RNY Vs. Lap Band

Hello, I was originally interested in having RNY, but my surgeon is recomending a lap band. I know the choice is my own to make, but now I'm confused. I feel that RNY may cause too fast of weight loss and could possibly cause me to be healthy, but look sickly. With the lap band I fear that I won't lose weight quick enough which may cause me to be depressed. I am 23 and plan to have children in about 4years from now and wonder if the band is better for that reason. I just need some advice about how others made their decison. At this point I'm thinking a lap band would be better, but I'm still iffy. ~michelle~

Michelle: This is sometimes a very hard choice to make, but you have to carefully weigh the pros and cons of each procedure based on YOUR needs and desires. Keep in mind that some RNYers will lose weigh faster or slower than others, and some bandsters will, too. (laughs) And once we have chosen our procedures, we all seem to be fiercely devoted to the one we chose. I have lost weight faster than most band patients I know - almost at bypass speed, but I know that this is the exception, not the norm, and try to impress that upon people making their decision. My reason for wanting the band was not based on speed of weight loss; quite the opposite. My argument was that I didn't get obese overnight, and didn't expect to lose the weight overnight, either. I just personally felt that the bypass procedure was too invasive FOR ME. You're doing the right thing by doing a lot of research. This is a big decision and one that you shouldn't make lightly. There are a lot of people out here who will help you, and one of my best suggestions is to discuss both procedures further with your surgeon, particularly as they relate to a future pregnancy. Best of luck on your journey. Please feel free to take a look at my profile to read more about my journey, and feel free to email me if you have questions. Bette Banded December 2, 2003 376/170-something, depending on the day

I looked at your profile. You look really good. I understand what you mean about not gaining the weight overnight, and yes my ultimate goal is to be healthy, but I have been fat all my life and at age 23 I want to lose weight, feel good and LOOK GOOD. I don't want to look sick and saggy like I have seen in some cases. I read one article where a woman had 20lbs of exta skin and needed a tummy tuck. I carry all my weight on my legs and I want them to look toned and heslthy when its all said and done. Thats why I'm leaning towards the lap band, but the weight comes off slow and steady and I feel that I will be able to tone my body more effectively. Obviously my health is my overall concern that why I want WSL, but I am very concerned on what I will look like when this is all over.Thanks for your help...please keep in touch. ~michelle~

I don't think what procedure you have is going to effect what your skin is going to look like afterwards. I think anytime you lose massive amounts of weight you are subject to have loose skin. Genetics and age are a BIG factor in that. The younger you the more elastic your skin tends to be, but it's also genetic (also why some people don't get stretch marks). I have lost about 125lbs and I really don't have much loose skin, but I could still use a tummy tuck. Especially after having 2 kids. My legs and my arms are pretty good. Exercise will also help some. You are doing the right thing by doing your research and good luck with whatever you choose.

Michelle, It depends on you and whatever decision you make. Everyone's makeup is different, some lose very fast, some medium, and some slow. It will depend on your commitment and what your doctor decides is best for you. I had the RNY laporscopic in December 2004. I have been out 9 months and have lost 105bls. There are some members out less than me and have lost alot more. It does not matter what you have lost its how you feel and how healthy you become. Weigh your options and research both thoroughly. Talk with your surgeon on your concerns too. Don't hesitate to ask any of us questions no matter how dumb they may be. Good luck in your decision and welcome to the WLS Family. Hugs KimC

A few misconceptions to clear up to help you make the best possible choice for you. The way you'll look with redundant (also called excess) skin will be the same whether you lose your weight quickly with a lap band or very quickly with a RNY. The skin is there now, parts of it are stretched already. You'll look sickly if you don't maintain good nutrition-- a risk which is minimized (regardless of your surgical method) by daily vitamins and good food choices. Secondly, if you are going to give yourself four years to start a family, then either method would have you in a position to be able to get in enough nutrition; getting pregnant months after an RNY is not advisable, but after about 2 years, you are in a good position to be able to better plan your dietary needs. If you were planning on getting pregnant sooner than 2 years, then the lap band would be the better weight loss method because you could minimize your fills at that time to allow for greater consumption. Some people might suggest that the complication rate is lower for Lap Band than for RNY, but those statistics are not entirely accurate when compared against the complication rates for comparably skilled surgeons. If you choose a surgeon who has performed over 100 Lap Bands or over 100 RNY's, you risk of suffering a band slip is about the same as your risk of suffering an adhesion, internal hernia or stenosis (the typical complications particular to RNY). Gall bladder disease risk is the same. It is tough to not worry about failure-- and to wonder if you'll be happy with the rate of weight loss regardless of the method you choose. However, keep in mind that, with vigilence, you can enjoy consistent weight loss with either surgical method. On average, your weight loss will be quicker with the RNY and on average you will tend to lose more of your excess weight with RNY than with lap band. But, as Bette points out, there are exceptions (and great success stories) for proponents of each surgical weight loss method. For me, I knew that I needed a method that would permanently reduce the size of my stomach and that would provide disincentives to overeating and to eating sugars. You see, I was obese as a child and, despite losing my weight as I entered high school (due to intense exercise), I yo-yo'ed all through college and adulthood. Consequently, I knew that I needed a permanent solution. Also, I knew that I would need a program that offered extensive education and support group services (which made Dr. Crum and Norwalk Hospital an easy choice for me). If you feel pressured by the surgeon with whom you met, think about going in for a consult with a different surgeon. Good luck.

I'm glad that you're asking questions now and taking an active part in the decision making for your future. Far too many people simply accept the opinions of their surgeon and go with that. Your concerns about excess skin and how you will look have nothing do do with the type of surgery you choose. If you loose 100 pounds in 3 months of 6, you will have the same amount of excess skin in the end. There MAY be a period of time with the rapid weightloss where your body will need some time to adjust and catch up a bit, but it's very transient. The issues you need to really think about are YOUR eating habits, WHY are you obeese? How did you get that way? And which surgery will asist you best in your quest to permanently your lifestyle? Either surgey is fine if you want to have children 4 or so years from now. After you reach a stable weight you can begin considering children with RNY. I would think you would want to be as close to ideal weight as possible before going ahead and getting pregnant, if you're not in a hurry. So, the surgery is not so much of a factor in the pregnancy discussion. Either way you have surgery, you will need to monitor your nutrition closely to make sure the baby is getting what it needs. We can't answer the question for you, but, we can direct you to think about the major habits, heredity and behaviors that have caused your obesity and consider those when you choose your surgery. Personally, as Steve mentioned, I also needed the permanent stomach size reduction of RNY. I started out thinking I wanted Lap Band, but later reconsidered based on my needs and extensive discussion with my surgeon. I'd like to mention: I think one of the arguments that often sways people who are tentative or scared toward Lap Band is that Lap Band is reversible and RNY is not. Please know all the facts if this is a concern to you. While Lap Band is removable, is is rarely if ever done, mostly in life threatening situations. RNY also, technically, is reversible in certain life threatening situation. That is also rarely done. So, you ca see, there are always two sides to the coin. Feel free to get a second opinion if you're unsure about what your Dr. is recommending. It's VERY VERY important to get to know other patients of your surgeon and see what their experiences have been, so search for them on this board and in support groups and talk with them openly. They will be the best judges of your surgeon. Your biggest factors that come into play when having any WLS surgery are: 1. The skill and expertise of your surgeon 2. The type of surgery you choose matching your needs 3. The immediate aftercare and long term care and support that your surgeon compels his patients to participate in, which are key to maintaining weightloss. If you'd like to discuss further, please feel free to email me privately. This is one of the most important decisions you'll ever make. I wish you the best of luck, Lisa C