How do you decide?

I have another question. How do you decide which surgical procedure is right for you - how did those of you who have had surgery make the choice?

Hi Jody, I attend several different seminars and found out what each Dr. does vs a different Dr. I knew I didn't want the lapband, you can only lose weight at 1-2 lbs a week, eat the same foods that got you overweight just in smaller portions. The Gastric bypass is what most Dr.'s do. The RNY procedure the pouch is cut away from the main stomach, you lose weight face, and you can't eat what got you overweight in the first place. You're taught how to eat properly and in smaller quanities. In five months I have lost 86 lbs. I feel better, don't have to take my high blood pressure meds, or my diabetic meds. You wouldn't lose that kind of weight with lapband. I wanted it to be a permanent procedure. With a lapband, there is the constant fill in's to tighten up the band, done by laproscopic procedure. Some insurance companies won't cover the lapband. It's still attached to the main stomach, and I know several that after 2 years were gaining the weight right back on. That's how I made my dicision, I didn't want the weight to be able to come back on. Best of luck in your decision. Always Here, Kathy

Kathy, Some of your statements about lapband are incorrect. Yes I am able to eat almost all of the foods I ate pre-op, but really and truthfully sweets are not what caused me to be obese. My lapband IS a permanent procedure. I eat healthy foods post-op and am also being taught how to eat properly by a nutritionist. It is a requirement for most patients that they have to see a nutritionist no matter what procedure they choose. The lapband is tailored to suit ME. It is tailored to each patient individually and some NEVER need a fill. Others may need between 1-5 fills depending on what size of band they have placed. You DO NOT have to go thru additional laproscopic surgery to have a fill done. It is done by a needle being inserted into a port (a small circular device that is implanted under the skin that is attached to the lapband by a thin tube). The procedure of getting a fill is painless. Your statement of "The Gastric bypass is what most Dr.'s do." ***Yes most doctors in the US do preform RNY, for so many years it was the only hope that obese people had and most doctors still perform it today. But there are other procedures available also, DS,RNY, Lapband,VSG,VBG,BPD. While it is true that some ins. companies don't cover the lapband, or try and say it is still an experimental procedure, the lapband has been approved for use in the US by the FDA. Lots of ins. companies just don't cover ANY type of WLS. You stated that you know several people who after 2 years are gaining the weight back who have had the lapband placed. There are successes and failures with ALL of the surgery types. Over 5 years the results show about an even loss for comparison to RNY and lapband. There are also patients who have had RNY, who are now having a lapband placed over their RNY because they have stretched out their pouches and are seeing weight regain. With RNY you have about an 18 month window of opportunity to loose your weight and then your body adjusts and you CAN start to regain weight. With lapband I don't have that issue, it will still work for me in 18 months or 3 years, BUT I will only get out of it what I put into it. If I am not willing to eat right and exercise and I eat junk all the time and consume too many calories, I will start to gain weight. It doesn't matter what procedure you have, if you don't learn to eat right and you consistently consume too many calories and don't exercise - then you will begin to see weight regain. We all have the same goal - to loose the weight and be healthier. It is wonderful that you have lost 86 pounds in 5 months, congratulations. I know you are elated that you are off the extra meds. But you stated that "you wouldn't loose that kind of weight with the lapband", there are several patients on the lapband board who have lost 200 pounds or more. Yes it took longer than with RNY would have, but that doesn't negate their success. Your statement of "That's how I made my dicision, I didn't want the weight to be able to come back on." Do you think that any of us, regardless of the procedure we choose, want the weight to come back? I didn't go thru all of the testing and surgery, not to mention the expense, just to PLAN on having my weight come back some day. I did all of it to gain a tool to help me loose weight - God knows I wasn't able to do it without having the help of WLS. Please educate yourself on how a procedure is done and what kind of post-op care is going to be needed if you are going to pass out advice on that procedure. Trisha

Trisha, I was stating a fact that I heard at a seminar. That's how I got my information. Kathy

Kathy, I really hope you didn't feel flamed with all this. I am sorry that you were given the wrong information. As a person who did as much research as possible on all of the types of surgery before I made my decision, I just took it as offensive that wrong information was being passed out. I guess that lots of us banded folks felt that way, huh? I don't negate the good aspects of any of the types of WLS. What works well for one person is just not a good choice for another person. I feel that it is very important that those of us who have had WLS (no matter the type) make sure and tell people who are just beginning to do their research to look at all the types of surgery and choose what is best for that person individually. I don't want to be responsible for a person choosing a surgery type based on my recomendations and then that person isn't/can't be successful with it because they didn't know or weren't prepared for something directly related to that particular surgery type. Like dumping or strictures for RNY folks or PB's and sliming for banded folks. Our end goal is loosing weight to be healthier & happier. It doesn't matter if you get there by dieting without surgery, or have any form of WLS. Trisha

, Kathy! Did you know that RNY patients can wind up medically needing to have the lapband, too?

Kathy: Please know that I am not here to bash your reply but I do have a couple of question about your reply. You see I am not the type to tell someone that one surgery is better than the other, I only know that one surgery was better for ME than the others. When you say constant fill in that is done by a laprocopic procedure, are you saying that the fills are done each time by another surgery? Please tell me this is not the information that you are giving out. Let me educate you about fills. Fills are done in the doctors office, with a special needle, some get a numbing shot before (that will be me) and some doesnt. Saline is inject in the port which is located underneath the skin, this is how the band is tighten, it not a constant thing, it is as individuals need. I sorry to tell you but with RNY some can eat what got them overweight in the first place, I have several friends who had rny and they can eat cookies, cokes, cake and they dont even have the mercy of dumping. For some loosing fast is their goal, but some it not their goal, my goal is to loose the weight at a sensitive pace in order to give my body time to adjust, in 4 months I have lost right at 50 pounds, but I can almost know that I wont have to have PS. You stated that you know several with lapband after 2 years who are gaining the weight back, that might be true but I too know RNY patients after 2 years who are gaining the weight back and guess what? The one with lapband at that point is better off because thanks to their band and the adjustablity of it, they can start all over again, jump back on the bandwagon with fills. Can you say the same for RNY after their window of opporutuntiy is over? I hope that your weight does not come back, that is the goal of everyone who undergo WLS, however I pray that you know that it is a possibility. One last thing before I close, for the record 1-2 pounds a week is the average weight loss, it not that you can only lose that, believe it or not, a person who has not had WLS can lose more than 1-2 pounds a week if they really try. All I am asking from you is to be a responsible information giver, give the information about what you know, if that is RYN then so be it, if you dont know the correct information about lapband or other surgeries, then please dont give out false information, it does no one any good. The decision of what type of surgery is on that individual, all I ask is that we (anyone who had WLS) give correct information, not what we think or what we feel. Thank you for taking the time to read this and I wish for you nothing but continue success in your WL journey. very respectfully submitted LaVerne

I don't understand. The research is there for all of us to read so that we may make informed decisions. In Septemeber, 2005 there was ONE lapband death. I'd say that makes the percetages much better than previously guessed to be 1 in a thousand. There were many more lapband surgeries in the US from 2001- Sept. 2005 than 1000. Am J Forensic Med Pathol. 2005 Sep;26(3):297-301 AND just this past February a comparative study published: J Am Coll Surg. 2006 Feb;202(2):252-61. Epub 2005 Dec 19 excerpt: "After controlling for differences of admission body mass index, gender, and race, the LAGB (LapBand) group had an almost three and a half times lower likelihood of a complication compared with the RYGB group (odds ratio, 3.4; 95% CI, 2.2-5.3, p < 0.001) and had an over three and a half times lower likelihood of a complication compared with the BPD with DS group (odds ratio, 3.6; 95% CI, 1.8-7.1, p < 0.001). There was no statistically significant difference between complication rates of RYGB and BPD+/-DS. CONCLUSIONS: Bariatric operation complication rates range from 9% to 25%; very few complications are serious. Laparoscopic adjustable gastric banding is the safest operation in terms of complication rate and severity when compared with laparoscopic Roux-en-Y gastric bypass or laparoscopic malabsorptive operations." Not opinion, just facts.

I know you are so tired of being flamed, or slightly toasted at least, but I'll comment to the gaining weight back after two years part. The processes are like apples and oranges. With lap band, you don't gain back "after two years," you really should still be in the weight loss process after two years. The expected route takes 2-3 years. All the other stuff you said was a condensed, simplistic way to understand it in your mind, but it was pretty wrong on most accounts. This method is intentionally "slow," and someone who chooses it must come to grips with the fact that it's slow not because it's in error, but because it's just different. Also, did you know that only 33 to 40 percent of RNY patients have dumping as a result to eating sugar and highly concentrated fats? This means that it's a roll of the dice, but many bypass postops can also "eat the foods that got them overweight." Your weight loss is fairly common after RNY, but it can be experienced by lap band postops. Some, can even top your results without the reinforcement of dumping and malabsorpion. The RNY window of opportunity is 18 months. It's not a given, but weight loss usually slow at this point and there is some "regain" expected even in the most compliant patients. In all fairness, you should have mentioned the 18-month RNY window. Most doctors who do seminars do. My first year, I got "one" constant fill and lost very well. We are all different, but I hope you can see we didn't make a dumb mistake. Choice *and* proper education are great things. We do wish you well and support your decision to have wls. You just aren't extremely versed in explaining the differences, that's all. All my best, Frances

OMG Kathy you are soooo wrong! I really think yoou should know more about a procedure before you start trying to ba**** I want to see your posts in a few years lets see if your view on things are still the same. Wendy