Tuesday, March 15, 2011

Lap Band vs. Gastric Bypass

I know we've all gotten roped into the debate.  Non-surgical weight loss vs. WLS.  Bypass vs. Banding vs. Gastric sleeve.  A recent study makes the bold claim that Bypass is unequivocally better than Banding.  You can read about the study here.

The article I provided gives a pretty decent balance.  Most the articles in the mass media (Fox, MSNBC, ABC) make bold, sweeping statements basically saying how fantastic RNY is compared to Lapband.  My doctor (and I'm biased...because I LOVE my doctor) responded to this study and made some interesting points. You can read those here:

Push come to shove, I don't think they did a fair comparison.  They had a surgery center that performs more bypasses than anything else also perform the lap band procedures.  So the operating times were longer than it was for most of us and the participants were only given 3 fills in the year after banding as opposed to the average 6 that most people need.  I think we can all agree that the band does not work as well if it's not properly adjusted.  No matter how you look at it, it's not comparing apples to apples.  I think it's impossible to compare a highly intrusive surgery like Gastric Bypass that is permanent and requires a long recovery time to a laparoscopic procedure with mere days to recover like Banding.  And as we've seen from some our fellow bloggers, the fact that it's reversible is a huge benefit.  Also, they only went a year out.  We all know that after two years, the weight loss is about the same for both procedures - that's been proven time and time again.  We all have anecdotal stories about our gastric bypass friends who regained all their weight and the lapbander who ate around their band and never got it adjusted and never lost anything.  The point is - different strokes for different folks.  I hope anyone considering WLS will look at a number of studies and statistics before deciding on which procedure is right for them. 

So I said earlier, I love my doc and I do.  I was banded by Dr. Terry Simpson in Phoenix, AZ.  Some other bloggers use his little cartoons to talk about restriction and what not.  He only does lap band and he's fantastic.  I've liked him from the get-go.  He's always been so supportive and nonjudgey.  His office staff is really helpful and most of them are banded too.  I got that shoulder pain again yesterday and emailed him to ask about it.  He responded within the hour with what we had all kinda guessed it was about.  Here was his response:

Typically that comes from eating too fast - which stretches the pouch which irritates the diaphragm.

See when this is in relation to when you eat
But als0 -- see if it is related to activity- because this could also be signs of a heart attack.
Given the proximity to the fill, however, I would most likely suspect that you are eating too fast and things are sitting above your band.

So there you go.  I think the heart attack thing is just to avoid a law suit in case that is what the problem was but I'm pretty sure I'm not having a heart attack.  The main thing I wanted to stress with this was a) answer the shoulder pain question for me and others who were wondering and b) show how nice it is to have a responsive doctor.  In keeping with the theme of this post (I have another post coming later), when researching WLS, make sure you find the right doctor for you and if you decide on lap band...make sure you find a doctor that is all about the aftercare.  The aftercare is so important when you're talking about a band.  Dr. Simpson is also available via phone, facebook and has his own blog.  I highly recommend him to anyone in AZ looking for a lapband surgeon.

Getting off my soapbox now.  I'll have a less scientific and boring post later.  LOL. 


Amanda said...

My doctor briefly mentioned the RNY. That I was a good candidate for it. But he said insurence didn't cover it so if I wanted to wait then I could! I did research on the band. I knew I wanted it. I knew the risks and the rewards and my mind was made up! He was happy with what I knew and there was no more talk about options! I feel good about my choice. In the end I suppose it's all about how you feel about surgery. I personally wanted everything intact. I have met people who have had bypass and have fallen way off the wagon. I haven't met anyone withthe band that has! Simply that is because I've not met anyone else that has the band yet. But I do think that women our age with our drive tend to be more successful. But it is about holding yourself accountable. That is hard for anyone! Good post. I love my doc too!

nikki said...

I went in wanting the band and was never steered in any other direction. At the last minute I did consider the sleeve, but although my insurance covered both, I was afraid I wouldn't be approved and didn't want to take my chances of being denied for both. The sleeve is faster weightloss, which was intriguing and tempting, sure. But I didn't want the more invasive surgery. I do believe my office is going more sleeve these days. I am very happy and never second guessed my decision to get banded, ever. Great post girl!

Susan said...

My doctor too said that weight loss was more "certain" with the sleeve and that I could only expect to lose 50% of my excess weight with the band. At that point I had already been reading blogs and so all of your BOOBS convinced me the band was for me and if I work with the band it will work for me. It is not easy- and I do feel like I am on a diet but that is okay. I am not regretting my decision at all!

Leslie said...

I think a supportive surgeon is the best thing to have. I love my office, everyone there is so awesome. I can call and say my first name and they know who I am and I know that they care for me and my progress.
They let me know my options and supported me in my decision.

LDswims said...

What a great blog! And I'm so jealous, I want a surgeon like that. You are absolutely right - aftercare matters the most, in my opinion. It's not whether or not they can do the surgery, it's whether you get along with them, agree with their philosophy, feel as though you can communicate openly. Aftercare matters. The band signs us up for a lifetime of aftercare. It's not just surgery...

amandakiska said...

Now I love you surgeon too!

Mo said...

My surgeon was great, and he does all types (and they all cost the same - so no choosing the cheapest option) oh and fills for the first year are included in the cost. So we went with what I was comfortable with - lapband. I said I was open if he really didnt think it was right for me, but it was the one for me.

I would be a complete failure if I only had three fills in the first year. I rang the other morning (a week after an unfill of 0.2) and got a fill of 0.1 at 12.30pm. I can ring a dietician and nurse any day and talk to them and the receptionist is a lapbander. A good supportive clinic makes all the difference.

Anonymous said...

I had gastric bypass in 2006, lost only 45 lbs!! I love that I can only eat small portions, but still need to lose 50-60 pounds......tried nutrisystem in 10 weeks lost 22 lbs... too expensive $300 a month.....recently gained 18 lbs back! need help!!!!!