surgeon out of my own pocket again. He bulk bulls everything, so its billed straight to our public health system and my private health will always pay for ANY hospital stay costs.

keithf · May 30, 2009

They have isolated a gene that causes obesity, and should be able to correct the problem within 10 years.

Having done this sort of thing in the past, there is a big difference between locating *a* gene, finding *all* the genes it interacts with (it's rarely if ever just a single gene you ever deal with), and successfully turning a set of genes off.

Imagine, if you will, a panel with four billion switches. A few million of these actually differ from person to person. You don't know where these useful switches are, though you can, with effort, find out. You don't necessarily know which switches are wired to which other switches without, again, a great deal of effort. You don't really know even then what the overall effects of flipping them will do.

In the simple cases, involving re-engineering e.coli, for example, there is a high failure rate. Failure often means death of the organism. Recall the one young man about 10 years ago who underwent gene therapy? Unfortunate, that, but it demonstrates how much we value a human life over that of a bacterial colony, or seed corn.

That was the state of genetics when I was involved in it about 6 years ago. About the only thing that seems to have changed since then is the speed at which they locate new switches.

I think it'd be safer to estimate on the order of 50 years before we can achieve halfway "safe" genetic therapies for, well, anything.

However, locating such genes enables us to detect early whether a child might have a tendency toward obesity, and under what conditions the child is vulnerable.