Gastric Sleeve May NOT be the answer to your Lap band WOES...Surgeons answer

I know this is not my board, but I really think it's necessary for me to make a point here.  I am four years out from a VSG and have been at goal for 3.5 years having lost 93 lbs.  I counted everything during the weight loss phase, and early maintenance, but I have not been counting calories in years.  I eat somewhere in the 1200-1800 range and I still follow some basice sleeve rules.  I did not exercise while losing my weight or during the first three years of successful maintenance.  My doctor insisted that health requires me to exercise and I have incorporated it into my week now.  I look better and have more muscle tone, but my weight is still quite steady in the 103-108 range.  Most of the people I know who have used my doctor and are as far out as I am are more or less in the same place.  None of them really count calories anymore, although some do, most don't exercise in any extreme way and the vast majority are keeping their weight off.  I am mindful of what I eat but I eat delicious meals and I drink wine and I have plenty of treats in my normal week.  I go out to eat on a regular basis and I never throw up or have issues with finding food that works for me.  For me, this has been a true gift. The sleeve is a tool, there is no surgery that doesn't require effort, however, I feel that the sleeve has given me a very normal life where I eat what other thin women eat and I maintain by keeping my eye on the scale and making adjustments when needed.  That's what normal healthy thin people do also.  If someone offered me a million to take my stomach back, I would turn them down in a second.  I love this new life and it works beautifully for me.

Elina,

I've watched you on the Sleeve board, you are a great inspiration and you look fantastic! I want to say congrats to you with helping others, I read some of your posts and you also motivated me too!

I believe the Sleeve is a good surgery and most importantly it probably works better with virgin Sleevers as opposed to Band to Sleeve based on what I've seen over the years.

The thing with the band is that we get used to TIGHT restriction, yes the band can be tighten up to the point of barely swallowing liquids. (however this is not recommended, but many live with an overly restricted band).

And someone going from very tight restriction to be able to "eat so much better" as some Band to Sleeve revisioner say...may not be what a Band to Sleever may expect or want...lol.

You see with the band some of us get spoiled.....with a very restricted band you CANNOT physically over eat, there is a brick wall, you can't overeat even if you tried, or else you'd be in severe pain, and have repeated vomiting until all the food comes back up and this can last for a few hours...as we say most have experienced a good ole fashion band whippiing...lol..

I think when people get the Sleeve, and food goes down differently and easier, this may take some adjusting, since the lap band will whip your butt if you overeat....so I am not sure if this kind of "behavior modification" will work for an obese person who is looking for something to stop them from eating...

But...the lap band IS not suppose to work like I just explained, it should work just like the Sleeve, with satiety and not stopping people from eating, it is designed to help you stop eating..but with lap band you can choose to use it however you want to use, you can tighten to the point of only getting down liquids or you can tighten to the point of like the Sleeve, were you eat a small amount of solids and feel satisfied.

I think you've done well with your Sleeve and serve as a good role model, I will tell you at least for ME, I kept my weight down easily with my band for about  6 good years, year 5 started to get tough....I could eat more, the Band pouch will stretch like the Sleeve overtime, we get complacent years out and forget to eat 2-4 oz meals....we just get tired, I think that is the cause of most weight regain, we just get tired of following rules the further out we get and revision surgeries just don't help a lot of people for this very reason.

I will tell you if I ever get into a position and I lost my band, as much as I don't want to remove my stomach, If I ever got to the point where I was up against a wall and was faced with a revisional surgery, I would surely fly out to California for Dr. Crangle to do my Sleeve -- since I hear all Sleeves are not created equal....I travel to California often anyway since my husband has lots of jobs out there in Northern California, we are heading out there in about 3 weeks to Lake Tahoe and Sacramento, I can't wait....

Again, Elina I don't think you are trust passing, you bring value and I respect that, anyway congrats again on your success!!

I hear you and I want you to know that I wish you all the success in the world and I want everyone who has the lapband to succeed just as much as I want everyone with a sleeve to taste success.  I think it is important to clear up a possible misconseption, I too feel strong restriction.  I can't eat more that about a cup of food even if I wanted to as long as the food is not a slider food. For example, I can only eat about 4 ounces at most of protein, probably closer to three, but I can eat unlimited amounts of potato chips.  Even with ice cream, I can only eat about one scoop.  So there is real restriction and as long as I eat healthy protein and veggies most of the time and refrain from drinking my calories most of the time, I do just fine.  I think the people with the sleeve that end up in trouble down the road are people that choose to get larger sleeves.  The part of the fundus that is left stretches to a magintufe of four, so what seems like a small difference, becomes a huge difference in the long run.  Those of us who have tight sleeves really don't regain very much, and the sleeve does not really strech much after it matures if it was made tight in the first place.  There just isn't much tissue left to stretch and the tissue that is left is the harder to stretch tissue.  People tell me that the size of the sleeve doesn't really matter because it only matters what people put into their sleeve.  I can only remind them that that strategy didn't work very well before the sleeve and my guess is that it will not work well long term after the sleeve.  It helps quite a bit to have a strong tool.

I am hopeful that your band will keep working for you and that you will never ever need another surgery, but, it you do, you have the right idea. 

After all these years I'm convinced that WLS isn't the answer for most people. It doesn't FIX anything. If it does, it's only temporary. So many people never change their lifestyles... or they do for a while, then go back to their old ways. Of COURSE you're going to gain all the weight back if you go back to eating garbage and stretching your pouch or eating foods that slide right down. ANYONE that loses a massive amount of weight has a risk of regaining. I don't know why some people want to act like it's their band's fault that they regained. No honey... it's the food you put in your mouth and the lack of movement in your leg area.

I don't favor any surgery. Part of me wishes my insurance had covered some sort of long term nutritional counseling program that actually helps address our true problems that caused our weight gain... our issues with food and lack of exercise. I also wish surgeons would require ongoing counseling. People can say, "Oh I have fibromyalgia/PCOS/hypothyroidism......" and the list goes on but there is no excuse for morbid obesity. I know plenty of people that have these issues and have lost weight without surgery. I know them because I'VE had to basically live the life of someone that hasn't had surgery because my band hasn't helped me much at all aside from the first 20-30 lbs I lost pre and immediately post surgery. And I wouldn't say it's helped me in the slightest after I had my first post-op baby... and now my second post-op baby. My weight loss is all what I eat and how I exercise.