Thursday, January 5, 2012

The Lap Band.... A good solution?


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I am an obese woman, 45 years old, who has tried a variety of diets and I'm considering the lap-band procedure. I am 5'3" and weigh 260 pounds. The best I ever did in the last ten years was on weight watchers and I got to 190 over 6 months but I put it all back on over the next year. I am strongly considering the procedure. Do you have any opinion on this for me?
Gender: Female
How old are you?: 45
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Psychiatric

Describe associated symptoms not listed above: I am depressed about the way I look.


I am "borderline diabetic" but otherwise quite active and healthy.
 
Check all conditions present in your immediate family... :
Cardiac Disease
Diabetes

Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally  
 
Summary:
 
What is the reality of the long term success with the lap band? Will I stop the yo-yo cycle? Are there any risks associated with the surgery aside from the normal surgical risks?

3 comments:

DOC2 said...

DOC 2 (bariatric medicine)

Lap band success is totally dependent on the ability of the recipient to change lifestyle. Weight Watchers success is totally dependent on the ability of the participant to change lifestyle. The low-carb diet success is totally dependent on the dieter's ability to change lifestyle. The DIFFERENCE is that lap banding or gastric bypass forces you to eat less. (Lap band to a lesser extent than bypass.) Other dietary lifestyle changes are a CHOICE and you must be mentally prepared to undergo the changes and not go back to those habits that made you gain or maintain unhealthy weight.

Lap band and gastric bypass should be reserved for those who have NO ability to exercise and in my opinion have a high likelihood of dying earlier in life because of the threats posed by chronic diseases (such as poorly controlled diabetes) and hypertension OR debilitating musculoskeletal problems.

In my weight loss practice I have had several long-term Bariatric surgical failures. Without appropriate changes in lifestyle, these bariatric surgical patients returned to obesity in 8-10 years. They go back to the same habits and mother nature seems to find a way to recreate the possible avenues back to obesity because the patients didn't keep vigilance. Furthermore, they weren't trained to do so and filled with the false hope of a quick fix. The TRUTH is that there is a temporary fix, but the long-term solution still goes back to the basics, proper diet and exercise.

I don't have access at the moment to any statistical data. I'm not in the particular venue to pull that up and present it to you. My experience is mine only and therefore purely anecdotal.

I will try to provide you with some statistical data if I can find it.

As far as risks, I happened upon this web page that does a pretty good job of explaining some risks. It's actually pretty thoughtful.

http://www.muschealth.com/weightlosssurgery/procedures/laprisks.htm

There are other non-surgical methods to lose weight and keep it off. You have to "want it off" and be vigilant enough to "KEEP it off."

MDSTAT_DOC_7 said...

Obviously, Doc 2 knows more about this procedure and related procedures since this is his field! My response is purely anecdotal and my opinion....
The lap band results in frequent painful esophageal spasms. It's not particularly effective. It's a foreign body that will live inside you forever- unless you have another surgery to remove it.
I would recommend looking more towards the gastric bypass.... Or the new (a little less drastic) modification of the bypass, the gastric sleeve.

MDSTAT_InternalMed_Doc 1 said...

Great points Doc 7. I would HOPE that you wouldn't lose sight of the possibilities of non-surgical options.

A gastric bypass is forced malnutrition in the beginning and requires vigilance regarding making sure that essential nutrients are maintained. Having worked as a Hospitalist, I have seen some bad outcomes, and I have watched a patient die as a result of a bariatric surgery nightmare. I sat with a mother as we watched her daughter pass away. She had made herself DNR (or Do Not Resuscitate) because she was tired of the pain she constantly had from her chronic and nonhealing buttock wounds. During that time I watched that mother cry as she held her picture of her obese daughter 3 years before the surgery and say "I wish I had my fat girl back."

I say all of this because I want you to realize that the after effects of this surgery are life-changing and require diligence on the part of the patient before and after. Make sure that your surgeon and the hospital obesity program has good support and education before and after the surgery. Lastly, remember that a gastric bypass is MAJOR ANATOMY-CHANGING SURGERY. There's no going back.