There are success stories with any form of WLS, but statistically speaking, the Band has the least weight loss, the highest rate of regain, and the highest rate of needing a second surgery. The Band's greatest success stories come from people with a starting BMI of 46 or less, so you're right on the cusp.

I suggest you read on the 'Revisions', 'Failed WLS', 'WLS Regrets', 'WLS Complications', and 'WLS Grads' boards for a while before making your final decision.

Going to the band forum and asking if the band works is like going to St. Patricks and asking if you should become a Catholic...

I had the band for over 3 years. I'm now enduring two additional surgeries to get the DS and fix my mistake.

Did I lose weight with the band? Yes. 120+ pounds.  Was it easy?  F*ck no.  I literally dieted for 3 years straight and THAT is why I lost the weight.  The band barely helped me at all.  It was my own efforts that made me lose the weight, not the band.

I wish you the best of luck but seriously - research other options.  The least invasive surgery has caused me to rack up 3 surgeries for the price of 1.  The band turned out to be more invasive than a DS alone.

LOL!  That first line is oh so true!

How is revision going for you?  I remember you being one of the 1st people I always read about when I 1st had surgery.

Hi Love!!

It's going eh... Second half of my DS is going to happen in a few months.  The VSG isn't helping a whole lot because my metabolism is absolutely fried.  I'll deal with it, though.

I understand  your pain and frustration! This band has been completely useless to me for 11 mos. I have lost about 55 lbs., but like u, have only done it through DIETING!!!

Though I realize the band has helped many ppl. There are far more that it has NOT substancially helped!!! To make matters worse........those posting concerning problems with their band on the band forum can sometimes be met with some very cruel, judgemental comments from other bandsters!

Best of luck with your DS!!!

I'm happy with it thus far.  It's the only WLS my vasculitis and lung doctors would allow me to get.  Is it a quick fix?  Hell no!  But have I lost weight and have I regained some of my life back?  HELL YES and to that I am thankful. 

If you want a faster "fix" then get RNY or DS (but I see many have gained back their weight...as do many with lap band.  But their surgeries aren't perfect either---all have risk. ALL OF THEM).  The sleeve is another option--I like this one.  Do your homework and pick what is best for YOU.  You will get some crazy DS posters saying their surgery is the only surgery that works.  I beg to differ since I see many of them have gained a lot back, but they fail to tell you that part.  I do think it's a great surgery though if you want that done to you (internally).  For me, if I could have had my pick it would have been lap band or the sleeve.

Good luck with whatever surgery you pick.  WEIGHTLOSS and health is what is important.  Not which person yells the loudest about their surgery type!  I would try to find a surgeon that does all 4 procedures that way he/she won't be biased against or for a certain type.

I have to add that if you are SEVERELY addicted to food then lap band wouldn't be the best choice.  A lot of it, especially the first 4-8 months is all about self control (which is hard when you're so addicted), but then the restriction sets in and it gets a lot easier.  I am severely addicted and like I said I couldn't have another surgery, so I am really comitted to making this one work. 

This is just my opinion and of course there are a ton of success stories with people that have heavy food addiction.

Adjustable gastric band to sleeve conversions/revisions September 18th, 2010 Posted in Bariatric surgery, LapBand, Realize Band, Vertical gastrectomy, Weight loss surgery results, surgical weight loss, weight loss plan, weight loss surgery As the popularity of adjustable gastric banding has increased in the United States, so have the problems associated with this approach to weight loss. Issues with band slips, erosions and most commonly inadequate weight loss surgery results or weight regain have become an increasing problem which weight loss surgery physicians must now address. Long-term data on the success of the adjustable gastric band (LapBand® and Realize® Band ) has shown consistent results with regards to surgical weight loss. Published studies in bariatric laparoscopic surgery report average percentage excess weight loss (%EWL) of 30%-60%, but vary widely.   The most accurate reports appear to indicate a range of 40%-55% EWL in patients who have been followed for more than 5 years. Perhaps a more important issue (and more neglected) is the long-term complication and failure rate of these devices. Some reports in the literature looking at results in patients 8-10 years after surgery report up to a 25% explantation (removal) rate, 6-10% rate of reoperation to address complications and 40% failure rate. With more than 400,000 adjustable gastric bands implanted worldwide, this stands to become a sizable problem. Because of these issues, forward-thinking bariatric surgeons have implemented strategies and algorithms to deal with failures and complications of these devices. Dr. Paul Cirangle, a pioneer of and one of the world’s experts on the Vertical Sleeve Gastrectomy (VSG), deals with conversions from the adjustable gastric band (AGB) to the Sleeve Gastrectomy on a frequent basis. He has recently reviewed his extensive bariatric surgery experience with these conversions and has found some very interesting findings. The incidence of patients complaining of “troubled eating" (pain with swallowing, regurgitation, heartburn or reflux) was extremely high (>60%), even in individuals who were successful in losing weight with the band. Among those who were not successful in losing an adequate amount of weight, many stated that dense foods were so uncomfortable to consume. This results in gravitating towards softer foods such as mashed potatoes and pasta, making it essentially impossible for them to reach their surgical weight loss goals. In the time period between July 2005 and July 2010, 69 adjustable gastric bands have been revised to a Vertical Sleeve Gastrectomy. The results in terms of %EWL, reduction of appetite and overall sense of satiety have been excellent – essentially the same as in patients undergoing a sleeve gastrectomy as a primary procedure.   When asked about the subjective difference, all patients concurred that the VSG produced little or no episodes of “troubled eating" and was universally superior in regards to satiety and suppression of appetite in comparison to the AGB.
http://lapsf.com/blog/?p=111

27 June 2010

ASMBS: Gastric Banding Gets Low Marks

ASMBS:  Gastric Banding Gets Low Marks

LAS VEGAS -- Adjustable gastric banding achieves only modest weight loss, and even that benefit deteriorates over time in most patients, a Dutch surgeon said here.

 

Five years after surgery, about two thirds of patients maintained 25% excess weight loss. At 10 years the success rate dropped to less than a third (31%).

 

Using 40% excess weight loss as the standard resulted in a five-year success rate of about 50%, which declined to 20% at 10 years, Edo Aarts, MD, reported at the American Society of Metabolic and Bariatric Surgery meeting.

Control of obesity-related comorbid conditions deteriorated similarly over time.

"If you perform adjustable gastric banding, you must realize that this is not the final solution, most of the time, for your patients," said Aarts, of Rijnstate Hospital, Amhem, The Netherlands.

Reviewing the history of adjustable gastric banding, Aarts noted that initial results were encouraging when the procedure was introduced in the early 1990s. Gastric banding achieved good results with respect to excess weight loss and was associated with a low risk of morbidity and mortality.

The five-year results have been mixed, as some studies showed durable weight loss and others deterioration of initial benefits. Because of the procedure's relatively recent introduction, little information has accumulated regarding the long-term results with adjusted gastric banding, Aarts said.

Rijnstate Hospital has the most active bariatric surgery program in The Netherlands, he continued. Surgeons perform more than 800 procedures annually, and more than 3,000 patients have undergone laparoscopic adjustable gastric banding.

Aarts and colleagues evaluated results in 201 patients who had laparoscopic adjustable gastric banding procedures during 1995 to 2003. All the patients had rigorous follow-up at three-month intervals during the first year and then annually thereafter. As a result, 99% of the patients had complete follow-up data, which spanned an average of 9.6 years.

The patients had a mean baseline age of 37, and women accounted for three fourths of the cohort. Baseline body mass index averaged 46 kg/m², and 20% of the patients met the definition of super obese. Excess body weight averaged 83 kg.

Using excess weight loss >25% to define treatment success, Aarts and colleagues found that adjustable gastric banding was successful in about 80% of patients during the first three years, followed thereafter by a steady decline to 64% at 5 years and 31% at 10 years.

When treatment success was defined as band in place and excess weight loss >40%, the success rate was 70% at one year, 64% at three years, 50% at five years, and 20% at 10 years.

A third of patients had undergone reoperation after five years, increasing to 53% at 10 years. The incidence of band removal increased from 0.5% at one year to 11% at five years and 35% at 10 years. Conversion to Roux-en-Y gastric bypass accounted for half of all reoperations.

Control of diabetes, hypertension, and gastroesophageal reflux disease all deteriorated significantly (P<0.01) over time. In particular, the incidence of new-onset diabetes and hypertension increased during follow-up, as did the proportion of patients requiring acid-suppression therapy.

On the basis of the results, surgeons at the Dutch center have begun to re-evaluate their use of adjustable gastric banding for treatment of obesity. What role, if any, the procedure will play in the future has yet to be determined, said Aarts.

Primary source: American Society of Metabolic and Bariatric Surgery
Source reference:
Aarts E et al. "Disappointing results in the long run after gastric banding." ASMBS 10. Abstract PL-118.

Obes Surg. 2006 Jul;16(7):829-35.

A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates.

Suter M, Calmes JM, Paroz A, Giusti V.

Department of Surgery, Hôpital du Chablais, Aigle-Monthey, Switzerland.

Abstract

BACKGROUND: Since its introduction about 10 years ago, and because of its encouraging early results regarding weight loss and morbidity, laparoscopic gastric banding (LGB) has been considered by many as the treatment of choice for morbid obesity. Few long-term studies have been published. We present our results after up to 8 years (mean 74 months) of follow-up.

METHODS: Prospective data of patients who had LGB have been collected since 1995, with exclusion of the first 30 patients (learning curve). Major late complications are defined as those requiring band removal (major reoperation), with or without conversion to another procedure. Failure is defined as an excess weight loss (EWL) of <25%, or major reoperation.

RESULTS: Between June 1997 and June 2003, LGB was performed in 317 patients, 43 men and 274 women. Mean age was 38 years (19-69), mean weight was 119 kg (79-179), and mean BMI was 43.5 kg/m(2) (34-78). 97.8% of the patients were available for follow-up after 3 years, 88.2% after 5 years, and 81.5% after 7 years. Overall, 105 (33.1%) of the patients developed late complications, including band erosion in 9.5%, pouch dilatation/slippage in 6.3%, and catheter- or port-related problems in 7.6%. Major reoperation was required in 21.7% of the patients. The mean EWL at 5 years was 58.5% in patients with the band still in place. The failure rate increased from 13.2% after 18 months to 23.8% at 3, 31.5% at 5, and 36.9% at 7 years.

CONCLUSIONS: LGB appeared promising during the first few years after its introduction, but results worsen over time, despite improvements in the operative technique and material. Only about 60% of the patients without major complication maintain an acceptable EWL in the long term. Each year adds 3-4% to the major complication rate, which contributes to the total failure rate. With a nearly 40% 5-year failure rate, and a 43% 7-year success rate (EWL >50%), LGB should no longer be considered as the procedure of choice for obesity. Until reliable selection criteria for patients at low risk for long-term complications are developed, other longer lasting procedures should be used.

PMID: 16839478 [PubMed - indexed for MEDLINE]Free Article


http://www.aace.com/pub/pdf/guidelines/Bariatric.pdf

Edited to add bandhope's deleted comments so I don't look like I'm talking to myself

  On October 5, 2010 at 12:20 PM Pacific Time, bandhope wrote: I don't want to get into a battle over what surgery is *******so don't want to start quoting studies or pretending I know enough about each surgery to voice my 2 cents about each one. I do want to say though...we all have one thing in common and that is the fight against obesity. We have so many differences and our lifestyles and habits are all so different. Is it really fair to try and compare and quote studies? Those people in the study did not live like lab rats eating the same thing, doing the same thing day after day for many years. It is just not fair to compare without a little more thought. Yes, I agree lap band isn't for everyone. I'm not here to say...my band with be with me for life or that I will never have an issue. However, none of us can say what our future will be with weight loss or anything else. We should just support each other and be careful not to make "blanket statements" and scare people. I wish everyone the best of luck no matter what direction you take. We all need it, because it's a hard battle to fight.
ME: 
I'm sorry, I know that facts can be scary for some people. They would rather pretend that the rainbows and butterflies will protect them.  Nope, the people in studies don't live like lab rats - they live like normal everyday people. That is why the statistics gathered by studying them, which are then compiled and reviewed for accuracy and errors or flaws in their collection methods that are then agreed upon by other doctors show a real life future trend.

I am always amazed that real facts scare so many people, no matter how far you bury your head in the sand it still can happen to you (it might not but statistically it can) At year 3 post op I sounded a lot like many of the bandsters here. Year 5 brought all the studies right to my doorstep. Instead of being scared - be proactive and prepared?

It is a very hard battle - its even harder when you go in unarmed. Its hard to spend 5 hours on the operating table while a doctor detaches your lap band from your liver and prys the port off of your abdominal wall and you spend the next month with severe muscle spasms due to the damage.  But that will only happen to 25% of bandsters - then again 50% off them will never lose more than 40-50% of their excess weight.