Monday, October 25, 2010

Does the Band Really Work?

Recently a person who had attended a weight loss surgery seminar the previous night asked if I could help her make sense of what she heard there. The surgeon who spoke was very anti-band. He said the band is fickle, he would never perform band surgery, and he believed that in 10 years, the band would be obsolete in the US. The person who listened to his anti-band tirade was very discouraged about the band when she left the seminar. When she got home and researched the band on the internet, she found that it has only a 55% long-term success rate. She doesn't want her stomach and intestines cut up and rearranged, she's willing to make healthy diet and physical activity changes, but when she sees others struggling to work the band and hears a surgeon say it's useless, she doesn't know what to think.

Here's what I told her. I don't know the source of the 55% long term success rate you quoted, and since the surgeon who spoke at the seminar refuses to perform band surgery, you're not going to get any accurate info from him. From my own research, I learned that long term success with the band is about the same as with gastric bypass - 65% at 5 years post-op.

Why isn't that figure 100%? Because obesity is a chronic disease and no bariatric surgical procedure can cure it. Why does the bypass seem to work "better" than the band? Probably because of the malabsorption feature. Since you've decided you don't want your intestines re-routed, that leaves the band or the sleeve as your WLS choices. If you don't want your innards cut up permanently, that leaves the band as your only WLS choice.

The band worked for me because I was a volume eater and because I was committed to making the lifestyle changes needed for long term success. My surgeon told me at the outset that if I lost only 50% of my excess weight, he would consider my band surgery to be successful. You might think, "Why would I go through all of this just to lose 50% of my excess weight?" Well, consider the alternatives...disease, disability, death. When I had lost "only" 50% of my excess weight, my co-morbidities were all either gone or under control, and I felt great - I felt very successful!

Just because a statistic indicates that 100% weight loss and lifetime maintenance aren't guaranteed doesn't mean that the weight loss and maintenance are impossible. I don't pay much attention to statistics any more. I don't want numbers to run my life, and as an old boss of mine used to say, "Figures can lie and liars can figure."

That anti-band surgeon could be right. In 10 years, gastric banding might disappear forever as a treatment for obesity. In 10 years, someone might have invented a non-surgical cure for obesity. In 20 years, someone might have invented a vaccine that prevents obesity from ever happening. And that would be wonderful. But in 20 years, I'll be 77 years old. If I had put off obesity treatment that long, I probably wouldn't have lived long enough to benefit from the treatment. So I decided to make the best of the surgical treatments available now so that I can make the best of the next 20, 30, or 40 years of my life.


Anonymous said...

I am at about 60% success and if someone had told me you can lose 60% or nothing, I'd sure take feels alot better than being 60 lbs heavier.

Mary Pat F said...

I do agree 100%.. It is a work in progress, but now I wonder why did I wait so long... But right time, right place..... Also. when I had first thought about it, only option was bypass.. I also did not want to rearrange my innards...
So much of the band is what you are willing to put in to it... With a proactive/ positive outlook, I see no reason for it not to work....