Obesity Surgery Procedures Part I: Lap-Band

Obesity operations are different

All weight loss operations are not equal and work differently. Anyone that tells you all obesity operations are the same, you have my permission to tell them blow it out their ear!  In this, and the next 3 blogs, I will make clear how the operations work and how they are different.  I kindly ask that all the Lap Band lovers out there not send me hate mail.

•Everything here is based on the most current obesity surgery science, as well as the latest science coming in the last 3-5 years and my 15 years experience as an obesity surgeon.
Lap Band® – Or any other name that ends in band. An adjustable silicone band is stitched in to place at the very top of the stomach with minimally invasive laparoscopic surgery. The band makes you full quickly. With good nutrition and daily aerobic exercise, you lose weight.

It’s adjustable so as you lose weight there’s more room for food, then the band is tightened. If it is too tight, it’s loosened. Adjusting the band is done by injecting medical salt water (called saline) in to it. Yup, a needle is poked through the skin in to a port, every time it needs to be adjusted.

What the band will do;
•Make you full quickly – ¼ cup to ½ cup of food.
•Make you vomit when you over eat.
That’s it. Just like the old stomach stapling.

losing weight with a lap bandWhat the band will not do;
•Regardless of what folks say on message boards on the internet, it has no magical qualities.
•Stop you from eating cookies, chips, candy, soda, fast food drinking soda, beer or wine.
•Make you exercise.
•Take away hunger – this will make band lovers howl.
The band does not change how the stomach works except make you full quicker – period. The stomach below the band is a normal stomach, when it is empty it will tell you, you are hungry!
•Create powerful hormone changes that revs up your metabolism. This happens with the Sleeve, Bypass and Switch.
People tell me they like the band because it’s reversible. Good idea, but when the band is taken out, people go back to obesity. Is that really what you want? After all that trouble and all that money, you want to be back to square one?

Is the band a bad operation?
No, its just OK, there are much better ones, depending on the result you want.  The band will not get rid of diabetes, sleep apnea, high blood pressure or GERD.

Who gets the best results with the band?
• Folks younger than 40.
BMI (Body Mass Index) less than 50.
•Don’t have diabetes or high blood pressure.
•Will do aerobic exercise – hitting the remote or going to work does not count – unless of course your job  is digging a ditch from New York to Los Angeles with a shovel!
What band lovers do not tell you about the band;
•It has a 75% failure rate. That means 75% of folks do not lose a significant amount of weight(
get their BMI less than 35).
•The band fills or adjustments happen more often than just once a month – that means a visit to the doctors office, losing time off work. Oh yeah and getting a needle stuck in to you every time.
•The band can slip, move, stretch your food pipe, block your food pipe, be too tight, give you
acid reflux, get infected or worse erode in to your stomach .
•Anybody with a band will need repeat operations anywhere from 1%-30% to fix anything that
goes wrong with the band.
•Lap band can be safely converted to other bariatric operations with laparoscopic surgery.

Truthfully, the band is just an OK operation. I have seen it work best on young patients with less
weight to lose. I am happy to place a band on any patient as long as they give me the chance to
share this information with them.