Lap-Band vs. Sleeve - How did you decide?
This is for Sandy R. Sandy I think it would be more helpful to people to not use one study or portion of one study to prove that one WLS surgery is better than another. As we all know WLS surgery is not a one size fits all and each time someone makes a WLS choice it is for many, many reasons that are as unique as the person choosing. Where in the world is the evidence that the sleeve causes " erratic behavior online" or whatever it was you posted about online behavior caused by the sleeve?!
I think it's wise to leave medical advice and information to the medical professionals and not lay people. As a mental health professional it is my opinion and experience that people generally are better able to process information given in a gentler and non-threatening way rather than in a manner that tears down one WLS in order to build up another. If someone wants to "educate" someone else, it is best handled by the professionals. Education is different than personal experience. All of us can relay our personal experience, no matter who we are, but only a medical professional can credibly "educate" people through evidence-based studies , and proven expertise.
"The Joy of the Lord is your strength." Nehemiah 8:10START: 330 CURRENT: 274.5 lbs GOAL: 190 TOTAL: 55.5 lbs
Shame on people that spread malicious, misinformed, misleading information to people honestly trying to make informed medical decisions. OH should ban people who make up a load of crap and post it as the truth.
You can lose weight with all of the WLS procedures. Each has it's good points and bad points. You need to get ACCURATE information from a truly informed source.
I chose the sleeve for many reasons. At this point, 4 1/2 months post-op, I am OFF my antidepresants, off my BP meds, have reduced one of my meds for rheumatoid arthritis. I couldn't be happier. I was not concerned about removing the majority of my stomach. I wanted a permanent solution. I can't imagine ever wanting to be fat again. Remember, also, that the band is sometimes nor reversible due to damage to the stomach. Be comfortable with YOUR decision. No one has to live with it but you.
40 pounds lost pre-op
on 10/8/08 9:37 am
In reading this thread I just wanted to give you some experienced advice. Ignore everyone who bashes any surgery type. Read profiles of people's experiences. My profile has all the reasons that I selected the band, along with my journey. Ignore the petty bickering between folks.
There are many many successful and happy people with all forms of weight loss surgery. It's up to you and your doctor to decide what will be best for you in the long run. We are all different and make our choices for different reasons.
I am really getting fed up with the attacks on surgery types, or attacks on people. You are looking for answers and support, right? Well most of the people here will respond well to you. I recommend that any person who is annoying in their reply should be blocked. That way you stay out of the line of fire.
Please let me know if I can help you in any way - you can PM me if you like. With a BMI above 50, whatever choice you make for WLS will be life-changing. In a beautiful way. Good luck!
Well said!
I've also included a few from him on normal ghrelin's anti-inflammatory effects, effects on sleep, heart function, and more.
the long term problems from very low ghrelin levles are simply unknown.
for those who do not know who dr John dixon is, he is the foremost obesity surgery researcher in the world. He studies all forms of WLS and has thousands of publications. He studis and reports on the consensus of knowledge worldwide , not simply from one study or one country.
Make up your own minds from info given, and others that you may find.
Sandy r
Brand new - out this monday - not even into archives yet
Psychiatr Genet. 2008 Oct;18(5):257.
Ghrelin gene polymorphism is associated with depression, but not panic disorder.
Nakashima K, Akiyoshi J, Hatano K, Hanada H, Tanaka Y, Tsuru J, Matsu****a H, Kodama K, Isogawa K.PMID: 18797403 [PubMed - in process]
Nat Neurosci. 2008 Jul;11(7):752-3. Epub 2008 Jun 15.
The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress.
Lutter M, Sakata I, Osborne-Lawrence S, Rovinsky SA, Anderson JG, Jung S, Birnbaum S, Yanagisawa M, Elmquist JK, Nestler EJ, Zigman JM.Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390-9077, USA.
We found that increasing ghrelin levels, through subcutaneous injections or calorie restriction, produced anxiolytic- and antidepressant-like responses in the elevated plus maze and forced swim test. Moreover, chronic social defeat stress, a rodent model of depression, persistently increased ghrelin levels, whereas growth hormone secretagogue receptor (Ghsr) null mice showed increased deleterious effects of chronic defeat. Together, these findings demonstrate a previously unknown function for ghrelin in defending against depressive-like symptoms of chronic stress.
Obes Surg. 2006 Aug;16(8):1068-74.
High ghrelin concentration is not a predictor of less weight loss in morbidly obese women treated with laparoscopic adjustable gastric banding.
Busetto L, Segato G, De Luca M, Foletto M, Pigozzo S, Favretti F, Enzi G.Obesity Unit, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. [email protected]
BACKGROUND: We analyzed the role of high plasma ghrelin concentrations at surgery as a negative predictor of weight loss in morbidly obese patients treated with laparoscopic gastric banding (LAGB). METHODS: Fasting plasma ghrelin concentrations were measured in 113 women before LAGB, and 16 of them were identified as having ghrelin concentrations clearly higher than expected according to the BMI levels. The 2-year postoperative outcome of these 16 patients was compared to the outcome of the remaining subjects. RESULTS: Mean fasting plasma ghrelin concentration in the group with hyperghrelinemia was 82.3+/-23.1 pg/ml and in women with normal ghrelin was 27.1+/-11.3 pg/ml (P<0.001). No differences in age, age at onset of obesity or degree of obesity were observed between the two groups. Women with hyperghrelinemia had a weight gain during the waiting time similar to women with normal ghrelin. The prevalence of comorbidities and eating behavior disturbances was similar in the two groups, but depression was 2.5 fold more prevalent in the hyperghrelinemic women than in the women with normal ghrelin. The %EWL after LAGB surgery was similar in women with high and normal ghrelin concentrations, with no differences in levels of postoperative band filling. No differences in band-related complications or revisional surgery rate were observed between the two groups. CONCLUSION: A high fasting ghrelin concentration at baseline did not significantly affect the outcome after LAGB in morbidly obese women, in terms of weight loss and complications rate.
Circulation. 2004 May 11;109(18):2221-6. Epub 2004 Apr 26.
Ghrelin: The Link Connecting Growth with Metabolism and Energy Homeostasis
Felipe F. Casanueva1 
and Carlos Dieguez2
| (1) | Department of Medicine, Endocrine Section (FFC), School of Medicine and Complejo Hospitalario Universitario de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain |
| (2) | Department of Physiology (CD), School of Medicine and Complejo Hospitalario Universitario de Santiago, University of Santiago de Compostela, Santiago de Compostela, Spain |
Without Abstract Cardiovascular Activities of Ghrelin and Synthetic GHS
Jörgen Isgaard2, Inger Johansson2 and Åsa Tivesten2
| (2) | Research Center for Endocrinology and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden |
Obes Surg. 2007 Feb;17(2):168-75.
Laparoscopic adjustable gastric banding in 1,791 consecutive obese patients: 12-year results.
Favretti F, Segato G, Ashton D, Busetto L, De Luca M, Mazza M, Ceoloni A, Banzato O, Calo E, Enzi G.Department of Surgery, Regional Hospital - Vicenza, Italy. [email protected]
BACKGROUND: This study examines 1,791 consecutive laparoscopic adjustable gastric banding (LAGB) procedures with up to 12 years follow-up. Long-term results of LAGB with a high follow-up rate are not common. METHODS: Between September 1993 and December 2005, 1,791 consecutive patients (75.1% women, mean age 38.7 years, mean weight 127.7 +/- 24 kg, mean BMI 46.2 +/- 7.7) underwent LAGB by the same surgical team. Perigastric dissection was used in 77.8% of the patients, while subsequently pars flaccida was used in 21.5% and a mixed approach in 0.8%. Data were analyzed according to co-morbidities, conversion, short- and long-term complications and weight loss. Fluoroscopy-guided band adjustments were performed and patients received intensive follow-up. The effects of LAGB on life expectancy were measured in a case/control study involving 821 surgically-treated patients versus 821 treated by medical therapy.
RESULTS: Most common baseline co-morbidities (%) were hypertension (35.6), osteoarthritis (57.8), diabetes (22), dyslipidemia (27.1), sleep apnea syndrome (31.4), depression (21.2), sweet eating (22.5) and binge eating (18.5). Conversion to open was 1.7%: due to technical difficulties (1.2) and due to intraoperative complications (0.5). Together with the re-positioning of the band, additional surgery was performed in 11.9% of the patients: hiatal hernia repair (2.4), cholecystectomy (7.8) and other procedures (1.7).
There was no mortality. Reoperation was required in 106 patients (5.9%): band removal 55 (3.7%), band repositioning 50 (2.7 %), and other 1 (0.05 %). Port-related complications occurred in 200 patients (11.2%). 41 patients (2.3%) underwent further surgery due to unsatisfactory results: removal of the band in 12 (0.7%), biliopancreatic diversion in 5 (0.27%) and a biliopancreatic diversion with gastric preservation ("bandinaro") in 24 (1.3%). Weight in kg was 103.7 +/- 21.6, 102.5 +/- 22.5, 105.0 +/- 23.6, 106.8 +/- 24.3, 103.3 +/- 26.2 and 101.4 +/- 27.1 at 1, 3, 5, 7, 9, 11 years after LAGB. BMI at the same intervals was 37.7 +/- 7.1, 37.2 +/- 7.2, 38.1 +/- 7.6, 38.5 +/- 7.9, 37.5 +/- 8.5 and 37.7 +/- 9.1. The case/control study found a statistically significant difference in survival in favor of the surgically-treated group.
CONCLUSIONS: LAGB can achieve effective, safe and stable long-term weight loss. In experienced hands, the complication rate is low. Follow-up is paramount.
DISCLAIMER: Any suggestions or comments are not intended as medical advice, but only as general information. Please always contact your own surgeon or his staff for any specific problems or concerns you are having. Although I have many years as a medical professional and band educator, I offer suggestions here only as an experienced Bandster.
That said, I will explain as best I can why I chose VSG over the band. Originally I was interested in the band because I did not want a procedure that re-routed my intestines, has malabsorption issues and because it was reversible. After lurking on this board, the VSG board, the main board, numerous websites, my informational seminar, and talking to my surgeon I decided the VSG is for me. After reading about people who have had really bad things going wrong with their bands and the very good probability that I would not lose all the weight I need to lose the band was eliminated as an option. My surgeon feels the VSG will be an excellent procedure for me as well. I am aware you are probably wondering why I am going with a non-reversible procedure and I have to say that after much soul searching and being completely honest with myself I know that I need a permanent solution. I know myself well enough to know that if I can eat around it easily I will. I know that if I was lucky enough to lose all my weight with the band and it stopped working that I would gain it all back. Those were hugh factors for me.
What it comes down to is you. You need to be totally honest with yourself and then find the best procedure that will help you lose the weight you need to lose. Do not let anyone give you medical information that you do not verify from the original source. Just because it sounds like it is valid doesn't mean it is. You have already demonstrated that you are researching all of your options. Because of this, I am sure you will be very successful with your weight loss choice.
Good luck!
"Women are like cell phones. They like to be held and talked to, but push the wrong button, and you'll be disconnected." ---Unknown
Please continue to research and be well informed in your decision to have weightloss surgery. As a previous poster stated, whatever surgery you choose it will hopefully help you have a better life. Please understand the replies are not usually so strong and opinionated in such a way that seem offensive. As you can probably see, each group feels very strong about their choice of WLS and have presented information to support their claims. Always keep in mind, this board is for SUPPORT and lastly entertainment purposes. Your final decision should come from research you have obtained from the trained professionals.
My Best Regards
10,000 steps walking challenge coordinator to register; http://10000steps.org.au/ and then pm me your email and I will link you to the challenge.
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