ASMBS: Gastric Banding Gets Low Marks

"Do these studies mean that EVERY person, with a BMI over 50, will NOT be successful with a bypass? Of course the answer is NO!! However if one was just to believe the facts, and if they had a BMI over 50, then according to these studies they should forget bypass. How inane!!"

Well, it's my personal opinion that people who are SMO should NOT be pursuing RNY as an option, but rather the DS... so I don't really see any issues with these studies.  Could you use this to argue against bypass?  Certainly, and SMO people SHOULD be steered away from traditional RNY.

"However if one was just to believe the facts, and if they had a BMI over 50, then according to these studies they should forget bypass."

I giggled.  You totally pulled a Stephen Colbert there - who wants to pay attention to FACT?!  How inane!  Giggle aside, the studies do not say forget bypass - the studies say that this surgery is a gamble at a BMI over 50 - and long term, it is.  The first study suggests an alternative with a higher success rate, the DS.

So, I'm not certain that your argument is coming across like you intend it to?

I agree! I think over 50 BMI, much more difficult and DS is probably a better choice. What kills me is when I see physicians counseling someone with a BMI over 40 to "try lapband." What is up with that?

BLR – You are properly correct in that my argument isn't coming across like I intend it. I am better at verbalizing than inscribing. All I am trying to say is, there isn’t one procedure which is 100% successful. While procedure “A" has any average weight lost of X pounds, a person could easily (well maybe EASILY is the wrong word, because we know we all have to work at success) surpass the “average" or come no where close to the average success rate.

Jillybean70 I apologize if I am not thinking logically enough for you. Guess my emotional side is outweighing my Vulcan side. I would love to talk you on this, and many other subjects. You seem like the person I could have a “real healthy (heated) discussion", and at the end go out and have a nice “cold one or two" (of course I mean frozen Protein drinks).

Everyone else:

For those who are having success with their operation decision, I wish you continued success. Be proud of your accomplishment, and know you are an inspiration to many.

For those who are struggling, I wish you all the best, and know I am here if you need (even if I didn’t have the procedure you had)

For those who are just deciding what procedure to have this is my advice to you

 

(1) RESEARCH before choosing any operation. Only you know you, and you know your eating habits. 

 

(2) This is a PERSONAL DECISION. While one operation has been successful for one person, it may not be for another. No one can choose for you. You need to know yourself.

 

(3) STICK TO YOUR GUNS. If you're planning on one operation, and a Doctor (or someone else) is trying to force you into another - walk away and get two more opinions. Some Doctors are comfortable doing one operation over the other, and will tell the patient operation "A" isn't good for you because blah-blah-blah. When in reality it's because they haven't had success or have been trained in doing the other operation. However if 3 Doctors tell you the same thing, then it’s probably right. Example, if you suffer from Type 2 Diabetes, the bypass is better at quickly addressing Type 2 Diabetes than say the band.

 

(4) Remember, all operations are only a tool. THESE ARE NOT A CURE ALL. You need to work at it. You need to change your eating habits. It will take some self-discipline and self-control. They put the tool around your stomach, not around your brain.

TTFN !! And good luck on your journey !!

 

I was at a  dinner last night with WLS patients.  Band and others  typs and there was a women there who had gastric by pass and lost 170lbs  7 years ago and gain back 100 and is now having the band on top of her Gastric by pass.  Go figure  Any surgery requires work.  We are fat heads and will have to think about what we put in our mouths for the rest of our lives.

I want to see those people in a few years who haven't change their eating habits (the band or other WLS patients), they will be in search of the next quick fix.

We have to change to be changed!!!

(Raises hand)

I had my DS about six and a half years ago. I can honestly say that I have NOT changed my eating habits, at least not in the sense that I refrain from eating certain foods. Nor do I intentionally limit my quantities---my DS has changed the way my body WORKS.

Pre-op, I was, literally, hungry ALL THE TIME. Now, I get hungry about 4-5 times a day, and when I get hungry, I eat until I'm satisfied. The difference is, with my Sleeve stomach it doesn't take much food to satisfy me, and the Switch causes my metabolism to treat that food differently. The DS has been a true 'cure' for ME. I say this because I don't do any 'working my tool'---I live a regular life, eat regular foods in regular portions and have had zero regain.

I didn't use willpower or psych myself into a different lifestyle---my DS fixed what was 'broken' with my metabolism. No 'next quick fix' needed, thanks!

Acute and Bilateral Blindness Due to Optic Neuropathy Associated With Copper Deficiency

Robert T. Naismith, MD; James B. Shepherd, MD; Conrad C. Weihl, MD, PhD; Nhial T. Tutlam, MPH; Anne H. Cross, MD

Arch Neurol. 2009;66(8):1025-1027.

Background  Acquired copper deficiency in adults is associated with a subacute to chronic progressive myeloneuropathy and optic neuropathy.

Objective  To describe an individual after gastric bypass surgery who developed a chronic progressive myeloneuropathy, an acute optic neuropathy, along with anemia and leukopenia.

Design  Case report.

Setting  Academic center.

Patient  A 55-year-old woman, following gastric bypass surgery 22 years earlier, developed progressive numbness, weakness, and sphincter disturbance over 6 years. She awoke one morning with bilateral blindness. Examination findings showed evidence of severe myelopathy and peripheral neuropathy.

Main Outcome Measures  Magnetic resonance imaging, optical coherence tomography, electrophysiologic studies, nerve and muscle biopsy specimens, and vision testing.

Results  Over 1 year of follow-up, copper infusion therapy seemed to stabilize the progressive myeloneuropathy and improved leukopenia and anemia. It had no effect on the optic neuropathy. Optic nerve tissue injury was observed on magnetic resonance diffusion tensor imaging and on optical coherence tomography.

Conclusions  Copper deficiency should be considered in cases of atypical optic neuropathy. Serum copper levels should be monitored in patients with a compatible neurologic syndrome who have undergone gastric bypass surgery. Although visual acuity did not improve after copper infusion in our patient, prompt recognition of copper deficiency may prevent further deterioration.

Author Affiliations: Departments of Neurology (Drs Naismith, Weihl, and Cross and Mr Tutlam) and Ophthalmology (Dr Shepherd), Washington University, St Louis, Missouri.

 

Put that in you pipe and smoke it!!

http://archneur.ama-assn.org/cgi/content/abstract/66/8/1025?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=gastric+bypass&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

What's your point? This woman's issues were caused by a copper deficiency. HAd she ben tracking her own labs all along, I'm willing to bet large sums of money that this could have been avoided. Thank you for stating the obivous - that we need to know how to properly take care of ourselves post-op from ANY operation.

That is my point.  Any surgery will or will not be successful if we do not take care of ourselves post-op.  So it really doesn't matter what surgery you have.  You can have success or  failure. 

It all depends on you!!!

But now you're comparing success and failure to complications or side effects - not the same thing.