This is going to be kind of long, but I want to tell you everything I wish I had been told three years ago when I first started considering surgery. I have not yet had surgery (waiting on insurance approval) so definitely take my advice with a grain of salt, but like you, I was die hard set on getting the band because the thought of the sleeve or bypass was just too much. I started looking into weight loss surgery when I was seventeen, but I thought no way, that's way too drastic, I'm not that desperate, I can do it on my own, etc. So I spent the next three years giving it 'one last shot' on my own. Not only did I not lose the weight, I had actually dieted myself just over 300lbs by losing ten, feeling like I was starving and giving up, gaining fifteen, starting over losing ten, throw in the towel and gain fifteen, stuck on repeat until I saw a number I NEVER thought I would see. So last November, I decided there was no shame in getting a tool to help me along the way, and I attended a bariatric seminar.
I had to be on a six month supervised diet (amongst other things) for insurance, which I've only completed just a few weeks ago, but up until maybe a month ago, I still wanted the band one hundred percent, because the sleeve and bypass seemed way too outrageous for me. I'm fairly young and I thought for sure that that kind of surgical intervention was absolutely insane. Like you I thought of it as an absolute last resort; if I tried the band and it didn't work out, I could always get it removed and carry on with life, right?
Wrong. I've read hundreds of articles, reviews, comments, and discussions written by people who have had the band in and had to have it removed, and a lot of them ended up getting a conversion to the sleeve. You will not go back to normal. The average person won't get the band taken out until there's a problem, so I've seen a lot of cases with scarring in the stomach that causes continued issues even after the device is removed, which also makes a band to sleeve revision a little more complicated/less effective than just getting the sleeve in the first place.
The thing you have to remember about the band is that it is a foreign object inside of your body. You will have to worry about the band slipping or eroding, or your body flat out rejecting it (that's very rare I hear, though.) You will have to go in for multiple appointments for fills/unfills until you find your 'sweet spot' where you start losing, but be advised that there are many people who never find their sweet spot, and even more who think of the band as surgically enforced bulimia - they DO lose the weight, but only because they're throwing up everything that they eat and things get stuck so they can't eat period. One comment in particular I remember quite well said, "When I had the lap band, I could eat cheetos but not raw veggies." Lastly, the band will not reduce your hunger, though obviously it will reduce your capacity to eat. So in other words, you may end up being one of the unlucky ones who feels hungry all of the time but can't get anything down.
If you want to rewrite your genetics, the band isn't going to cut it for you. My surgeon explained to me, when I was set on the band, that the best procedure for my issue would be the VSG (the sleeve). Over the course of six months with a dietitian and thorough required visits to their psychiatrist, I have essentially tackled head/emotional hunger - I'm not perfect, obviously, but no one is. Still, I over eat, not because I'm grazing all day, but because at meal time I am
hungry, and even healthier foods become less healthy when you eat too much at one time. He told me that this is because my stomach produces an excess of the 'hunger' hormone called Ghrelin (purely genetic - like you, the majority of my family has weight problems), so even when my body does not need any more food, it's sending signals to my brain that I'm hungry. With the vertical sleeve gastrectomy, they actually remove the part of your stomach that is the primary source of that hormone. Unlike the band, your portions will be reduced, but you will be 100% satisfied with that. During the first year, many people report having to remind themselves to eat because they're just not hungry. Now eventually your body will catch up and start producing more Ghrelin, but it will never be as much as it was.
Now like I said, I'm only speaking from second hand experiences here, as I have not had any kind of weight loss surgery yet. I've spent years doing my research, but I found it fairly easy to avoid or write off the negative reviews of the band out there when I was set on having it. I told myself constantly that it wouldn't happen to me because sure there's plenty of people who have been very successful with the band, but it seems like more people have problems than those who don't. It's a statistical fact that the band is not showing to hold up over time well - they haven't had much time to conduct this research, but so far it's showing that getting to/past the five year mark without experiencing a serious complication is optimistic.
All of that being said, for all I know you could very well be one of the people who is successful with the band! Ultimately the decision is yours. I suggest you read around as much as you can, but keep more of an open mind than I did. Good luck and I hope you find something that will work for you, no matter which you choose!