Lap Band Surgery: Proceed with Caution?

Lab Band Surgery is currently touted as the best solution for morbid obesity (a BMI over over 40, and in some cases over 35). What is it exactly? Is it Safe?

Unlike a Gastric By-Pass, which is a much more significant surgery – where by a portion of the intestine is actually removed or rerouted – a Laparoscopic Adjustable Band Surgery is the procedure where by an inflatable, adjustable bio-compatible strap is wrapped around the stomach. Both are examples of Bariatric Surgery. The lap band curbs a person’sappetite and limits how much food he or she can eat, thereby leading to weight loss. In fact, the available stomach left to hold food is a pouch that will hold only one half cup of food. In contrast, a normal stomach will hold six cups of food.

Success rates are touted to be over 50% of weight loss in the first two years. This can range from 30 – over 100 lb. However, only about 40% of people were able to maintain their weight loss successfully at the five year mark. Those were were successful were the one who were compliant with the recommended diet and exercise plan.

What is not highlighted in the press surrounding lap band surgery is that success depends on following the appropriate food plan. This includes most often changing the types of food the patient has been in eating in the past, as well as the quantities of food. What is also not emphasized is that if the patient were to make these changes in diet and eating alone, much of the same weight lost after the procedure would have occured – even without the procedure! This begs the question of if such a surgery, which bring a high rate of complications with it – is even necessary.

What are the complications? These include everything from discomfort in eating ie difficulty swallowing, bloating and nausea. Other more general symptoms are discomfort, such as indigestion and constipation.

More serious complications can be the lap band slippage to actual erosion of the band into the stomach, so that the device needs to be removed. While surgeons have improved the techniques markedly over the years, most studies point to at least 30 % of people suffering surgical complications. 20 per cent of patients required repeat surgery to deal with the complications. A most recent Belgian study found that 39 per cent of their surgical candidates experienced serious complications and nearly 50 per cent had the band removed within 12 years.

Most surgeons will agree that lap band surgery is most successful if their food plan is recommended. The plan? The following are typical suggestions:

Avoid:

• Sugar and sugary foods, including: high-calorie soft drinks, syrups, honey, jelly, jam, cakes, cookies, candy, ice-cream.
• High-fat foods, including: chocolate, chips, pies, pastries, ice-cream, bacon, sausage, fried foods, cream soups, cream sauces.
• High-calorie drinks, such as milkshakes, soda, beer, orange juice, apple juice, other fruit juices, whole milk.
• Starchy and white flour foods, such as pasta, rice, and doughy breads.
• Fats such as butter or oil should be restricted to 3 to 4 teaspoons per day.

If a person changes their diet to accommodate these recommendations, weight loss will be achieved. If the person is unable to follow through on these recommendations, with or without surgery – their food addiction will need to be addressed. Lab Band surgery will not address the underlying food addiction dynamic which may contribute to the inevitable and discouraging weight regain.