I wrote here several years ago when I was intensely on Nutrasystem. Needless to say it did not work to effect any long term weightloss for me. I just had my first consultation with the surgeon and need some advice.
I want the lap-band, the least invasive surgery. He told me that because of the amount of weight I need to lose, he might as well not put in a lap band
because it will not work. He wants to do a gastric sleeve and after I lose 100 lbs. he will do a gastric bypass. Great...from least invasive to most invasive.
My question for anyone out there who can help...
1. anyone out there who has to lose in excess of 250 lbs who has gotten a lap-band and it has worked well?
2. anyone had the same experience I have had?
I am really much more divided about having the surgery with those two surgeries in mind.
As you can see, I moved your post so that it would get more attention. First of all - welcome aboard. and please don't kick yourself. the main reason I turned to surgery was not only to lose weight, but to give myself the best chance of KEEPING it off.
now - about your Q. i wanted the lapband, but at 500+ pounds and bedridden, the surgeon said that i had to lose a lot of weight quickly and therefore the lapband wasn't a good choice for me. Needless to say, I was a bit disappointed.
the only other choice 10 years ago was the full bypass, which i had. and i don't regret it for a second.
having said that, though, if the sleeve had been available back then, I probably would have gone that route. the results have been excellent, both in terms of weight loss and keeping it off. and there's no dumping or malabsorption.
here's something to discuss with your surgeon: if you do well on the sleeve without the malabsorption, would that be enough so that you could avoid the second surgery? another consideration is that many insurance companies will cover only one WLS in a lifetime - so that might be an issue to discuss as well.
I initially wanted the lapband as well, but I was also told my weight prevented me from having one done. So, then I researched the sleeve and really thought it would work for me, but past issues with GERD disqualified me for that surgery as well. Since I could not afford a DS as a self-pay, RNY was the only option left for me. So far, I am happy with my choice.
All surgeries have their risks, even the lapband. It might be promoted as "least evasive," but that doesn't mean it isn't without side-effects, some of which can be serious. I would encourage you to continue researching all the procedures.
I know the band is promoted as being the least invasive, but that's really only true initially. It's also the procedure that will most likely require additional future surgeries. Even the Allergan (manufacturer of the Lap Band product) literatures staes (if you read closely enough!) that the band is NOT intended to be a lifetime product and will eventually likely need to be removed or replaced. And those future surgeries, whether to repair, remove, or replace the band, can be more difficult because you will likely have scarring/adhesions from the original band placement surgery. Plus, with the band, you will have to have adjustments after the initial placements - fills and unfills - and you never know how few or how many you may need; I know some people who did well with only two or three fills early out, and some people who have been in for fills/unfills trying to find their "sweet spot" more than 20 times!
So, "least invasive" is really all in how you look at the larger picture.
I went with the Duodenal Switch, or DS (to my knowledge, there are no surgeons in RI who perform the DS, so your doc wouldn't have mentioned it to you). To me, it was the "least invasive" in that it has the highest long-term success rate of any of the procedures available in the US, so I would be very unlikely to require a second procedure in the future and would have the highest statistical chances of long-term success.
With the sleeve now so much more widely available, honestly, I would always recommend the sleeve instead of the band. It has a higher success rate, requires no adjustments, and is still a restriction-only procedure. It does not create any unnaturally narrow man-made anastomoses for food to get "stuck" (like where the band is placed or where the gastric bypass pouch meets the intestine), and it doesn't bypass the pylorus (which is the primary cause of the increased risks of dumping syndrom and reactive hypoglycemia with the gastric bypass).
I urge you to do some more research before choosing a procedure, and then, AFTER you've decided on the procedure that is the best fit for you, seek out a surgeon who EXCELS at that procedure. I think to often people see a surgeon too early and are swayed by what that surgeon says. Not that we shouldn't listen to surgeons, but, as they say, the salesman at a Ford dealership isn't going to recommend a Honda for you even if the Honda is truly the better fit!
It is my understanding that the band is "usually" not sufficient for that amount of weight. And the complications can be horrendous and permanent. RESEARCH RESEARCH RESEARCH and look at what people report about long-term effects of the band.
I've read plenty about every surgery and honestly the band sounds the least appealing to me. Just the thought of food getting stuck in that little hole makes me scared. Before I read about the sleeve I was thinking about bypass and yes it is real invasive to the body but in long term I thought it would be the best. Now when I read all about the sleeve Im going for that! Lets hope my surgon agrees lol
Thanks for all your input everyone! I think if the doctor proposed the gastric sleeve only, I would be less stressed about what he said. From what I know about gastric bypass, I definitely do not want to do it. In any case, I am glad I spoke with the surgeon, now I know what I am facing. I have actually decided to spend at least a month researching the whole idea of surgery (or rather continuing my research). In the meantime, I am going to try out medifast, provided my primary care doctor approves as I take coumadin. If I can get consistent weight loss going using medifast without going crazy from hunger, maybe I will not need to go the surgery route.
Thanks so much for the advice and information, it is great to know I can come here for the questions I need answers to. There was nothing in the lapband that speaks to its limitations when you weigh too much.
vicky - i'm not here to talk you into one path or another, but i strongly suggest that you not only look at the weight loss aspect of your choices, but also [and perhaps more important] the issue of MAINTENANCE afterwards. every single one of us has yo-yo'd through fasts, prescription diets, pills and on and on and on.
Whatever path you decide on should enable you to lose the weight and keep it off using tools [eating habits, exercise, vitamins, whatever] that YOU can live with for the rest of your life.
You are absolutely right about the maintenance factor.
I wish there was a diet or surgery or pill or something else that could guarantee once pounds are lost they will never come back. Unfortunately there is not. A co-worker who had gastric bypass gained back most of what she had lost and a friend who is a doctor mentioned that many of her patients who have surgery keep their weight off a maximum of five years.
When I looked over Medifast I picked up on their maintenance issues right away, assuming I manage to lose what I want to on it, I will use their maintenance plan as a base, but go much more slowly than they suggest.
Eventually I would like to move to a Weight Watchers type plan, but only after a very, very long withdrawl from Medifast to make sure I do not gain the weight back.
I'm not one to normally tell people what not to do, but I would steer clear of the lapband. I promise I'm not trying to scare you!
I haven't had it personally, but my aunt did and had HORRIBLE problems with it. At her heaviest she was about 350/400. She lost about 100 pounds before she got it put on. After they put it on she had serious complications with it.
The band slipped on her several times and she ended up having surgery 3 or 4 times instead of once. She also ended up in the hospital due to an infection several times from the lapband. She lost a bit of weight, but then gained it back again because the lapband wasn't doing any good after the 3rd time they had to put it BACK on. She also got HORRIBLY sick several times (vomiting and diarrhea so bad that she ended up in the hospital for several days at a time).
She eventually gave up and had them take it off and had a different surgery that went really well.
I just worry about anyone who is thinking about it after the horrible experience that she had. I'm sure it works great for a lot of people. I just would hate for anyone else to go through what she went through.
Ultimately its your decision. I would keep researching like you said you were.
Either way, I wish you the best of luck and hope everything works out!
Ok, there are horror stories with any surgery, this is true. I think its best that you research it all, and then and only then make your decision with your doctor. I have a band and have no issues, but I didn't have over 100 lbs to lose either. good luck with your decision and go with what your heart tells you.
Jaleril, if you're considering Medifast, please come take a look at our little section of the forums. I can tell you I've been at it since April, this is the most weight I've ever lost, and I'm still motivated to keep going. I'm learning things about myself and my relationship with food, which never happened on any previous diets.
Best of luck to you, whatever route you decide to take.
I had the sleeve last July and love it. I have only heard bad things about lapband. I wouldn't know why you would have to have additional surgery RNY after the sleeve. I have heard it may become the "gold standard" for surgery in the future.
Also, last fall I rejoined Weight Watchers, and should receive my Lifetime membership next week. I am so excited that I have been able to combine my surgery with their program - although protein is always first.
Take care & good luck in your decision. If you have not checked out obesityhelp.com they have a lot of information on all the surgeries, etc.
I wouldn't know why you would have to have additional surgery RNY after the sleeve.
Not everyone would, but statistics show that the sleeve is less effective for higher starting BMIs. It's excellent for "lightweights" (BMIs of 35-45), but success begins to taper off as the starting BMIs increase.
Of course, that's just statistics - and there are people who fall on either side of the average, so some higher BMI patients do just fine with a sleeve and never need anything else, but you don't know 'til you get there!
Though I would also never let someone turn a perfectly good sleeve into an RNY pouch; if I needed further surgical intervention, I would revise a sleeve to a DS, not an RNY. But that's another topic
I could really use some advice...
good luck with your decision and go with what your heart tells you.
