Question:
Lapband or Gastric Bypass?

I am trying to choose between lapband or gastric bypass. My BMI is 52(same as my age). I am not concerned about how quick the weight comes off. I just want to be around for grandchildren, However, I have read so much about patients with lap band not losing or regaining the weight. I am trying to keep an open mind. The more I study the long term results the more I am confused. I have chosen a wonderful doctor. He has advised me on both. I need to make a decision. Please advise.    — topaz11 (posted on April 5, 2009)

April 5, 2009
I am 55, and had my Laparoscopic RNY Gastric Bypass surgery on March 2. My BMI was 48. Against the advice of friends and loved ones, I chose the Bypass as opposed to the lapband - for several reasons. First of all, I see a lot of comments on this and other boards about the band "slipping", and people wanting "revisions" to the bypass. Second, and this is my PERSONAL reason, and not to try and convince anyone else.... I strongly feel that the bypass surgery and its attendant unpleasant effects if you "push" things, is a lot like Antibuse is for an Alcoholic. See, if an alcoholic is taking antibuse and decides to drink.... he or she is going to get really nasty sick. If I, as a bypass patient, eat too much, or eat the wrong thing (like too much sugar or fat), or "push" my "tool" ("pouch" or "stomach") or whatever you want to call it, I will most likely become violently sick. If not with dumping syndrome, then with other unpleasant side effects.... like recently (I'm still getting acquainted with my pouch and what it likes and doesn't like)... I ate an ounce of soft scrambled egg. Then two hours later, I slowly and thoroughly chewed and enjoyed a less-than-one-ounce slice of liverwurst. Half an hour later, I began to sip some liquid spinach soup with Any Whey added avery 5 minutes or so, and within 15 minutes, I knew I was in trouble. It felt like I had a HUGE burp sitting in my stomach that wouldn't come up, and the sensation just kept getting worse. Soon, I couldn't even swallow my own saliva, and about half an hour later, I threw up. Luckily, the vomiting was not traumatic....it didn't hurt, it was just a HUGE relief. But that's what I'm talking about. If I do something wrong, I'm going to pay. And that is going to keep me on track. It's going to keep me honest and paying attention to what I eat. From what I've heard, lapband patients do NOT have this kind of problem. Oh, once they've had their first "fill", there is a restriction on how MUCH they can eat at one time, but not WHAT they can eat. You can eat pretty much everything you could before. For me, that would not be good, because my favorite foods were things like mayonnaise and gravy and butter, and things like Ms. Butterworth's syrup, and hollandaise sauce, and stuff like that - and they all had to be the real thing, no low-fat yucky-tasting stuff for me! So, if I'd had the lap-band done, I could still eat all the stuff I loved before, and I'd probably stay morbidly obese. I hope this helps you. It really is a personal, private decision....based on what you and your surgeon think will work best for you. I have a friend who wanted the lap-band surgery, but the surgeon talked him into gastric bypass because it would make his diabetes go away faster. Well, this friend had prepared himself mentally for the lapband, not the much more restrictive bypass, and he's had nothing but trouble since he had the surgery. Within 4 weeks of the surgery, he'd been back in the hospital 3 times, and the ER twice, because of not following the "rules of the tool"... he ate the wrong food way too soon after surgery and caused a blood clot which blocked the entrance to his intestine and made him throw up everything he tried to drink or eat afterwards, he gets angry at his partner because he can't eat what his partner is eating, he ignores the dietician at the surgeon's office... all because he was talked into having a surgery he didn't want and wasn't prepared for. Please, whichever surgery you decide on, please become as knowledgeable about it as you can. Read up on everything you can get your hands on, and ask questions on boards like this if you don't understand something. There are doctors and nurses on this board that have had the different kinds of surgeries and can help you based on their experiences and medical knowledge, too. BE PREPARED AND YOU WILL BE SUCCESSFUL AND AROUND TO SEE YOUR GRANDCHILDREN!! Good Luck!
   — Erica Alikchihoo

April 5, 2009
I am 58 and have a BMI of 40. Originally I had planned to have the lap band, but after going through a 6-month pre-surgery class, am now planning to do bypass instead. The biggest reasons are that lapband hasn't been around long enough to know what happens years later, and there is some possibility of band slippage. And finally I think I may have a little better chance of long-term successful weight loss with bypass. Certainly there are good reasons for choosing the lap band also. But from a lecture I attended, my uderstanding was that bypass is more often recommended for BMIs over 50. Best success with your research and WL.
   — Janell C.

April 5, 2009
I am 58 and have a BMI of 40. Originally I had planned to have the lap band, but after going through a 6-month pre-surgery class, am now planning to do bypass instead. The biggest reasons are that lapband hasn't been around long enough to know what happens years later, and there is some possibility of band slippage. And finally I think I may have a little better chance of long-term successful weight loss with bypass. Certainly there are good reasons for choosing the lap band also. But from a lecture I attended, my uderstanding was that bypass is more often recommended for BMIs over 50. Best success with your research and WL.
   — Janell C.

April 5, 2009
Hi, I am 48 years old, initial BMI was 53 and had lap RNY on March 9th. I made my decision on similar reasons to Erica above. I knew of people who needed re-operation for slippage or erosion and I felt I need all the consequenses that the RNY can give you for dietary indiscretions. I've always been able to lose weight (Last year I lost 50 lbs following a vegan diet, went off the diet and gained 55 back) There are success and failure stories with all WLS so you really need to look at the advantages and disadvantages of each and decide which seems best for you. What I am trying to wrap my head around is maintainence. I am carefully following the guidelines on diet and exercise. I am exploring new foods, new ways of cooking, and most important how to organize my life so that I can eat withing guidelines and do the things I want to do with my family. I am trying to hammer in a 5-6 day a week exercise program by only doing things I enjoy and not making it a contest with myself to push myself to exhaustion. I've always done that in the past and quit exercising. Now I know that if I do that will just lose muscle mass as I lose weight and be at higher risk for regain later. I can advocate the RNY because I had a very easy experience, not everyone does. The lapband is much less invasive and on average should be easier to tolerate the procedure but that will also vary widely from one person to another. I have been looking for all the books I can find by people who are long term successful at weight loss from wls. Irregardless of what they had done they all changed their lifestyle to one of healthy food choices and exercise, they all follow the basic guidelines for all wls patients (with their own individual quirks) so you can be successful irregardless of which you choose. Like Erica, I feel I need the extra kick in the pants of the the threat of dumping and the tighter restriction but that is me. Good luck on everything while making your decision. Kevin
   — hapkidodoc

April 6, 2009
at a BMI of 52 you should be looking more at the RNY or the Sleeve. The band is not likely to bring you down to the weight you want. It goes very slow and generally is for people with 100 pound or less to lose.
   — trible

April 6, 2009
Hi, have you researched the duodenal switch? With your BMI, it's likely the best choice for you. Lots of people don't know about it, though it has been around for over 20 years. It has the best statistics for greatest amount of weight lost and KEPT OFF than any of the weight loss surgeries. It has the best statistics for resolution of comorbidities like diabetes, sleep apnea, hypertension, etc. It also offers a superior postop way of life because it preserves the existing stomach and pylorus valve (no pouch), so there is no dumping, no vomiting, no "foamies", and no stuff getting "stuck". Also, since we don't absorb 80% of the fat we eat, there is no dieting or counting calories or fat grams. We just watch our carbs while we're losing and increase them when we get to goal. Most of us have to watch our carbs to some extent, forever, because we absorb 100% of simple carbs like sugar, so we can't go crazy on sugar or we will gain weight. However, DS is the most forgiving of all the surgeries and the easiest to live with, postop. We have to make sure we get plenty of protein, drink lots of water, take our vitamins and supplements, and get regular lab work to make sure we aren't deficient in any area. Some of us get stinky gas when we overdo it on carbs like bread or pasta. That's pretty much it. Please check out www.dsfacts.com and www.duodenalswitch.com, as well as the DS forum here on OH. This is the biggest decision you'll ever make with regard to your health and I want to make sure you're informed about ALL the choices you have in WLS.
   — Maria C.

April 6, 2009
I considered both surgeries very closely before making my decsion. I decided on the gastric bypass because I had a lot of weight to lose and a high bmi. I had surgery on 2-11-09 and have lost 50 pounds I have a lot to go but I really feel great. There are many things to consider with the bypass and many life long changes you have to be willing to make. We are all different and our bodies react differently so the best thing you can do is get educated on both and talk to your Dr. and make the right choice for you. Good luck in your journey it is life changing and wonderful and like you said I am looking forward to seeing my grandchilidren someday. God Bless Stacie:0)
   — sse032568

April 7, 2009
I had a BMI of 53 and had lap RNY in Sept of 2006. It was the right decision for me. I've lost 200+ pounds and am at goal weight (who would have thought that could happen - LOL). I am 47 years old. I had too much weight to lose to use lapband and I knew I didn't have the patience or was well behaved enough to be succesful without having RNY.
   — waferqueen

April 7, 2009
I agree that the most people that do the lap band either gain the weight back or do not loose significantly. My surgeon does not advocate the lap band for these reasons. If you follow what your surgeon says then persinally I think the RNY is the best way to go.
   — abuddingrose

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