Tell me again, why not the band?

Hi Everyone, Just another of my crazy questions (more come up by the hour lol.  For those of you who had laprascopic bypass, why did you choose that over the band?  My family keeps telling me to do that first, and see if it works.  Then, if it doesn't, do the bypass.  They are worried about the idea of changing around my insides and it being permanent and all.  They say, at least the band is reversible and they don't cut anything.  I know I chose the bypass because I was told I would not lose as much with the band, but then I see all these people who have lost a ton of weight with the band.   What influenced your decision to have the bypass instead of the band??? Mousie

I know that it is a personal decision for each of us. Just like it's a personal decision who your doctor is and do you go lap or open. Only you can make that decision. I know that with me I needed the more drastic choice of having my insides changed. As someone once said, Chocolate can melt and Ben and Jerry's makes a nice soup. You can find ways to cheat the band. You can't cheat the bypass. I also am diabetic and that helped influenced my decision.

Hi Kathy, I just had to respond to your response to Mousie; you can definitely "cheat" the bypass; it's called grazing.  This is how most people gain the weight back.  We may not be able to sit down and eat a bagfull of cookies in one fell swoop anymore, but we sure as hell can eat one cookie at a time every 5 minutes until the whole bag is gone.  The only guarantee in this journey is to DO THE HEAD WORK.  We must work hard at understanding our relationship with food; we must work hard to learn how to eat to nourish our bodies instead of using food to numb feelings; we must learn to incorporate physical activity into our daily lives. This is the only guarantee - I caution anyone going into this against viewing the surgery as the all-mighty cure-all to obesity. It is only a tool. It will only jump start the weight loss. WE are the guardians of how much we ultimately lose and how long it stays off. Sorry if this is not what people want to hear but it is nonetheless the stark truth. Be well, all. Maureen

LOL I never thought about that since I am not a grazer. I also did alot with Jenny Craig and I learned about emotional eating then. I had stopped doing that years ago but had started up again after I got married due to not knowing how to handle a psycho mother-in-law. Once I realized what I was doing I stopped. I hope I didn't come across as thinking it was the all-mighty cure-all. I in no way think of it as that. I know that it is the last resort and as I get closer I wonder did I really do all I can or did I just give up too early?

Hi, Well, when I first started the process, I was going to get the band.  I felt it was less invasive and the fills could be removed if necessary.  A few different factors influenced my decision.  First of all, my dr. recommended the bypass for me.  I also don't view the band as removable.  My dr. won't remove it for just any old reason.  I was also an avid reader of the lap band board and I saw lots of people with complications.  Personally, I decided that I wanted to go in once for surgery and be done (which I know is never a guarantee).  My insurance doesn't cover fills and I didn't like the inconvenience of having to take time off of work, etc.  So, as you can see, I gave it a lot of thought.  I would research them both, look at both surgeries pros and cons, and try to make the decision that best fits your life. Good luck, Jen 

You can talk to your surgeon about which procedure he thinks would be better for you.  I know that Dr. Aranow will make a recommendation to his patients based on your BMI, past dieting history, etc.

Hi Mousie, I choose the band in 2002 and in 2006 had a revision to gastric bypass.  I had no expectation that the band would not work for me.  4 years later and 3.5cc in a 4cc band I had lost 30 lbs when I needed to lose 130.  I gained back 20 of those 30 lbs incidently.  My advice would to be to really check your eating habits.  Be honest about your food intake, what when and where and be completely honest about your ability to follow a food plan.  I think your answere lies there.  I do know people who have the band who have done well over time. Lots of time. That process is slower than the bypass and can derail you if you become impatient.  I regret spending 4 years spinning my wheels.  I would say unless you are extremely disciplined the band may not be the best surgery choice for you.  Your Doctor, Psychologist and Nutritionist should be able to determine that along with you. I am doing well.  I used to "PB" all the time with the band and have not gagged once with the bypass.  I have been blessed with no complications. I'm 10 months out.  Because I am older my weight loss is slower, but I'm down 74 lbs, feel wonderful, don't look half bad (naked is not pretty) and I'm happy.   Good luck... helen 

I had the band in April and lost over 80lbs, I think exercise is really key in how much weight you lose with the Band. If you stay active you can lose the weight at a good pace, though I seen people with the band who are not active lose at a much slower rate and be disappointed in it. Good luck. eddie

Whether you choose to be banded, have an RNY or go for the DS (which I think offers lots of advantages for the morbidly obese, particularly as it has been improved over time), there is an important factor to consider regarding further surgeries.  The biggest risk we face when having our bariatric surgeries is the risk of being obese and under anesthesia.  As a result, you don't want to set yourself up needing a second surgery when the first one fails because, presumably, you would still be obese and a surgical risk.

That's why it is critical to consider what path you took to obesity, what work you're willing to do after surgery (both emotional, behavior modification and follow-up medical work) and what risks you're willing to live with.  Also, you need to evaluate (along with your surgeon and PCP) the risks presented by any co-morbidities and the health factors of a fast or more gradual weight loss-- after all, the health risks when we are obese continue even after we've had bariatric surgery until we've lost our weight, so you do need to consider if there is a medical reason to want a quicker or more gradual weight loss. For me, the Band was only available in very limited fashion when I was considering surgery, so my choices really were an open RNY, a lap RNY or a DS.  I worried about the need to maintain the vitamin regimen after the DS even though I was a border-line compulsive eater who would have benefited by that surgery.  Given the fewer compliations of the lap  RNY,  my goal then became finding the surgery who could do a laparoscopic procedure on a 510-pound man.

I didn't see anyone mention this above- so I will.  Technically- the band is not 'reversible' unless you have a life threatening problem.  So- thinking that is sort of a void point.  Yes, I understand that thought of you not 'rearranging' your insides- but don't think that you can just 'reverse' or 'remove' the lap band as a standard- that's not realistic.  In fact- there can be issues with having the lap band first and then converting to RNY- scar tissue is one of the issues that would make a second surgery much more complicated, amongst others your surgeon could easily discuss with you.

Anyway- I just thought I'd mention that.  You need to choose the surgery based on the best recommendation from your surgeon- he or she would base that decision on your weight/history/eating habits and ongoing concerns.  It's a medical decision- and often family 'opinions' just don't count in that type of situation, even though tehy think they have the best in mind for you. Also- Steve's comments are really poignant- but his almost always are :-) so read what he had to say carefully.

Best of luck to you in your decision making.