i have ALOT of questions!! :-)

hi ... im sara.. i am 26 years old and i will be turning 27 in june.. i have two kids and i have been married for 6 years but we started dating when i was 15 so...ya its been a while... i cant say i was WAY over weight as a kid or a teenager..i was heavy yes but not omg look at that woman heavy :-)  now that im going to be 27 i feel like i am that woman... im 5'9 and i weigh about 255...i gained alot of weight after i had my first child i topped out at about 275-280...and i say AFTER becus while i was peggers with him i lost 25 lbs...lol i know weird!! after i had him i got high cholest. and my doc put me on a diet...lost 30 lbs...gained it back... so skip ahead 6 years and i get preggers with my second child and i lose 20 lbs again and not only that i breatfed and started working 6 months after she was born and dropped down to 220 IT FELT GREATTT!!! lol and i even went to the gym...EVERYDAY!! then i lost my job and couldnt pay for the gym and i pretty much stayed home with my kids 24/7 and gained it all back :-(  and i have tryed working out at home and watching what i eat...but come on..when u sit home 24/7 you kind of get depressed and i cant sleep anymore at all! lol that is why i am typing this at 2:33am! lol ANYWAY i was going to give u a short back story...but it turned into a book!! lol anyway i feel like i want a change in my life...i want to be that "happy" sara inside of me...i guess what i want to ask is what did you all try before this? when did you say enough is enough and got this done..do you think i should try more? would you say this is somthing i should look more into? i havent yet cuz im a big chix that gets emmabrassed real easy and i dont want to walk in my doctors off. and say "hey we both know im over weight i want to talk about it!" so i just smile and say "everything is fine" :-) how did you all start this? do i talk to my doctor? call the centers? call the number from that guy on tv? what? if you could give me tips ideas tell me to go for it! tell me not to and why! idk i just have this feeling that i want my life back!!! my life...

I didn't get heavy until my late 30's and even then I didn't look bad, it was just too much for me. I gradually gained up to 214.8 (I am 5'4" and carry it all in my upper abdomen and some lower. I had tried many things and skipped many more because I either didn't want the hassle, knew I wouldn't last, or knew I would never be able to maintain. When my health went downward I knew if I didn't do something it would only get worse. In my final decision I decided that I could probably lose most of it on my own if willing to suffer but could never maintain for any significant time. WLS was my choice.

WLS should only be chosen as a course of last resort. Any surgery has risks and remember, you would be permantly altering your body for life. This is still not a guarantee of keeping it off. Many, many people gain everything back and more. It will take a commitment to keep up the new habits for life.

Most insurance policies require either a BMI of 40 or 35 with comorbidities. They also require some documented attempts at weight loss. These could be Weigh****chers, other diet programs that can be monitored, or simply  a reasonable eating plan monitored by your family doc by weigh ins. A good place to start would honestly talk to your doc. Do everything you possible can and then if all else fails check on wls. Never jump into it thinking it is the easy way. It is not and most who think that fail.

Another thing you could try would be a counselor familiar with eating disorders or a support group for medical weight loss through a bariatric center. Never just call the number on TV.

I know this isn't easy to hear but at your age and background I think you will be better off.

If everything fails at some point then check into wls. Not until then.
Good luck, Sue

Sara - I know exactly how you feel! I stayed home with my little girl for the first year after she was born and that is probably when I gained the majority of my weight (even tho i was already heavy). I wouldn't say that I tried EVERYTHING, but I did try my fair share of diets and working out. I think it just came to a point for me where I knew that I needed something to help me with my portion control.... and once I had my lapband, it was like everything CLICKED! I GET how to eat right, excersize and plan my meals. My husband is even excited about the fact that I am cooking much healthier now.... and that he is loosing weight too (not that he needed to... lol)!

I know that I am only 8 weeks post-op, but I am a believer in the lap band. What would it hurt for you to do some research on all WLS... and see what is right for YOU? There is nothing to be ashamed of.... you have to start somewhere! Good luck to you girl! And.... if you want to follow my journey... I have YTube videos.... JennasBandedJourney!  =)

Each person’s journey begins differently. For me, I tried every diet known to mankind, and a few obscure one. My Doctor basically made up my mind when she said “We’ve tried every diet there is, and nothing seems to help long term. You’re young enough and healthy enough to do something NOW, but I can’t tell how you will be in a year, AND the rate you’re going you won’t be around in 3 years". .. Well when Death was on my doorstep I decided I wanted to LIVE longer.

I did a lot of online research, spoke to people who had the operation (basically friends of friends), and went to at least 5 different seminars before I chose my Doctor.

Here’s MY advice, and again it’s only MY advice. However YOU decide to go will be the CORRECT way, because YOU know YOU.

I suggest speaking to your family Doctor. Some Doctors will be very supportive. OTHERS WON’T. But what you need to stop and ask yourself, “If my Doctor says I am making the wrong decision, do I still want to do this?".  Now there may be medical reasons you shouldn’t have the operation. If your Doctor gives them to you, write them down and ……

Plan on seeing a Bariatric Doctor and discuss your case. Make sure you tell them the apprehension (if any) your family Doctor has. Sometimes these concerns could be problematic, other times it could be the Doctor is not versed in Bariatric world.

Before you see a Bariatric Doctor, make sure your insurance company will cover it. Some do, other’s don’t. And just because your friend has the same Company you do, the PLAN can be different. Some companies EXCLUDE Bariatric surgery, so you need to make sure you know (A) you are covered (B) what the Insurance company demands from you (example: BMI rate; monthly weigh ins, nutritionist and/or psyc exam, etc).

Now I am unsure if the Doctor on TV is good or not. My advice, DO A LOT OF RESEARCH. Obesity Help has a section which will list Doctors in your state, check them and the patients reviews. Also, ask total strangers (again friends of friends) who they used; are they happy, and would they recommend them.   

See if there are Support Groups in your area. GO TO THEM EVEN BEFORE YOU DECIDE. Get the “truth" of what life is before/during/after the operation. KNOW IT ALL BEFORE YOU DECIDE.

For folks who know me, I can be brutally honest – but I do it with love and compassion. What you need to remember it (A) This isn’t a cure all. You will need to WORK IT EVERY DAY (B) There are NO GUARANTEES you will be successful. If you follow the rules, you should be. If you decide to continue eating the wrong foods, then you won’t (C) NO OPERATION ALONE will give your LIFE BACK. Losing all this weight SURE HELPED ME, but also I HELPED ME. There are rules you need to follow, plus you need to change your outlook on things. Sure being able to move; wear smaller clothes; do things the “average" person does sure does help, but know if you see the negative in EVERYTHING, no operation will be able to change that.

Please know I am here if you need. I am willing to “walk with you" every step of the way. Never be embarrassed to ask questions. We’re all here to help you.

Good luck on your journey!!

 

The only other thing I would add is to look at clinics that are Centers of Excellence.These are the places that are approved by a governing board and most insurance requires where you go be approved.

This message is not to band bash by any means. It works well for many people, or at least that's the impression I get reading this board and one other. However, it wasn't the tool for me I hoped it would be. I was never at a sweet spot for very long. I would go from being very hungry to not even being able to keep a protien shake after a very small fill. That being said, I did loose all the excess weight. I followed the high protien, low carb, low fat diet reccomended. I do feel like I pretty much did it on my own. I hadn't tried to loose weight in years. In hindsite I wish I had given good old excersise and healthy diet one more try.
Only you can decide what is best for you. It is a huge, life changing decision. As already said, do lots of research so you can make an informed decision. Good luck!

Research, research and then research some more. In all honesty I would not suggest a band for someone as young as you because they are not intended to stay in for more than 5-10 years. You will need something that will work for life not just a few years, plus the band doesn't work for everyone. I only lost about 20-30 lbs in my 4 years with the band. I would strongly sugggest one of the other 4 main surgeries the VSG, RNY or DS, you can read about all of them right here. Also read the forums for each and see how the folks are living with their own surgery. Then when you really know what surgery will be best for you and only then go see your primary care doc and check with your insurance to see if they cover it. I really want you to succeed and not go thru what I and so many others have with little to no success with the band. Good luck to you!

Don't get the band!

This is going to be a very long reply

I know this must feel overwhelming to you right about now, but the good thing is...that this is not a race and you can take all the time you need to research all the different WLS that are out there. I'd like to offer you a few helpful tips in organizing your research if I may.

1. At the top of this page, close to your user name, you will see a link named "Bookmarks" every time you come across information that you want to save for future reference, all you have to do is click on that link and it will bookmark the page you are currently reading. You can also change the title of that page and have it reference the key information contained within the bookmarked page.

2. Spend as much time as humanly possible researching your options and remember that it's okay to change your mind over and over again.

More tips toward the bottom...

"All weight loss is a result of the lifestyle change."

However there is a lot more information about the band that you need to weigh here. I'm going to give you some links for you to follow and I am inviting you to click on the link in my siggy. That link will take you to a private message board here on OH which has over 300 members ( not all are failed bands ) but many are and some are there because they have a relative or friend who has had one.


(link removed on 2/26/12 by the request of OH)

This link is a link that is provided to surgeons by the manufacturer of the Lap Band. What you are seeing here in the graph below is the EWL ( estimated weight loss ) per # of patients at 6 through 35 months. This is the expected outcome of EWL with the Lap Band per the manufacturer.
www.allergan.com/assets/pdf/HM0670_94800-16_lapband_dfu.pdf

Mean %EWL by Visit
Visit               N                             %EWL
6 months        233                             26.5
12 months      233                             34.5
18 months      190                             36.4
24 months      189                             37.8
30 months      148                             37.9
36 month        178                             36.2
N = Number of Patients

There is something very concerning about the graph above to me. I live in California and we are being fed a constant and steady diet of Lap Band ads here. You cannot go an entire day without hearing, seeing or reading a Lap Band ad, unless you hole up in your bedroom with the all electronics turned off.
The average weight lost per the most recently updated information I have heard is 50 %. Some say it is 55%. I will use my WLS stats as an example here to demonstrate the graph above for you.

Starting weight was 256
Normal  BMI weight for my height is 145
Weight at 6 years out for me was same at 36 months is 184
72 lbs lost

My EWL per manufacture at 50 %

256 - 145 = 111 pounds excess weight

256 - 184 =  72 pounds lost

72 / 111 = 0.648...  = 65%

It is very important to tell you that I am not the norm. I am one of the few.

I have lost 65% of my excess weight. I am a huge success according to the manufacture of the Lap bands chart right ?

Here's the truth, At 184 LBS I would still have a BMI of 31.5. This indicates that I am still Obese. 
According to the National Institutes of Health, being overweight or obese have known risk factors for the following:

• diabetes
• coronary heart disease
• high blood cholesterol
• stroke
• hypertension
• gallbladder disease
• osteoarthritis (degeneration of cartilage and bone of joints)
• sleep apnea and other breathing problems
• some forms of cancer (breast, colorectal, endometrial, and kidney)

Obesity is also associated with:

• complications of pregnancy
• menstrual irregularities
• hirsutism (presence of excess body and facial hair)
• stress incontinence (urine leakage caused by weak pelvic floor muscles)
• psychological disorders, such as depression
• increased surgical risk
• increased mortality

So if your intention for losing weight is not purely for vanity and you think you would not be happy at 184 pounds and still be at risk for the above mentioned obesity related risks. Then I would urge you to consider other options. I am not a big fan of the RNY, but if the Lap Band & the RNY were the only choices available to me...If I had this to do over again today, I would choose the RNY over the Lap Band.

If " Less Invasive & Easily Removed " means this to you: 

"It means I am too afraid and/or unsure to commit to bariatric surgery and I probably won't die on the table if I get a Lap-Band."

Then you have more research to do and that's not a bad thing to think it just won't get you where you want to be.

Now onto more tips.

3. COE's

Q.  What is a "Bariatric Center for Excellence?

( Credit to Diana Cox for the COE explanation.)
A. It is a hospital where the insurance companies have conspired with certain hospitals and surgeons to consolidate bariatric surgeries, for the sake of "efficiency."  Now one aspect is true - the learning curve DOES favor hospitals where a lot of surgeries are done - the doctors are more experienced; the staff knows how to work as a team; they have better equipment.  But as for the rest - in exchange for being the SOLE provider of bariatric services for the insurance companies, the hospital and surgeon make a deal with the devil - they agree to accept low rent prices from the insurance company.  And to work with the insurance company to keep costs low - often at the expense of the patient.

So, basically, "Bariatric Center of Excellence" = SURGERY MILL.

In case anyone is under the mistaken impression that they are actually "special" or that this designation means anything particularly good.


4. You are going to come across many posters (such as myself ) who you may perceive to be angry or overly emotional regarding your WLS choices.  The best gift you can give to yourself is to put aside your emotions while researching your choices and to really hear what the message is within all these tangled emotions.

Try to understand that ( I'll use myself as an example here ) when I'm sharing with you my opinion regarding the lap band....please keep in mind that it is not you personally whom I am against, it's the lap band I am against.

5. This is probably the most important tip I can pass on to you.   Your choice of WLS should not be a decision that is decided on between you and your surgeon...and here's why,

I'm going to use the Duodenal Switch WLS as an example..... The DS surgery is IMO the best WLS of all four of the WLS being offered today, but that doesn't mean it's for everyone ( you can ask a DS'er why over on the DS forum ). If you consult with a surgeon who does not perform the DS surgery...that surgeon will most likely steer you away from the DS and toward a surgery he performs because he does not want to lose you and more importantly your money.$$$$$

Surgeons did not go through the time and expense of medical school to not make money...This is their livelihood and they have to provide for their families too.This is purely a business decision on their part and there is absolutely nothing wrong with that...to a degree.

Out of the 4 main WLS being performed today....the lap band surgery is the money making surgery for WLS surgeons...why you ask...well let me tell you why...

1. It is a quick surgery and lap band surgeons can perform many of them in a single day $$$$$

2. Lap Bands seem to have the highest re-operation rate of all the WLS, therefore pretty much guaranteeing your surgeon a second surgery with you and your money $$$$$

3. Lap Band adjustments guarantee your surgeon more of your money $$$$$

We have a special name for lap band surgeons who perform multiple lap band surgeries almost everyday and they are....Conveyor Belt Surgeons. These CBS are not only performing 3 or 4 lap band surgeries in a day, they are performing 6 and 7 of these money making surgeries a day and this is exactly how Allergan the manufacturer of the Lap Band markets their product, The Lap Band to these surgeons at weight loss surgery conventions every year. These surgeons tend to only work in their offices 1 or 2 days a week. One of those days is set aside for new surgical consults $$$$$ and the other day is set aside for lap band adjustments. That means that it can take a very long time to be seen by your surgeon once you've already been banded.

If your band is too tight and you need to quickly get it unfilled, you will need to make an appointment and it can take up to a month before you can be fit into their schedule. My surgeon was so busy that he would have me come into the ER  between his surgeries so he could unfill my band $$$$$.

If your band is too loose and if you have chosen a CBS, then you could be waiting for an entire month or more just to get in and see your surgeon for that fill. My surgeon was a busy busy man, but he was very caring and he was able to squeeze me in whenever I needed an appointment. He even gave me his cell phone number so I could call him directly if I ever needed anything. He was a rare breed of doctor.

I sincerely adored my band surgeon, but it was the band itself that caused me and many others like me to suffer permanent damage. For this reason...please choose your surgery first and then choose a qualified surgeon.

For the above stated reasons... do not allow a surgeon to guide you in your choice of WLS. Surgeons are sales people too, they will tell you whatever they want to in order for them to close the deal and if that means lying and/or scaring the living **** out of regarding other WLS then that is exactly what they will do.

" Free " Weight Loss Seminars ( They're all free ) are another tool surgeons use for selling you the WLS they perform. Lately we are starting to see more CBS advertise that they perform all  the WLS, but once they get you there...they or their staff will talk you out of any surgery that they do not perform by scaring the crap out of you or flattering you and telling you that you don't need the bypass or DS surgeries because they are too extreme and you don't have that much too lose.$$$$$

If after all I have said to you and you have read the provided links in their entirety and you still want the Lap Band, then here is my # 1 tip for eating with your Lap Band. This may or may not help keep you safe, but it's worth noting.

How to eat with a LAP BAND.

• A “half a cup" of food should be placed on a small plate.
• Take a small bite and chew well.
•  Use a small fork or a small spoon to eat.(an oyster fork or baby spoon)
  
• A single bite of food should be chewed carefully for 20 seconds. This provides the opportunity to reduce that bite of food to mush.
  
•  After chewing the food until it is mush, the patient should swallow that bite. 
• Swallow, then wait a minute. The patient must wait for that bite to go completely across the band before swallowing another bite. Normally, it will take between two and six peristaltic waves passing down the esophagus, which can take up to one minute.
• A meal should not go on for more than 20 minutes. At one bite per minute, that is just 20 small bites. The patient probably will not finish the “half a cup" of food in this time. The patient should throw away the rest of the food.
  
• It takes between two and six squeezes to get a single bite of food across the band
  
• The patient should not be hungry after 20 bites or less.
  
• After undergoing LAGB, the patient should never expect to feel full. Feeling full means stasis of food above the band and distension of that important part of the LECS above the band. This destroys the LECS, the mechanism that enables optimal eating behavior and appetite control. A patient should always keep this process in mind.
  
• If the patient finds that after eating the “half a cup" of food he or she is still hungry, he or she should review his or her eating practices, correct the errors, and consider the need for further adjustment of the band. If this is occurring, it is usually an indication that the patient is not in the green zone. 

There are three common eating errors:

1.The patient is not chewing the food adequately. Food must be reduced to mush before swallowing. If it cannot be reduced to mu**** is better for the patient to spit it out (discreetly) than to swallow it.

2. The patient is eating too quickly. Each bite of food should be completely squeezed across the band before the second bite arrives.

3.  The patient is taking bites that are too big to pass through the band.

Each of these errors leads to a build up of food above the band where there is no existing space to accommodate it.  Space is then created by enlargement of the small section of stomach or by enlargement of the distal esophagus, both of which can compromise the elegant structure of the LECS. If the LECS is stretched, it cannot squeeze. Without the squeezing, satiation is not  induced. When satiation is not induced, hunger persists, more eating occurs, and stretching continues. If our patient continues this each day for a year, it is inevitable that chronic enlargement will occur, the physiological basis for satiety and satiation is harmed, and stasis, reflux, heartburn, and vomiting supervene.

Esophagus

After food is chewed into a bolus, it is swallowed and moved through the esophagus. Smooth muscles contract behind the bolus to prevent it from being squeezed back into the mouth. Then rhythmic, unidirectional waves of contractions will work to rapidly force the food into the stomach. This process works in one direction only and its sole purpose is to move food from the mouth into the stomach.^[2]

In the esophagus, two types of peristalsis occur.

AA simcplified image showing peristalsis

• First, there is a primary peristaltic wave which occurs when the bolus enters the esophagus during swallowing. The primary peristaltic wave forces the bolus down the esophagus and into the stomach in a wave lasting about 8–9 seconds. The wave travels down to the stomach even if the bolus of food descends at a greater rate than the wave itself, and will continue even if for some reason the bolus gets stuck further up the esophagus.
• In the event that the bolus gets stuck or moves slower than the primary peristaltic wave (as can happen when it is poorly lubricated), stretch receptors in the esophageal lining are stimulated and a local reflex response causes a secondary peristaltic wave around the bolus, forcing it further down the esophagus, and these secondary waves will continue indefinitely until the bolus enters the stomach.

Esophageal peristalsis is typically assessed by performing an esophageal motility study.

Good Luck with your research and if there is anything I can help you with please feel free to ask me.

Lisa