Debating the Lapband or RNY
FYI
Weight Loss Surgery: Restrictive, Malabsorptive, and Combination
In this artticle we'll look at the three types of Weight Loss Surgery: Restrictive, Malabsorptive, and Combination Surgeries
Restrictive Surgeries
Restrictive weight loss surgeries are the least preferred option by the medical community. There are two types of restrictive surgeries.
Adjustable Gastric Banding (AGB) or LapBand®
An elastic band made from a special silicone material is placed around the upper part of the stomach to create a small pouch. The pouch can hold only a small amount of food at one time generally just 1 ounce to begin with which later expands to 2-3 ounces. The opening of the small pouch to the larger pouch or the majority of the stomach is very small -- only about a quarter of an inch. The food thus passes from the small pouch to the large pouch very slowly and one feels full longer with a lesser amount of food.
Pros of LapBand® surgery:
The biggest advantage is that there is no removal of any body part including stomach and intestines.
The body is not altered in any unnatural ways.
Recovery period is short.
A simple procedure that is fairly safe.
Less possibility of complications.
Cons of LapBand® surgery:
A 5% possibility of complications that include an internal infection, erosion/damage to the band or leakage from the small pouch.
Some patients simply cannot eat after the operation, which can cause problems.
Less successful than malabsorptive techniques in maintaining long-term weight loss.
Vertical Banded Gastroplasty (VBG)
This is the most commonly used type of restrictive surgery. It is similar to LapBand® surgery except that VBG uses both bands and staples to create the small stomach pouch.
Pros of VBG surgery:
The biggest advantage, and the reason why it is so preferred, is that the procedure is completely reversible.
The body is not altered in any unnatural ways.
The food passes through the body slowly and steadily so no dumping syndrome.
Recovery period is short.
A simple procedure that is fairly safe.
Less possibility of complications.
Cons of VBG surgery:
Less successful than malabsorptive techniques in maintaining long-term weight loss.
Requires the patient to follow a strict diet plan to avoid any complications.
If the patient eats too quickly or does not chew the food properly it can lead to vomiting.
Malabsorptive & Combination Surgical Procedures
Malabsorptive procedures are generally more successful in long-term weight loss than restrictive procedures. Malabsorptive procedures bypass a portion of the intestine by creating a direct connection from the stomach to the lower portion of the intestine. The food then comes in contact with a smaller portion of the intestine. Thus, fewer calories are absorbed into the body, resulting in weight loss. There are three different types of malabsorptive and combination procedures.
Roux-en-Y Gastric Bypass (RNY)
This is the most common of all bariatric surgeries. A small pouch is created by stapling the upper portion of the stomach to reduce food intake. A Y shaped section of the intestine is then attached to the pouch.
This allows the food to bypass the first two portions of the intestine and severely restricts absorption of calories and nutrients thus effecting weight loss.
In one study it was found that almost 2% of patients who had undergone RNY died within thirty days of having the surgery.
However, 27% fewer patients that had the surgery died
than those who did not in a 15-year follow up.
This suggests that the surgery is definitely helpful but risky as well. (Source: Journal of American College of Surgeons, Oct 2004) Some studies have shown that patients who undergo RGB lose an average of a 100 pounds after surgery.
Pros of RNY surgery:
An average 77% of excessive body weight is lost after one year. Patients have been found to keep off almost 50-60% of the weight loss, even after 10-14 years. This is definitely the most effective long-term weight loss surgery available today.
A reversible procedure, though not easily.
Severely controls the ability to eat food.
Found to provide a cure for other obesity-related problems like sleep apnea, back pain, diabetes, high blood pressure, and even depression.
Cons of RNY surgery:
Possible complications can arise if the staples used to create the small pouch fail to do their job effectively.
Possibility of the patient developing ulcers and hernias.
The narrowing of the stoma (stomach outlet) can cause it to get blocked.
If the patient eats too quickly or does not chew the food properly it can lead to vomiting.
The dumping syndrome can occur due to high intake of sugar, fats, or overeating. The contents of the stomach are literally dumped too quickly into the intestine and can cause nausea, weakness, fainting, diarrhea and sweating.
Can cause nutritional deficiencies over a period of time. Vitamin and mineral supplementation is essential. If the patient fails to take supplements as prescribed by the doctor for life it can cause major deficiencies.
This procedure requires close monitoring of the patient and lifelong restrictive eating habits. Also, regular check ups and follow ups are a must for life.
Biliopancreatic Diversion (BPD) or Scopinaro Procedure
In this type of surgery portions of the stomach are actually removed and just a small pouch is left behind. This pouch is then directly connected to the last portion of the intestine completely bypassing the duodenum and jejunum.
Pros of BPD surgery:
The stomach capacity is 4-5 ounces with BPD so one can lose weight and still enjoy a healthy meal.
There is significant weight loss that is maintained over a long period of time.
Cons of BPD surgery:
Portions of the stomach are removed from the body and altering the natural body can always create problems.
High risk of developing ulcers, chronic diarrhea, and pungent stools and flatulence.
Since the duodenum and jejunum are completely bypassed, the patient invariably suffers from nutritional deficiencies. These must be supplemented carefully.
Calcium and vitamin deficiencies are also possible.
High chance of dumping syndrome.
Duodenal Switch (BPD/DS)
The duodenal switch is similar to BPD but less invasive. It leaves larger portions of the stomach intact and also retains the pyloric valve that controls the release of the stomach fluids and juices into the intestine. This surgery also retains part of the duodenum in the digestive track.
Pros of BPD-DS surgery:
Less invasive than BPD.
Better absorption of nutrients like calcium, iron, and vitamin B12.
The patient can eat better as compared to other weight loss surgeries.
Practically resolved issues of ulcers and dumping syndrome.
Cons of BPD-DS surgery:
Pungent stools and flatulence but less so than with BPD alone.
High risk of contracting chronic diarrhea.
Very high malabsorptive component.
http://www.nawls.com/public/101.cfm?sd=2
Weight Loss Surgery: Restrictive, Malabsorptive, and Combination
In this artticle we'll look at the three types of Weight Loss Surgery: Restrictive, Malabsorptive, and Combination Surgeries
Restrictive Surgeries
Restrictive weight loss surgeries are the least preferred option by the medical community. There are two types of restrictive surgeries.
Adjustable Gastric Banding (AGB) or LapBand®
An elastic band made from a special silicone material is placed around the upper part of the stomach to create a small pouch. The pouch can hold only a small amount of food at one time generally just 1 ounce to begin with which later expands to 2-3 ounces. The opening of the small pouch to the larger pouch or the majority of the stomach is very small -- only about a quarter of an inch. The food thus passes from the small pouch to the large pouch very slowly and one feels full longer with a lesser amount of food.
Pros of LapBand® surgery:
The biggest advantage is that there is no removal of any body part including stomach and intestines.
The body is not altered in any unnatural ways.
Recovery period is short.
A simple procedure that is fairly safe.
Less possibility of complications.
Cons of LapBand® surgery:
A 5% possibility of complications that include an internal infection, erosion/damage to the band or leakage from the small pouch.
Some patients simply cannot eat after the operation, which can cause problems.
Less successful than malabsorptive techniques in maintaining long-term weight loss.
Vertical Banded Gastroplasty (VBG)
This is the most commonly used type of restrictive surgery. It is similar to LapBand® surgery except that VBG uses both bands and staples to create the small stomach pouch.
Pros of VBG surgery:
The biggest advantage, and the reason why it is so preferred, is that the procedure is completely reversible.
The body is not altered in any unnatural ways.
The food passes through the body slowly and steadily so no dumping syndrome.
Recovery period is short.
A simple procedure that is fairly safe.
Less possibility of complications.
Cons of VBG surgery:
Less successful than malabsorptive techniques in maintaining long-term weight loss.
Requires the patient to follow a strict diet plan to avoid any complications.
If the patient eats too quickly or does not chew the food properly it can lead to vomiting.
Malabsorptive & Combination Surgical Procedures
Malabsorptive procedures are generally more successful in long-term weight loss than restrictive procedures. Malabsorptive procedures bypass a portion of the intestine by creating a direct connection from the stomach to the lower portion of the intestine. The food then comes in contact with a smaller portion of the intestine. Thus, fewer calories are absorbed into the body, resulting in weight loss. There are three different types of malabsorptive and combination procedures.
Roux-en-Y Gastric Bypass (RNY)
This is the most common of all bariatric surgeries. A small pouch is created by stapling the upper portion of the stomach to reduce food intake. A Y shaped section of the intestine is then attached to the pouch.
This allows the food to bypass the first two portions of the intestine and severely restricts absorption of calories and nutrients thus effecting weight loss.
In one study it was found that almost 2% of patients who had undergone RNY died within thirty days of having the surgery.
However, 27% fewer patients that had the surgery died
than those who did not in a 15-year follow up.
This suggests that the surgery is definitely helpful but risky as well. (Source: Journal of American College of Surgeons, Oct 2004) Some studies have shown that patients who undergo RGB lose an average of a 100 pounds after surgery.
Pros of RNY surgery:
An average 77% of excessive body weight is lost after one year. Patients have been found to keep off almost 50-60% of the weight loss, even after 10-14 years. This is definitely the most effective long-term weight loss surgery available today.
A reversible procedure, though not easily.
Severely controls the ability to eat food.
Found to provide a cure for other obesity-related problems like sleep apnea, back pain, diabetes, high blood pressure, and even depression.
Cons of RNY surgery:
Possible complications can arise if the staples used to create the small pouch fail to do their job effectively.
Possibility of the patient developing ulcers and hernias.
The narrowing of the stoma (stomach outlet) can cause it to get blocked.
If the patient eats too quickly or does not chew the food properly it can lead to vomiting.
The dumping syndrome can occur due to high intake of sugar, fats, or overeating. The contents of the stomach are literally dumped too quickly into the intestine and can cause nausea, weakness, fainting, diarrhea and sweating.
Can cause nutritional deficiencies over a period of time. Vitamin and mineral supplementation is essential. If the patient fails to take supplements as prescribed by the doctor for life it can cause major deficiencies.
This procedure requires close monitoring of the patient and lifelong restrictive eating habits. Also, regular check ups and follow ups are a must for life.
Biliopancreatic Diversion (BPD) or Scopinaro Procedure
In this type of surgery portions of the stomach are actually removed and just a small pouch is left behind. This pouch is then directly connected to the last portion of the intestine completely bypassing the duodenum and jejunum.
Pros of BPD surgery:
The stomach capacity is 4-5 ounces with BPD so one can lose weight and still enjoy a healthy meal.
There is significant weight loss that is maintained over a long period of time.
Cons of BPD surgery:
Portions of the stomach are removed from the body and altering the natural body can always create problems.
High risk of developing ulcers, chronic diarrhea, and pungent stools and flatulence.
Since the duodenum and jejunum are completely bypassed, the patient invariably suffers from nutritional deficiencies. These must be supplemented carefully.
Calcium and vitamin deficiencies are also possible.
High chance of dumping syndrome.
Duodenal Switch (BPD/DS)
The duodenal switch is similar to BPD but less invasive. It leaves larger portions of the stomach intact and also retains the pyloric valve that controls the release of the stomach fluids and juices into the intestine. This surgery also retains part of the duodenum in the digestive track.
Pros of BPD-DS surgery:
Less invasive than BPD.
Better absorption of nutrients like calcium, iron, and vitamin B12.
The patient can eat better as compared to other weight loss surgeries.
Practically resolved issues of ulcers and dumping syndrome.
Cons of BPD-DS surgery:
Pungent stools and flatulence but less so than with BPD alone.
High risk of contracting chronic diarrhea.
Very high malabsorptive component.
http://www.nawls.com/public/101.cfm?sd=2
Take Care, 
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
NYmama:
Hello!
Researching is the most important part of the journey...making the most educated and informed decision goes far on being both successful and healthy postop!
WHERE ARE YOU ON YOUR JOURENY? Have you been to a surgeon? A preop support group? PReop educational seminar??
Preop/postop dietsvary by bariatric program....I recommend you investigate the surgeon and program to make sure it is multidisciplinary and a center of excellence either with American Board of Surgery?
www.absurgery.org
American College of Surgeons?
http://web3.facs.org/acsdir/public/Detail.cfm?CHKDGTS=00299031800
Is he a member of the American Society of Bariatric Surgeons? http://www.asbs.org/html/about/membersearch2.html
What you want out of the bariatric procedure you choose, what risks and benfit you are willing to accept/desire really is a big piece in all of this..of course the tliterature canhelp us make decisions as well...For instance...
Taking a quick look at your profile your BMI is listed as 50. With that said the literature points to those with higher BMIS not finding success with the band..I think the last article I posted stated 46 http://www.obesityhelp.com/forums/NY/3939384/Failure-of-adjustable-gastric-banding-starting-BMI-of-46-kg/ was the BMI where failure seemed to become exceedingly high. I am uncertain your exact HT/WT but I am guessing you have about 200# to lose give or take...with a band the research point you may lose ~ 30% of the excess at 1 yr that is about 60# is that acceptable for you???
I am pro-bariatrics and glad there are choices.
With that said each of us is an individual and makes the surgery choice based on our research, understanding and acceptance of possible outcome and risks. We all are bias in some way based on our choice, our needs, etc...(*my disclaimer that I am bias as well! I had a bypass, although I now feel a BPD/D may be the better choice for many longterm! ESPECIALLY those with higher BMIS or who wanta more regular way to eat and longerterm excess wt loss that is the higests int he field!)
Another article shows with lapband FAILURES included that longterm at 3 yrs band shoed 37% excess wt loss vs bypass at 73%...again that is 74# with a band vs 148# with a bypass..NOTE neither will help one get to ideal bodywt and most will remain overwt with either tool.
article here at (you just have to register for free to read if you want I have full article email me) http://www.medscape.com/viewarticle/576331_print
Now these are stats, you may find your mileage varies to lesser or greater extent...On success.
Look at the risks of each..
This is the long and short of it...RESEARCH RESEARCH RESEARCH! All surgeries have risks, all have benefits which one will be best fit for you and what risks are you willing to take and what potential outcomes are you looking for makes your decision oersonal!
Know that all surgeries have risks and benefits. Making an informed and educted decision is recommended for each of us individually.
We all have biases, we all have opinions and we are all right for ourselves; judging choices of others is not helpful. Sharing our experiences, strength and hope can be helpful IMHO. You will hear success with any surgry and you will hear failure as well. You will hear about revisions from any tool. NONE are magic or perfect!
I am pro WLS, whatever that means to an individual. I am glad we have choices! I originally researched the lapband after that I decided for me I wanted lap Gastric Bypass. Happy with my choice 6 yrs out....I can say I now beleive that BPD/DS would be my choice based on what I now know; but in 2002 I didnt have that choice with insurance or local surgeons.
You can spin statistics anyway you want...I can share reasons that the lap band seems great or why it seems a horrible choice...I can do the same for any surgery....GBP, Sleeve, DS, MGBP etc......
For instance one article stated Lapband and RNY at 5 yrs had both 50% excess wt loss, sure because that study did not include lapband failures, remembering that 30% of those with bands get them removed (complications, failure etc) when that is factored in RNY at 3 yr was 73% excess wt loss and bands were 37% big difference (different spin see!)...want articles I have them just email me off list [email protected]
Longer one has a band higher complicaation rates go, so early on seem low vs bypass later on exceeds greatly!
BPD/DS I feel is the surgery of choice for super morbidly obese, it has record of greatest excess wt loss over time...I agree a person with BMI over 50 the stats I have seen show that (band or proximal bypass) are not enough to impact comorbidities, 30-50% excess wt loss when one is 200# or more overwt is not worth risk, the Sleeve as step one and then BPD/DS as step 2 seems the way to go for many..Lap Bypass seems to not get Super Morbidly obese (BMI > 50) close to normal BMI either....it is not meant to.....
Sleeve and band may give same excess wt loss but sleeve changes internal hormonal mileu having greater impact it seems on metabolic issues like diabetes, appetite suppression. Bands are contraindicated with autoimmune disease like Lupus, Gastric sleeve is of choice fo those with Chrones disease over other malabsorbtive surgeries.....
What is surgeon recommending how high is your BMI, what is your age, comorbidities, what are your eating issues (sweet eater?) these all factor into a decision for you...
--------------------------------------
Be educated be informed, remember all sites, articles and personal replies (mine included) come with disclaimer of some bias! You'd NEVER convince me to get a band EVER I have seen too many issues with close friends and those in my support groups I facilitate (erosions, slips, perforating stomach, port flips, infected ports, disconnected tubing... faiures on failures, defeating the tool getting revision to bypass more and more) but that is me...You probably wouldn't convinve me to get a proximal lap bypass again either due to the issues of stretched stomas, wt regain etc....but hindsight is 20/20! The BPD/DS is not perfect it is for the HIGLY motivated and compliant person due to nutritional issues for life that are needed to be monitored (not that RNY isnt either but seems distal bypass or DS more so).... Again my choices may differ greatly form others!
LOOK AT ALL YOUR CHOICES (what insurance will pay and what the surgeons around you do!)
Hello!
Researching is the most important part of the journey...making the most educated and informed decision goes far on being both successful and healthy postop!
WHERE ARE YOU ON YOUR JOURENY? Have you been to a surgeon? A preop support group? PReop educational seminar??
Preop/postop dietsvary by bariatric program....I recommend you investigate the surgeon and program to make sure it is multidisciplinary and a center of excellence either with American Board of Surgery?
www.absurgery.org
American College of Surgeons?
http://web3.facs.org/acsdir/public/Detail.cfm?CHKDGTS=00299031800
Is he a member of the American Society of Bariatric Surgeons? http://www.asbs.org/html/about/membersearch2.html
What you want out of the bariatric procedure you choose, what risks and benfit you are willing to accept/desire really is a big piece in all of this..of course the tliterature canhelp us make decisions as well...For instance...
Taking a quick look at your profile your BMI is listed as 50. With that said the literature points to those with higher BMIS not finding success with the band..I think the last article I posted stated 46 http://www.obesityhelp.com/forums/NY/3939384/Failure-of-adjustable-gastric-banding-starting-BMI-of-46-kg/ was the BMI where failure seemed to become exceedingly high. I am uncertain your exact HT/WT but I am guessing you have about 200# to lose give or take...with a band the research point you may lose ~ 30% of the excess at 1 yr that is about 60# is that acceptable for you???
I am pro-bariatrics and glad there are choices.
With that said each of us is an individual and makes the surgery choice based on our research, understanding and acceptance of possible outcome and risks. We all are bias in some way based on our choice, our needs, etc...(*my disclaimer that I am bias as well! I had a bypass, although I now feel a BPD/D may be the better choice for many longterm! ESPECIALLY those with higher BMIS or who wanta more regular way to eat and longerterm excess wt loss that is the higests int he field!)
Another article shows with lapband FAILURES included that longterm at 3 yrs band shoed 37% excess wt loss vs bypass at 73%...again that is 74# with a band vs 148# with a bypass..NOTE neither will help one get to ideal bodywt and most will remain overwt with either tool.
article here at (you just have to register for free to read if you want I have full article email me) http://www.medscape.com/viewarticle/576331_print
Now these are stats, you may find your mileage varies to lesser or greater extent...On success.
Look at the risks of each..
This is the long and short of it...RESEARCH RESEARCH RESEARCH! All surgeries have risks, all have benefits which one will be best fit for you and what risks are you willing to take and what potential outcomes are you looking for makes your decision oersonal!
Know that all surgeries have risks and benefits. Making an informed and educted decision is recommended for each of us individually.
We all have biases, we all have opinions and we are all right for ourselves; judging choices of others is not helpful. Sharing our experiences, strength and hope can be helpful IMHO. You will hear success with any surgry and you will hear failure as well. You will hear about revisions from any tool. NONE are magic or perfect!
I am pro WLS, whatever that means to an individual. I am glad we have choices! I originally researched the lapband after that I decided for me I wanted lap Gastric Bypass. Happy with my choice 6 yrs out....I can say I now beleive that BPD/DS would be my choice based on what I now know; but in 2002 I didnt have that choice with insurance or local surgeons.
You can spin statistics anyway you want...I can share reasons that the lap band seems great or why it seems a horrible choice...I can do the same for any surgery....GBP, Sleeve, DS, MGBP etc......
For instance one article stated Lapband and RNY at 5 yrs had both 50% excess wt loss, sure because that study did not include lapband failures, remembering that 30% of those with bands get them removed (complications, failure etc) when that is factored in RNY at 3 yr was 73% excess wt loss and bands were 37% big difference (different spin see!)...want articles I have them just email me off list [email protected]
Longer one has a band higher complicaation rates go, so early on seem low vs bypass later on exceeds greatly!
BPD/DS I feel is the surgery of choice for super morbidly obese, it has record of greatest excess wt loss over time...I agree a person with BMI over 50 the stats I have seen show that (band or proximal bypass) are not enough to impact comorbidities, 30-50% excess wt loss when one is 200# or more overwt is not worth risk, the Sleeve as step one and then BPD/DS as step 2 seems the way to go for many..Lap Bypass seems to not get Super Morbidly obese (BMI > 50) close to normal BMI either....it is not meant to.....
Sleeve and band may give same excess wt loss but sleeve changes internal hormonal mileu having greater impact it seems on metabolic issues like diabetes, appetite suppression. Bands are contraindicated with autoimmune disease like Lupus, Gastric sleeve is of choice fo those with Chrones disease over other malabsorbtive surgeries.....
What is surgeon recommending how high is your BMI, what is your age, comorbidities, what are your eating issues (sweet eater?) these all factor into a decision for you...
--------------------------------------
Be educated be informed, remember all sites, articles and personal replies (mine included) come with disclaimer of some bias! You'd NEVER convince me to get a band EVER I have seen too many issues with close friends and those in my support groups I facilitate (erosions, slips, perforating stomach, port flips, infected ports, disconnected tubing... faiures on failures, defeating the tool getting revision to bypass more and more) but that is me...You probably wouldn't convinve me to get a proximal lap bypass again either due to the issues of stretched stomas, wt regain etc....but hindsight is 20/20! The BPD/DS is not perfect it is for the HIGLY motivated and compliant person due to nutritional issues for life that are needed to be monitored (not that RNY isnt either but seems distal bypass or DS more so).... Again my choices may differ greatly form others!
LOOK AT ALL YOUR CHOICES (what insurance will pay and what the surgeons around you do!)
Take Care,
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
By 6 mo I felt no one would know i was a bariatric pt based on what I ate or could eat unless I told them.....you'd never know today! What I eat is based on my choices and self control more than the tool at this point and how much I exercise really.its the lifestyl I learned for the first 6-12 months! I at out first at 2 mo postop 3 shrimp coctail was my meal..food became about nutrition eating out was about company, this was the lesson I felt important postop...
http://www.sabariatric.com/life_and_success/
http://www.cornellweightlosssurgery.org/pdf/diet_guid_gas_bypas.pdf
http://www.lapbandinformation.com/RECOMMENDED_FOOD_PLAN.pdf
http://www.cornellweightlosssurgery.org/pdf/diet_guid_lap_band.pdf
HOw you lose wt preop is individual based on program...I follwed a 1,500 cal diet lost 45# preop in 3 mo (30 in first 30 days) that is how bad my habits were and how much I didntexercise at the age of 29! Just walking 2 miles a day helped.they were slow 20-25min miles but I was mooving!
Eating After WLS:
It is expected that most people after WLS will be able to eventually eat just about anything they ate before surgery, only in smaller portions....I think the key words here are...MOST & EVENTUALLY.....
Not everyone gets food intolerances or dumping. And just because you dump say on candy for example, it doesn't mean you can't eat it! I have heard people say "I know eating the donut was going to make me sick (dump) but I ate it anyways, I paid for 2 hours after, but I ate it.." It is still a choice, now most people use this behavior mod. tool and don't eat the donut again...but not everyone! We all have food issues and to different degrees....
The farther you are post-op the less problems you usually (key word usually) have with food, amounts/sizes or dumping. Some people dump for a year, then stop...It is expected that you will be able to eat more at a year than at 2 months out otherwise you would whither away to nothing! Malabsorption decreases over time also as the body learns to work more efficiently with what it has....
Not to scare you but you can regain weight lost, even all of it if you do not use this surgery as a tool...It will not fix everything. We have to make major behavioral changes in our live, dietary habits have to change, exercise habits have to change...Yes this does sound like a diet, but it is the tool that makes it different. It works hard for you for the first 6mo +/-, giving you great weight loss, motivation and a feeling of success and self-esteem. It also gives you ~ 6mo to learn how to use it most effectively, so when it works a little less, and you have to work a little more, you have used the time to develop better eating and exercise habits....
My clinical nutritionist told me at 2 months out I should be able to eat anything, in small amounts and to introduce food slowly and one thing at a time...But on the other hand she also recommends I stay away from: sugar, carbonation, alcohol, chocolate and caffeine, for a year (some are gastric irritants, others may make you dump or slow wt. loss or minimize wt loss)...It is all about personal choices. The pouch does stretch or expand over time from its original 1 oz...for some to as much as 9-10oz...But never to the stomachs original size (~44 0z or so)....Even if you can not eat allot at one sitting, it is the food you choose (nutritional quality or lack thereof) and how often you eat that will affect your outcome! Constant grazing (eating several small meals all day) or drinking high calorie beverages allday (juices, shakes etc) will diminish wt. loss or even cause wt. regain...
Don't get me wrong, this is a wonderful tool, but you get out of it what you put in! Just be informed! Good Luck!
Gastric bypass diet: Nutritional needs after weight-loss surgery
http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007
Laparoscopic Adjustable Gastric Band Nutrition: How to Achieve Weight Loss Success
http://bariatrictimes.com/2009/03/06/laparoscopic-adjustable-gastric-band-nutrition-how-to-achieve-weight-loss-success/
March 2009
by Liz Goldenberg, MPH, RD, CDN
Ms. Goldenberg is from New York Presbyterian Hospital, Weill Cornell College of Medicine of Cornell University, Department of Surgery, New York.
http://www.sabariatric.com/life_and_success/
http://www.cornellweightlosssurgery.org/pdf/diet_guid_gas_bypas.pdf
http://www.lapbandinformation.com/RECOMMENDED_FOOD_PLAN.pdf
http://www.cornellweightlosssurgery.org/pdf/diet_guid_lap_band.pdf
HOw you lose wt preop is individual based on program...I follwed a 1,500 cal diet lost 45# preop in 3 mo (30 in first 30 days) that is how bad my habits were and how much I didntexercise at the age of 29! Just walking 2 miles a day helped.they were slow 20-25min miles but I was mooving!
Eating After WLS:
It is expected that most people after WLS will be able to eventually eat just about anything they ate before surgery, only in smaller portions....I think the key words here are...MOST & EVENTUALLY.....
Not everyone gets food intolerances or dumping. And just because you dump say on candy for example, it doesn't mean you can't eat it! I have heard people say "I know eating the donut was going to make me sick (dump) but I ate it anyways, I paid for 2 hours after, but I ate it.." It is still a choice, now most people use this behavior mod. tool and don't eat the donut again...but not everyone! We all have food issues and to different degrees....
The farther you are post-op the less problems you usually (key word usually) have with food, amounts/sizes or dumping. Some people dump for a year, then stop...It is expected that you will be able to eat more at a year than at 2 months out otherwise you would whither away to nothing! Malabsorption decreases over time also as the body learns to work more efficiently with what it has....
Not to scare you but you can regain weight lost, even all of it if you do not use this surgery as a tool...It will not fix everything. We have to make major behavioral changes in our live, dietary habits have to change, exercise habits have to change...Yes this does sound like a diet, but it is the tool that makes it different. It works hard for you for the first 6mo +/-, giving you great weight loss, motivation and a feeling of success and self-esteem. It also gives you ~ 6mo to learn how to use it most effectively, so when it works a little less, and you have to work a little more, you have used the time to develop better eating and exercise habits....
My clinical nutritionist told me at 2 months out I should be able to eat anything, in small amounts and to introduce food slowly and one thing at a time...But on the other hand she also recommends I stay away from: sugar, carbonation, alcohol, chocolate and caffeine, for a year (some are gastric irritants, others may make you dump or slow wt. loss or minimize wt loss)...It is all about personal choices. The pouch does stretch or expand over time from its original 1 oz...for some to as much as 9-10oz...But never to the stomachs original size (~44 0z or so)....Even if you can not eat allot at one sitting, it is the food you choose (nutritional quality or lack thereof) and how often you eat that will affect your outcome! Constant grazing (eating several small meals all day) or drinking high calorie beverages allday (juices, shakes etc) will diminish wt. loss or even cause wt. regain...
Don't get me wrong, this is a wonderful tool, but you get out of it what you put in! Just be informed! Good Luck!
Gastric bypass diet: Nutritional needs after weight-loss surgery
http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007
Laparoscopic Adjustable Gastric Band Nutrition: How to Achieve Weight Loss Success
http://bariatrictimes.com/2009/03/06/laparoscopic-adjustable-gastric-band-nutrition-how-to-achieve-weight-loss-success/
March 2009
by Liz Goldenberg, MPH, RD, CDN
Ms. Goldenberg is from New York Presbyterian Hospital, Weill Cornell College of Medicine of Cornell University, Department of Surgery, New York.
Take Care,
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Thanks!! Both of you, this is all apart of my research. I have not found a doctor yet, only because I do not have insurance yet. It is coming but somewhere along the line, the paperwork on their end got messed up:( Anyways, I found a support group in my area and plan on attending next week. I also found a person who wants to exercise with me at a gym. I an excited about that.
I am 31 years old, I am 5'8" and I weigh 330. As of 2 years ago, I did not have BP issues or sugar issues, but since that last appointment, I have gained 40 pounds. I have tried to diet, I guess I did not want it bad enough. However, I have had enough. I want to live for my children. 2 years ago, there was no way I was going to have surgery. Too many risks, however, I can hardly walk up my stairs to get into my apartment without being winded. I do not want my children to say years down the road. IF only she played with me........
So, I am researching to find the best tool to my weight loss, who knows maybe surgery is not it, but it is definitely a candidate for a tool to help me.
I am 31 years old, I am 5'8" and I weigh 330. As of 2 years ago, I did not have BP issues or sugar issues, but since that last appointment, I have gained 40 pounds. I have tried to diet, I guess I did not want it bad enough. However, I have had enough. I want to live for my children. 2 years ago, there was no way I was going to have surgery. Too many risks, however, I can hardly walk up my stairs to get into my apartment without being winded. I do not want my children to say years down the road. IF only she played with me........
So, I am researching to find the best tool to my weight loss, who knows maybe surgery is not it, but it is definitely a candidate for a tool to help me.
While you are at it, check out the VSG, vertical sleeve gastrectomy, NOT the same as VBG. Go to the VSG forum here, listed at the top under "Forums", "Surgical Forums". It's the last one on the list. It is fast becoming one of the more popular surgeries. Restrictive, with no long term malabsorption issues.
Better yet, here's the link: http://www.obesityhelp.com/forums/VSG/
Better yet, here's the link: http://www.obesityhelp.com/forums/VSG/
(((HUGS))) Mary 
Survivor!
Handle every stressful situation like a dog.
If you can't eat it or play with it,
Just pee on it and walk away.
Welcome! Did you ever think about having the duodenal switch (DS)? I was looking into having an RNY last year until I heard about the DS. It has better long term results & is supposed to be the BEST choice for people with high BMI's (my BMI is 49). DS'ers can eat more “normally" than other WLS patients post-op also! Also, on the DS Board here at OH, or the Revisions Board, you will notice quite a number of former RNY & lap band patients who have had revisions to DS. If RNY is considered the “gold standard" in WLS, DS is considered the “platinum standard"! And Rochester has a DS Surgeon.
PLEASE, please, please check out the DS Board, especially DSFacts. Of course, I think DS is the BEST, but please look into all options & decide what's best for you. Feel free to PM me if you have any questions. Best of luck to you on your journey! www.duodenalswitch.com
PLEASE, please, please check out the DS Board, especially DSFacts. Of course, I think DS is the BEST, but please look into all options & decide what's best for you. Feel free to PM me if you have any questions. Best of luck to you on your journey! www.duodenalswitch.com
Jodi 
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