Just wondering what your thoughts are on this. John T. made a post about his 5 yr. bandiversary. He stated in it that it's harder to lose weight now. Most of the bandsters that I have spoke with that are further out say that the band stops working/ harder to get restriction/harder to lose weight after a few yrs.

One of the selling points of the band was that it is adjustable and therefore you would always have restriction since it is adjustable. So why do you think this is???

I wonder also!  I was hoping I would just would pop in and
get a fill at any point in life and all would be well again.

Yeah that is how we were told it would be. Does NOT seem to work that way in real life. :-(

I remember when I first got my band about 10 years ago. I told someone who was bashing my choice, "Well, I'll be able to go in and get my band adjusted for my whole life." 

Live and learn. It's embarrassing to think back to how ****y I was about it! I really believed it, too.

Yeah that was another huge selling point of the band......"least invasive" and "can be adjusted to maintain restriction FOREVER"! lol

Being overconfident can be a bad thing. 

There weren't many issues back in 2008 2009 when i researched until end of 2009/early 2010 when I started having issues and starting to see more and more of issues!  

I love my bandless life!

Maria -
Good question -- I am happy to give my viewpoint.

I am 3 years, 3 months post band.

I consider myself to be at my goal weight, and it naturally fluctuates plus or minus 3 pounds.

I chose my goal based on the Weigh****cher range for my age and height (54 and 5'6) and would really like to lose 5 - 7 more pounds.

Those have been a challenge for me --- and her are some of the reasons I think.

1.  having been morbidly obese for the better part of 35 years, my body may not need to go lower than it is  -- and any loss is now a good portion of my % of weight
2.  having reached the 'goal' I set -- I considered myself 'there' and stopped focusing on weight loss
3.  I am not willing to make the sacrifices that additional weight loss will take

None of those things mean that I don't have a level of restriction that is appropriate for me.

IF I eat the way that I did 3 years ago when I was totally focused on getting to my goal (protien weighed and measured at every meal, no liquid calories, eating on a schedule, etc) I could probably lose the pounds I want to lose.

IF and when I eat that way, my band is satisfied with the small amounts I feed myself, and my exercise level is adequate to produce weight loss.

However, I have learned that I can have a glass of wine (or more than 1) a few nights a week and maintain within a 3 pound range.
I have learned that I can eat more processed carbs -- cereal bar for breakfast or granola or oatmeal instead of eggs or yogurt  --- and maintain within a 3 pound range

While I was losing weight, and focused on eating more solid protein, I would eat a small amount and then not only 'not be hungry' -- but I actually did not want to eat for several hours.

When I am not as focused on my food, and eat more processed foods, I have the sensation that I 'could eat' a much bigger part of the day -- and I succumb to that knowledge and snack more often.

My life if a bit different now than it was 3 years ago, I have been promoted at work and do more business travel.  I have many  more opportunites for restaurant food and drink -- that is paid for by expense account -- and less opportunity for consistency in my exercise program.

My band does not need adjustment --- my eating habits and my attitude do -- IF I want to lose more weight.

I suppose my actions will answer that question ----for now, with business travel and vacation scheduled for 5 out of the next 6 weeks, it is likely that I will be happy to maintain within my window.

I do stay accountable by weighing myself often and taking action when the scale is beyond those  pounds -- I know how easly a 3 pound gain can become 30 and it would not be long before I was inching back up towards 300 pounds.

I am grateful that my band IS adjustable, and when the problem is that it is not adjusted properly, I can have that corrected ---- however, while the problem is that my eating behavior and attitude need adjustment -- I will work on those.

I don't think it has anything to do with the Band.  I think it has to do with our habits.  We become complacent.  We lose our weight and are out living our lives.  We're happy and we stop paying attention to our intake.  We push our limits and eat more carbs and things that we shouldn't be eating.  Whenever I wanted to lose weight with the Band, I did just get an adjustment and the weight loss resumed, just the way it was advertised.

What happened to your band? Why are you revising? How long have you had it?

Maria,

We don't meet eye to eye, and I rarely post here but I thought I would honestly answer your question. It's NOT the lap band, the lap band IS adjustable forever as long as it's not damaged/slipped or eroded.

Weight gain usually comes from getting complacent and no longer following the recommended diet and exercise plan. I can't speak for other vets but I can speak to why I gained weight last year while I had great restriction.

I simply started eating around my band and eating too much - why? Well I got married started eating out at yummy restaurants with my husband, traveling and thought it was impossible to gain weight even though I had restriction and the main factor why I gained weight was I stopped exercising along with eating too much.

Also I started eating too much on a restricted band which also caused problems with my band last year, I started having some mild reflux and coughing and shortness of breath during the day -- I knew this was dangerous and I knew that it was band related and I knew that it could lead to aspirating food into my lungs. After a week of these symptoms, I immediately went to my surgeon and they removed most of the saline from my band. The reflux and constant coughing stopped immediately after most of the saline was removed from my band.

I stayed unfilled for a few months (by choice) I wanted to make sure my esophagus and stomach surrounding my band was well healed before I started to get my band tighten up again. And also I wanted to be mentally prepared and ready to following the eating rules with my band before I got it tighten back up. (during my unfill I gained additional weight back) this is why I know that if I did not have a weight loss surgery that was NOT adjustable like the lap band I would gain all my weight back and if I got my band removed I would also gain my weight back, it gets tougher to stay motivated and on track the further out you get with ANY weight loss surgery.

Now with all that said, I went back a few months ago to start filling my band up, now my band is as tighter as it was my first year and I have NO reflux (stomach tissues will heal themselves most of the time if you recognize the problem before damage is done, if someone waits and have those adverse symptoms for long periods of time, often times the lap band cannot be saved and must be removed --unfortunately.

I agree it is harder to lose the regained weight this time around, why? One word, I no longer have that high motivation to exercise every single day and eat the restricted foods I ate 7 years ago when I first got my lap band.

I am living proof the lap band will still work for long periods of time, but you must get to your surgeon immediately if you start to have adverse issues like constant reflux, night time regurgitation and coughing. Eating too much on a too tight lap band has always been the number one reason for band slippage and it still is, as well as vomiting daily.

Although I gained back some weight, I still have a good functioning band and I still have good tight restriction at 7 years post op -- I am now slowly losing weight again, but it will be more quicker if I followed the rules and exercised more.

Am I afraid of long term problems with my band? Not really, I've had my band now long enough to identify any type of problem that can happen, also as I get older and I get tired of following the rules with tight restriction, I will simply loosen the band, I've never known anyone to suffer band slippage on a loose band.

Also remember, I suffered a mild band slippage about 6 years ago (concentric pouch dilation) from being too tight, it was a horrible experience, so I know how bad acid reflux and lap band complications can be. I healed because I got to my surgeon immediately before my band was permanently damaged and my pouch went back to normal size after removing all the saline from my band -- along with medications to stop all the burning and stomach acid, and I moved on without having to have a repeated surgery because I got excellent aftercare from my surgeon.


Here is a good diagram from Dr Simpson's website on lap band issues and eating with the band.



http://drsimpson.net/fills/Lap-band-problems/Lap-band-slip-w hat-is/Lap-band-slip-what-is.html

What is a Lap-band slip?

The Lap-band is forced down the stomach – it really doesn’t slip. This typically happens when the upper pouch (the stomach above the band) is dilated.

As you eat too fast or get things stuck the upper pouch dilates. The band goes from pointing to the heart to a horizontal position. This is either an acute slip- or a chronic one.

At this point the Lap-band has slipped. It may need surgical repair.

To repair the slip we place the band above the slip. Then the dilated stomach is tacked up so it drains well. Sometimes we have to remove the band - sometimes unbuckle the band.

Three Types of Lap-band Slips – all different:

There are three types of band slips – and all are treated differently:

The most common band slip is a chronic Lap-band slip - where the upper pouch is dilated slowly over time and forces the band down. This is also called a Type 1 slip – it requires one of three types of repair (reposition the band, remove the band, or unbuckle the band- see below).

An acute Lap-band slip, Type 2 slip – happens when something gets stuck - as a result the upper pouch acutely dilates, forcing the band down and obstructing it. This repair, if gotten to quickly, is fairly simple – all one has to do is open the band, pull down the stomach and close the band. Often will require some suturing. Sometimes this can be fixed by letting fluid out of the band and allowing the stomach to slip back to normal.

An acute on chronic Lap-band slip – Type 3 slip – is a chronic slip that gets an acute component to them – there is a chronic dilation of the pouch, then something happens that acutely dilates the upper pouch (something gets stuck). These require removal, repositioning, or unbuckling of the band.

What causes a Lap-band to slip?

Eating too fast is the primary cause. By eating too fast the food is not given time to go past the band. So the upper stomach begins to dilate above the Lap-band. Once the stomach begins to dilate, it s easier and easier to dilate (think of blowing up a balloon, it is easier to blow it up the larger the balloon becomes).

Getting food stuck can also cause the band to slip. When food gets stuck some people try to force it down with water or soda – and this causes a dilation of the upper stomach. Your body produces a lot of “slimeÂÂÂÂÂ" to try to lubricate the stuck food. Typical foods that have caused slips include: goldfish crackers, white bread, rubbery eggs (they need to be cooked properly), and dry chicken.

Can a Lap-band slip be fixed?

If we take the pressure off the band - remove the fluid, and you can tolerate liquids sometimes the band will return to normal size. This happens a lot if we can get to the band early.

If we don’t get there early then we try “conservativeÂÂÂÂÂ" measures in the hospital – if the person cannot drink. IV fluids, steroids to reduce swelling, and keeping the person without food or drink will resolve some.

If that doesn’t work then an operation is needed. The band will either need to be removed, repositioned, or unbuckled for a bit. Sometimes we leave the band unbuckled - remove adhesions, and leave the band unbuckled for a few months. This is an option for when the stomach is too dilated to allow operative reposition of the band. But it does require another operation to go in and re-buckle the band.

Can this be dangerous?

If the upper pouch is too stretched out sometimes we cannot replace the band, and have to remove it for a while. We cannot always just “unbuckleÂÂÂÂÂ" the band - especially in some of the older bands – or in the act of unbuckling the band the balloon is injured and we must remove the band.

Re-do surgery is always at an increased risk above just placing a band.

What are the signs of a Lap-band surgery slip?

Typically patients develop heartburn, nighttime cough, or reflux of food at night. These are not normal with patients who have the band. If you have these you at least need to have fluid removed from the band, but need to get an evaluation by the surgeon. Sometimes we catch things in time that it can correct itself- but then the real correction will be the person learning to eat better.

How do you fix the slip?

From the last two illustrations above – we place the band above the slip – then tack the dilated stomach so that it will easily drain into the stomach. The surgery takes about an hour or less to do.

If I get my Lap-band surgery repaired how can I avoid this in the future?

The band works great for weight loss- but it does mean you have to change some things. Usually patients have the slip long before they know it, and have changed things- so it isn’t an issue. Finishing a meal in 20 minutes instead of five minutes- and avoiding foods that get stuck in the band are the two biggest contributors to this.

The other is when you get in trouble; call your surgeon earlier rather than later. Know that heartburn and reflux are not normal with the band. They are an early warning signal that the band is too tight. Sometimes this resolves with removing fluid from the band - but if it does not then your surgeon will want to have an x-ray with you swallowing barium