HY 1/08: Could a Band Help You Lose Weight?

Adjustable gastric banding is a new option for people considering surgery

The latest option for those who want to shed significant weight and keep it off is adjustable gastric banding weight-loss surgery (also known as LAP-BAND® or Realize™). Similar to gastric bypass surgery, it’s performed through small incisions and restricts the amount of food entering your stomach. Less food means fewer calories and more weight loss.

Unlike bypass surgery, though, “it doesn’t involve sectioning off a portion of the stomach and reconnecting it to the small intestine,” says bariatric (weight-loss) surgeon Richard Boorse, M.D., of Lehigh Valley Hospital and Health Network. Instead, an adjustable silicone band is placed around the top of the stomach to create a pouch. “That greatly reduces the risk for complications from surgery, and you go home the next day,” Boorse says.

How it works

The band is lined with a balloon, like a tire inner tube, connected to a chamber embedded beneath the skin of the abdomen. To adjust the band— a simple office procedure— your doctor injects fluid into the chamber to fill the balloon, making it tighter and restricting more food.

“Most patients require four to six adjustments the first year, providing for a weight loss of about one to two pounds a week,” Boorse says. That averages out to about 50 percent of excess weight over two years, says registered dietitian Elizabeth Stark of the hospital’s Weight Management Center. By contrast, gastric bypass patients typically drop about 70 percent of excess weight within a year. “Weight loss with the band typically isn’t as abrupt,” Stark says, “but over five years, you’ll lose about the same total weight with either procedure.”

Before surgery, patients participate in a six-month program focusing on nutrition, exercise and the emotional factors that contribute to overeating.

Is it right for you?

To qualify for any type of weight-loss surgery, you must be at least 100 pounds over your ideal weight or have a BMI (body mass index) above 40 (above 35 if you have health risks like diabetes or hypertension). Although most weight-loss surgery patients are women, Boorse says, men also make good candidates for banding.

The procedure is especially effective for large-volume eaters—those who eat healthy foods but consume too much—as opposed to sweet-eaters. “Because the band doesn’t slow nutrient absorption as bypass surgery does, you continue gaining weight after the surgery if you eat too many calorie-rich foods,” Boorse says.

The band also appeals to people who want more control over losing weight, says licensed clinical social worker Gerald Rodriguez of the Weight Management Center: “Because it’s adjustable, they can manage the pace of their weight loss.”

Period of adjustment

Though most patients respond well to banding, some have trouble adjusting to the idea of a foreign object inside their body. Others grieve the loss of old eating patterns. “They may have used food to manage stress and must now find new ways to cope,” Rodriguez says.

Through counseling and support, most patients ultimately feel empowered. “These are people who’d really lost hope,” Rodriguez says. “It’s phenomenal the improvement in their health and confidence after surgery.”

Want to Know More about LAP-BAND surgery? Call 610-402-CARE.

Published from Healthy You Magazine, January-February 2008