Hello,

I was banded in 2006 lost about 40 lbs. I've kept most of it off but recently have had a lot of reflux. I was completely emptied to help the situation. Didn't help much with the gas etc but did help with the burning I was having. They did some testing and found that my band looks fine.

I'm a singer and don't really want to have the band re-filled for fear of worse reflux. I've been working very hard to try not to gain weight now that it's unfilled. I have been successful after the first couple weeks of adjustment. My question is what to do next. I am still 110 lbs over weight. Over this past year and a half I've developed the habit of working out by swimming 3x a week and doing weights 2x a week but I've not seen any weight loss from that. Should I have the band out and revise to RNY or just leave it the way it is? How much time would I be out of work? If I've not been able to lose much weight with the band and working out will I have any success with any other surgery? Any help with this would be appreciated. How different is what you can/can't eat with the band vs RNY? Thank you for your input, Norma

Hi Norma,

It sounds like you're pretty active - it would be frustrating to not lose any weight though. In my opinion, you have two options:

A) Try to make the band work for you. Even unfilled, it does give you some restriction. What you could do, to use that to your advantage would be to throw out all sugars/pasta/carbs from your house and eat protein-forward meals. Start tracking your food intake on MyFitnessPal and make sure you drink 64oz of water a day. No drinking calories. You could essentially (with the little help from your unfilled band) do a post-op diet to see if you lose weight that way. I had a band for 4 years and didn't lose any weight, and finally in the months prior to getting the band removed, I decided to try the RNY post-op diet to see if I would lose weight. I lost 35lb during that time and didn't feel hungry too often. I think it worked well for me because eating dense protein fills up even a normal stomach!

B) You could look into having the lap-band removed entirely and consider another weight loss surgery. Since you have a band, any of the other 3 main options are available for you: VSG (Sleeve), RNY (Gastric Bypass), and DS (Duodenal Switch). All three have their pros and cons. Because you already have reflux, the VSG might not be a good choice for you.

To answer some of your other questions (to the best of my knowledge!):

Q: How much time would I be out of work?

A: From what I have noticed, you would be out from work between 1-3 weeks depending on the activity level required at your job. Right now I am 11 days out from my DS surgery and I think today is the first day I might be able to go back to work if I wanted... however I have disability insurance, and my surgeon prescribed taking 3 weeks off from work, so I have 10 more days off remaining that I will be using.

Q: If I've not been able to lose much weight with the band and working out will I have any success with any other surgery?

A: There are people here all the time on ObesityHelp who originally had a failed lap-band and are now QUITE successful with their new surgery. The surgery won't be magic, however, and you will need to follow the eating plan and not stray back to old carb-heavy habits because with all surgeries that will stop weight loss and cause regain. Also revision patients tend to lose slower than 'virgin' procedures, but success is definitely still an option if you're committed!

Q: How different is what you can/can't eat with the band vs RNY?

A: I don't have an RNY, but I have been on these boards for a while (and for a short time I was going to get an RNY myself). I believe both the RNY and Band will cause you to throw up if you overeat. In addition, ~30% of RNY patients have what is called "Dumping Syndrome" which is super unpleasant and caused by eating too much sugars (or fats or dairy for some people). I won't describe it here, but let me just say that it involves writhing in agony on your bathroom floor in the fetal position.

I personally decided that my surgery of choice was the Duodenal Switch because it allows the most 'normal' eating of any of the weight loss surgeries. Many DS patients are successful on a high-protein high-fat diet due to having high malabsorption of fats, moderate malabsorption of protein, (we do absorb almost all carbs though) for life. It has a sleeved stomach (just like the VSG) but has additional intestinal changes that affect how we absorb food.

I hope some of this helps!

Thank you for your response. It helps a great deal.

Unfortunately my long term GERD damaged my vocal cords and I can not sing (soprano) in the choir. MY GERD is severe and I was advised not to have the sleeve, but the rny. My GERD improved as I was losing weight, but the rny did not cure it. My weight loss was slow with rny and I never made it to goal. Due to a low HR (40s) and testing, it is assumed I have a slow metabolism. In past 2 years, I've gained 59 lbs and GERD is worse. My GI doctor feels that the increased abdominal weight has cause pressure on my pouch (and bladder), and losing weight would take care of the problem. Now, I'm wanting to revise to a DS with a larger sleeve, to help me lose and keep most of the weight off.

I hope you find the solution for yourself. I wished I had wls sooner, so I could sing again. (I can sing for one minute, then my voice goes deeper and flat). I stopped singing, so my speaking voice would not be damaged any further.

Hi there Norma,

I can share my experience with you, but only you and your Dr. can decide what you should do.

I had a band and a similar experience to you. About a 50 lb loss and then the severe pain and burning. Gradual fluid removal lead to less pain and then no fluid at all left in band. Almost all the weight came back gradually.

After a few years and much research and time spent w surgeon, he offered a revision to RNY or sleeve to me but suggested I'd have better results with RNY. On 3/23 of this year I had the band removed and RNY. I recently had my 6 mos check up and with the 13 lbs I lost right before surgery, I am now down a total of 99 lbs!! I exercise 6 days a week though and I think this boosted my loss.

I'm so thrilled w my choice. The surgeon explained that leaking could be a very unlikely side effect, but still a possibility and I do not have any of that or burning/pain. He felt I'd do as well as anyone getting the RNY without a band.

No continual burning/pain/feelings of something stuck ALL the time. Just a feeling of fullness and being satisfied with a small amount of healthy food. There are MANY rules to follow and believe me, I follow them all. I am so happy with how I feel and look and I am blessed to have had the support of family and a great team at my doctor's office.

Good luck to you in your decision making :)

HI Norma,

I was banded in 2009 and it was the worse thing I ever did. I threw up for the full 6 years that I had it. My surgeon emptied my band and I gained 30lbs which he did warn would happen. I had to wait another full year before I can have my RNY because the job that I had at first denied my surgery. Then I started to work for the hospital that my surgeon worked for and he promised that he would get me covered and he did. I had my RNY on Sept 23 2015. I was out of work for 2 weeks. Im almost 4 weeks post op and I feel great. You pretty much have to follow the same rules as you did with the band. Little by little you start to introuduce solid foods back and see what you tolerate. Of course they want you to stay away from bread, pasta, rice and of course alchol. I know a few people that have introduced all of these things back into their diet but just make sure they do it in moderation and continue to work out. Swimming is a great way to burn calories especially right after surgery your only eating about 600 calories to begin with. I hope this helps. Good luck