Okay, so you've learned a bit more about gastric bypass and you aren't sold yet. Good for you! Gastric bypass may be the most common bariatric surgery, but it isn't for everyone. After weighing all of your options, I know you'll make the best decision that gets you closer to that new, healthier, slimmer you! To aid in your decision-making around weight-loss surgery options, I'm sharing the cheat sheet on the adjustable gastric band that I used when deciding which surgery was the right one for me.
Name of surgery: Adjustable Gastric Band, aka REALIZE Band, LAP-BAND
Medical criteria: Similar to gastric bypass. BMI of 40 or more where diet, exercise and medicine have been unsuccessful or BMI of 30 or more with a comorbid condition such as Type 2 Diabetes, hypertension, or asthma; Extensive screening process that will evaluate your psychological status (depression, sexual abuse, eating disorders, etc.) which will not disqualify you from your bariatric surgery, but it may postpone it. Remember, they are setting you up for success, so they will want to address any underlying demons that may interfere with your healthy lifestyle after your surgery. They will also review your medical history looking for risk factors that could make surgery unsafe for you (such as blood clots, heart conditions, liver disease) and have you undergo a physical exam and lab work.
Be aware that after you have been approved for gastric banding you will need to make certain lifestyle changes before your surgery. This may include losing weight, diet and fluid restriction, smoking cessation, counseling to prepare you for your post-surgery life and perhaps beginning an exercise regimen.
How it works: Technically, there are two different forms of gastric banding, but whereas vertical banded gastroplasty has fallen out of favor due to less weight-loss and more complications, I won't delve into detail on that option. Only approximately 5% of surgeons even perform this type of gastric banding today.
Laproscopic Adjustable Gastric Banding (AGB) is the second most common bariatric surgery and is the least invasive; gastric bypass is the most common weight-loss surgery and is more invasive than AGB. AGB decreases the size of the stomach by using a silicone band to portion off a part of the stomach, called the pouch, so that it only can hold one ounce of food. A one inch wide opening is left at the bottom of the pouch so bypass is not necessary to reach the intestines. The silicone band can be adjusted via a plastic tube that runs from the band to just below the skin's surface. Saline is injected by the bariatric surgeon to make the band tighter and saline can be removed to loosen the band, as well. Banding works the same as bypass to make you feel full faster due to the smaller stomach, however it does not interfere with food absorption like bypass does, so vitamin deficiency is not as much of a concern with banding as it is with bypass.
Cost: $15,000-$20,000. Check with your insurance company as some will cover part or all of the surgery. Market research shows that approximately 80% of banding surgeries were covered in some part by insurance.
Recuperation time: It is possible to have same-day banding surgery, so there may not be hospital recovery time. Recovery is generally considered to be 4 weeks post surgery, although you should not expect to be eating solid foods until 6 weeks post surgery.
Average weight loss: 40% of the excess weight. Like bypass, banding is intended to produce long-term weight-loss over a period of years with the proper diet and exercise.
Long-term success rate: Gastric banding has come under heavy fire due to a higher rate of complications (33% will develop complications) and the need for major reoperation (22% of patients). While some sources quote the average excess weight loss (EWL) at around 60% at 8 years, others put it at only 33%, and many journals quote a lack of research in the long-term success rates of gastric banding.
Previous article: Is Gastric Bypass the Right Surgery for You?
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You can read about my decision to have weight loss surgery back in 2003 and my journey to maintain a lifetime of obesity disease management since that time. My wish is to help you on your own journey of lifetime obesity disease management with shareposts along the way to help you navigate that journey successfully.
Published On: December 12, 2011