Let’s Talk about Gastric Banding

grabCurrent information about gastric banding comes from Cheryl Ann Borne, the individual behind the website My Bariatric Life. A very useful page outlines the criteria and preparatory steps. Borne says:

After you have been approved for gastric band surgery, you will need to make certain lifestyle changes before your surgery.

Here is where the trouble begins. Some people are just so massive that any kind of surgical procedure would be ill-advised. Consequently, preparation might begin with the need to lose weight, just for the privilege of getting on the operating table. (One might ask, if the person was capable of losing weight, would she or he not have done so already, rather than put it off until staring surgery in the face?) Exercise might be required and diet will have to change.

This groundwork looks like a job for W8Loss2Go, which unfortunately did not exist when Ms. Borne was contemplating her surgery. However, Childhood Obesity News is acquainted with another bariatric surgery success story, Ellen Burne, who has said that such an app “would be an invaluable support for young people battling to get their weight under control.” W8Loss3Go could be very useful to a patient working to bring her or his weight down to the level where surgery is feasible.

The vertical banded gastroplasty used to be the procedure of choice, but laproscopic Adjustable Gastric Band surgery (AGB) has overtaken it. A silicone band encircles the top end of the stomach to create a pouch that can only hold an ounce of food. Borne says:

The silicone band can be adjusted via a plastic tube that runs from the band to just below the skin’s surface. Saline is injected by the bariatric surgeon through a port in the skin’s surface to make the band tighter. Saline can be removed to loosen the band.

In 2012, when AGB constituted 39% of the bariatric surgery market, a New York Times article described how the laparoscopic procedure started with five slits being made through the patient’s skin and underlying adipose tissue. The abdomen would be distended with a gas to give the surgeon room to navigate, and the surgical instruments, along with a mini camera, would be poked through the incisions. This account describes how the doctor “wrapped the band around the neck of [the patient’s] stomach and cinched it with a ridged buckle, like the type on swimming goggles.”

Gastric banding is the least invasive choice, and the only reversible one. Because it doesn’t really interfere much with absorption, vitamin deficiency is not a big concern. It is usually done on an outpatient basis, and the recuperation period is relatively short, generally permitting the introduction of solid food after a mere 6 weeks. On the downside, the gastric band “yields the least weight loss,” about 40% or maybe even 50% of the patient’s excess weight, on average.

Because the remaining pouch is so small, it is easy (in theory) for the person to feel full. A determined overeating addict can ruin it—but that is a subject for another post. If a person does it right and follows the rules, a great degree of success can be attained. That part about following the rules indicates that here, too, the W8Loss2Go app could have a role to play.

Your responses and feedback are welcome!

Source: “Gastric Band Surgery Facts,” MyBariatricLife.org, undated
Source: “Young, Obese and in Surgery.” NYTimes.com, 01/07/12
Image by Christy Mckenna

 

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Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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