Helpful for people deciding on a surgery
I thought this was worth sharing. I found it in another message board.
Food for thought.....
1. Invasiveness of surgery. The RNY is extremely invasive; The Band
is minimally invasive. Banding is usually a 1-night-in-the-hospital
event whereas bypass can range from 2-7 days depending if done lap
or open. The typical time off from work (for desk jobs/non physical
jobs) is 1 week. Bypass anywhere from 3-6 weeks.
2. Changes to natural anatomy. The RNY completely alters the
digestive tract and how it functions; The Band does not alter the
anatomy.
3. Absorption of Nutrients. The RNY not only causes malabsorption of
calories, but also of necessary nutrients. As the Duodenum is
removed from the equation altogether (and it's the primary place
iron, B12 and calcium are absorbed), the body will never properly
absorb those nutrients again. Supplements using very specific forms
of those nutrients most affected can help offset these issues, but
there is no guarantee that deficiencies will not occur even with the
most thorough supplementation. This can mean premature osteoporosis
(just saw a 27 year old RNY patient diagnosed with this on another
board, 2 years out from her surgery), chronic anemia (iron
deficiency) and/or pernicious anemia (B12 deficiency, in which the
damage done is not reversible). The Band does not change the body's
absorption of nutrients, although a multivitamin (with iron for pre-
menopausal women) is recommended due to overal reduced caloric
intake.
4. Reversibility. RNY fundamentally not reversible (yea,
a "takedown" can be done in extreme cir****tances, but very few
surgeons in the USA will touch patients needing one). Band
fundamentally reversible.
5. Adjustability. RNY fundamentally non-adjustable (requires
additional, fully-invasive surgery (aka a revision) to "adjust" the
amount of intestine bypassed or to reshape the pouch). Band is fully
adjustable.
6. Mortality Rate. RNY has shown mortality rates falling between 1
in 50 to 1 in 200...high anywhere in that range. The Band has shown
mortality rates more in the 1 in 2000 area. So that means the Band
is 10x safer than the 1 in 200 death rate...and 40x safer than the 1
in 50 rate. Either way, it's very significantly safer in terms of
someone dying from it.
7. Complications. Rate and severity of complications much greater
with RNY than Band.
8. Dumping syndrome. RNY, no more than 70% of RNY patients dump, so
those choosing RNY because they assume they will dump and have
a "built in" deterrant from eating sugar may find they are outta
luck. Band, no dumping syndrome.
9. "Foreign object" inside you. Actually, this is here only to make
a point. Both RNY and Band place foreign objects in the body, unless
someone thinks that hundreds of metal staples are not foreign 
10. Rate of weight loss. RNY, very fast (which probably means quite
a lot of lean tissue is being lost as well since there's only so
much fat the body can actually give up at a time). Band, in line
with sensible healthy rates of loss as recommended by the vast
majority of the medical and nutritional/health communities. I've
seen plenty of studies that support that slow, sensible rates of
loss are healthier for the body and more likely to be maintained. If
someone ever sees scientific studies that show super-rapid loss to
be equally healthy and as likely to be maintained, please bring it
forward as I've yet to find ONE The rate, at the 2-3 year mark,
becomes irrelevant as studies are showing that at that point out,
bandsters will have caught up to RNYers in terms of percentage of
excess weight lost.
11. Maintaining loss. RNY, big struggle to maintain loss, as at the
2+ year mark, the body starts to adapt to the malabsorption of
calories wherein the remaining intestine grows more cilia and in
some cases the pouch will have stretched out to some degree. The
irony is, of course, that even with the calories no longer being
malabsorbed, certain nutrients will never be properly absorbed
because of the duodenum no longer participating in digestion. Also,
with rapid rates of loss, there will be higher than average loss of
lean tissue, which means slower metabolism (plus compound that with
the near-starvation rate of intake many of these patients live on
for a year or two...consider: RNY patient with approximately 30%
rate of malabsorption, many of whom are told to eat no more than
1000 cal/day, which means they're actually only getting 700 of those
calories. I've seen quite a few RNY patients (even distals) told to
eat no more than 700 cal/day...which means some of these people are
living on 350-400 cal/day which WILL wreak havoc on a metabolism no
matter how you slice/dice it). The Band is adjustable and designed
to stay in to be there to help you with portion control. It also
encourages learning new behaviors right from the start as there is
no honeymoon period so you'll be better prepared for the challenges
of maintaining loss.
10. Rate of weight loss. RNY, very fast (which probably means quite
a lot of lean tissue is being lost as well since there's only so
much fat the body can actually give up at a time). Band, in line
with sensible healthy rates of loss as recommended by the vast
majority of the medical and nutritional/health communities. I've
seen plenty of studies that support that slow, sensible rates of
loss are healthier for the body and more likely to be maintained. If
someone ever sees scientific studies that show super-rapid loss to
be equally healthy and as likely to be maintained, please bring it
forward as I've yet to find ONE The rate, at the 2-3 year mark,
becomes irrelevant as studies are showing that at that point out,
bandsters will have caught up to RNYers in terms of percentage of
excess weight lost.
11. Maintaining loss. RNY, big struggle to maintain loss, as at the
2+ year mark, the body starts to adapt to the malabsorption of
calories wherein the remaining intestine grows more cilia and in
some cases the pouch will have stretched out to some degree. The
irony is, of course, that even with the calories no longer being
malabsorbed, certain nutrients will never be properly absorbed
because of the duodenum no longer participating in digestion. Also,
with rapid rates of loss, there will be higher than average loss of
lean tissue, which means slower metabolism (plus compound that with
the near-starvation rate of intake many of these patients live on
for a year or two...consider: RNY patient with approximately 30%
rate of malabsorption, many of whom are told to eat no more than
1000 cal/day, which means they're actually only getting 700 of those
calories. I've seen quite a few RNY patients (even distals) told to
eat no more than 700 cal/day...which means some of these people are
living on 350-400 cal/day which WILL wreak havoc on a metabolism no
matter how you slice/dice it). The Band is adjustable and designed
to stay in to be there to help you with portion control. It also
encourages learning new behaviors right from the start as there is
no honeymoon period so you'll be better prepared for the challenges
of maintaining loss. 
The band is a great alternative for wls, but I just can't help but feel this is way too lopsided in the favor of the band. In other words, it is a biased opinion and not objective. That's okay - we all have our preferences, but I would hope that in an effort to present the positives of the band that the RNY wasn't so disparaged. It's not as bad as it is presented here, and indeed it is considered the "gold standard."
As with any surgery there are risks involved. The band has it's own set of risks, and it is contraindicated on folks who have a hiatal hernia. A large portion of the obese population do indeed have a hiatal hernia. In addition, the RNY is more effective in helping the larger patients lose the weight they need to lose. The band has not been as successful in helping with a higher loss rate.
This is not to imply that the band sucks though. I would have had the band had I the right set of cir****tances because I am a compliant dieter and would have probably fared well with it. But for those who are not very compliant, it can make it much more difficult for them to take off their weight than with the RNY.
It's wonderful to be informed, but we need to remember the good and bad in all the procedures and try not to be overly biased. That is hard when you loved your experience, I know. But for everyone to make a well informed decision, I think it is important to try to focus on that.
Dina
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