Some of the Most Commonly asked Questions
The following are questions we commonly receive about Adjustable Gastric Banding. It is important to ask your surgeon all the questions you have about obesity surgery and the subequent “life with a band”. Click the Question to reveal the answer.
A: The LAP-BAND System limits food intake. If you feel nauseated or sick on a regular basis, it may mean that your band is too tight and needs to be loosened some. In general, if you have trouble drinking even beverages, then your band needs to be loosened. Alternatively, it might mean that you are eating more than your adjusted capacity and you need to cut back on the volume that you consume. If you only have trouble with solids and not liquids, then you should try smaller volumes and quit before you get sick. Finally, it is possible that certain foods (bread, pastry, dry meats) are simply too tough to be adequately broken down and pass through the band. If you indeed only have trouble with such foods, then you should not challenge yourself and for the period of time that you are trying to lose weight and your band is kept fairly tight, you might consider avoiding such foods.
A: It takes most patients about a week to return to work and most routine activities including gentle exercise. Patients with extensive medical history might have other restrictions that will need to be considered on a case by case basis.
A: Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. For a patient with a good understanding of the function of the band and a willingness to “work with the band” an average weight loss of 1-2 pounds a week is to be expected. There are no time tables and patients can lose weight indefinitely until they reach their desired weight. Remember that a gradual weight loss is most desirable. Losing weight too quickly creates a health risk and can lead to a number of problems. The main goal is to have weight loss that prevents, improves, or resolves health problems associated with severe obesity
A: Surgeons have reported that gastric bypass patients lose weight faster in the first year. At five years, however, many LAP-BAND patients have achieved weight loss comparable to that of gastric bypass patients. You should focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health.
A: Check-ups are a normal and very important part of the LAP-BAND System follow-up. On the average, patients will require a band adjustment every 4-6 weeks during the first year and every 2-3 months thereafter until the desired weight is achieved. Once the desired weight is achieved, the visits are reduced to once or twice a year.
A: The LAP-BAND does not hamper physical activity including aerobics, stretching and strenuous exercise.
A: Adjustments are often carried out in the office and will take 5-10 minutes. In some circumstances, your physician might require additional information or assistance from x-rays in which case the procedure might be performed in an x-ray room. Typically, a fine needle is passed through the skin into the access port to add or subtract saline.
A: There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit any physical exercise. The only sensation you may experience from the port occurs when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.
A: Although the LAP-BAND System is not meant to be removed, it can be laparoscopically removed in some cases. Following band removal, the stomach generally returns to its original shape. It is important to note that after the removal of the band, many patients may gain some or all of their lost weight.
A: That is not always the case. The age of the individual, the total amount of weight loss, the pace with which the weight is lost and the amount of exercise and muscle toning during the weight-loss period all contribute to the need for reconstructive surgery. On the average, of all of our highly successful patients, 1/3 will not need any intervention, 1/3 will need it but may choose against it due to concerns about the outcome and the cost of reconstructive surgery and 1/3 go ahead with some kind of reconstructive surgery with very good results.
A: This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day the water content in the body redistributes itself and this may cause the band to feel “tighter” some of the time. Some women have also noticed that the LAP-BAND feels tighter during menstruation.
A: The gastric band works through a combination of portion control and elimination of hunger. As a result, despite eating very small amounts, a person should not battle hunger throughout the day. One of the components of “healthy eating with a band” is to never “deprive” yourself. Accordingly, when you feel hungry, you should enjoy a “solid” snack which is rich in “protein”. Examples include a handful of mixed nuts, a protein bar, or a hardboiled egg.
A: One of the major advantages of the gastric band is that it can be adjusted. If your illness requires you to eat or drink more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline.
A: Throwing up might become necessary such as when you have eaten “bad” food. Although the band creates a substantial resistance against “passive” movement of stomach acid up into the esophagus, the “active” process of throwing up is often accomplished without much difficulty. Having said that, it might become necessary for us to empty the band when a patient has become ill to make the process of throwing up even easier.
A: Becoming pregnant can be easier as you lose weight. Your menstrual cycles may become more regular. Many patients who have failed to become pregnant before losing weight find themselves becoming pregnant after unprotected intercourse. As a general rule, it is neither good for a patient to gain a whole lot of weight nor is it good to lose a whole lot of weight during pregnancy. Accordingly, the decision to empty the band might have to be individualized. It is very important for a patient to let us know if and when they know about their pregnancy so we can closely monitor their weight and their overall health.
A: Given the overall lower volume of food and beverages, you might find your stools harder after gastric banding. It is important for you to consume an adequate amount of non-caloric beverages (water, unsweetened iced tea, sugar-free/diet beverages, etc.) during the day. But in an effort to avoid helping your pouch empty the food that has recently been consumed, you should concentrate on drinking when your pouch is empty already which is typically just before you are getting ready to sit down and eat your next meal.
A: Since it is possible to not get enough vitamins from three small meals a day, all of our patients are encouraged to take daily vitamin supplements during the period in which they are aggressively losing weight.
A: You should be able to take prescribed medication though you may need to adjust their dosage. As a general rule, antihypertensives (medications for high blood pressure), hypoglycemics (medications for diabetes), diuretics (water pills), and blood thinners (Warfarin/Coumadin) will need special attention. Please let both your surgeon and your primary care physician know about your medications, especially around the time of your initial operation.
A: Order only a small amount of food, such as an appetizer. Don’t feel obligated to finish the entire meal and stop as soon as you feel full. Get in the habit of sharing meals with others or bringing home left-overs.
A: Alcohol has a high number of calories and breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.
A: After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little it is important to include foods rich in protein. In general, although a balanced diet is the best diet for most individuals, for patients who are trying to lose weight, avoiding carbohydrates is the most efficient method of weight loss and losing stored fat. In addition, liquids will travel through the band with little difficulty and will defeat the purpose of gastric banding.
To learn more general information about our program and the LAP-BAND® surgery, we encourage you to attend one of our free seminars. See our schedule.