Gastric Banding:

 

FAQ

Before  you have an appointment with me in the office to discuss your options, read through the list of FAQ's below. This will help you have the most meaningful discussion with me, and get the most out of our visit.

 


About the Operation

Is Gastric Banding safe?

Laparoscopic Gastric Banding is the “safest” of all weight loss operations, meaning that the risk of complications arising during or immediately following surgery is extremely low. This is one of the most common reasons why so many people choose to undergo the gastric banding. Once a person is 100 pounds overweight, the risk of dying from obesity within five years is substantially higher than the risk of dying from gastric banding surgery. This is what morbidly obese people are up against – choosing between dying from obesity which reduces life expectancy by 15-20 years, and an operation, which although it sounds scary to people, actually drastically improves lifestyle, health and longevity.

What is the Adjustable Gastric Band?

The gastric band is an adjustable silicone band that cinches around the top of your stomach, designed to help you feel full on a small amount of food, thereby making it easier to lose excess body weight, improve weight-related health conditions, and enhance quality of life. 

How does the Adjustable Gastric Band operation work?

The adjustable gastric band is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface.  This creates a new, smaller stomach pouch that can hold only a small amount of food, so the food storage area in the stomach is reduced.  The band also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach.  When the stoma is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested.  As a result, you eat less and lose weight. 

What is the Adjustable Gastric Band?

The gastric band is an adjustable silicone band that cinches around the top of your stomach, designed to help you feel full on a small amount of food, thereby making it easier to lose excess body weight, improve weight-related health conditions, and enhance quality of life. 

How soon will I get back to a normal lifestyle after surgery?

Patients are generally shocked at how good they feel after the gastric banding and the gastric bypass operations. The recovery time is the same for both operations, in that folks go back to work 5-7 days after the surgery. However, what surprises people is how good they feel over the first few days. About half of the patients take some pain medication for a few days, and the other half takes only Tylenol. People frequently expect that they will be lying in bed, “taking it easy” for several days. However, the reality is that they are not only up and around, but the people who come in from out of town for the surgery are going to the San Diego Zoo, Sea World, the beach, and the Wild Animal Park the day they leave the hospital. People often bring their families to San Diego and make a family vacation out of the trip. One patient who was an antique dealer who requested an early morning discharge from the hospital so she could make it to the shops by opening time. She went antique hunting all over San Diego and had several loads of furniture shipped back home, so it was waiting for her when she returned. 

How is Gastric Banding different from the Gastric Bypass Roux-en-Y operation?

Unlike gastric bypass surgery, gastric banding does not require stomach cutting and stapling or gastrointestinal rerouting. It simply reduces the volume of the top of the stomach – the part that receives food first. The gastric bypass reduces one of the hunger hormones, Gherelin, while the Banding does not. 

How much weight will I lose?

Weight-loss results vary from patient to patient.  A weight loss of two to three pounds a week in the first year after the operation is possible, but one pound a week is more likely.  Twelve to eighteen months after the operation, weekly weight loss is usually less.  The main goal is to have weight loss that prevents, improves, or resolves health problems connected with severe obesity. 

What can I expect over the first 6 months?

The first 6 months are filled with positive changes, and weight loss is only part of it. The timeline goes as follows:

When people leave the hospital, they are tapering down on their medications… the most common being for diabetes, blood pressure, cholesterol, water retention and joint pain. Some patients are taking pain medication at this time, but most feel that Tylenol is all they need.

When  patients check in one week after the surgery, they have already lost around 5 pounds. They are starting their exercise programs – breathing is easier already.

One month after the surgery, the joint and back pain is decreased significantly or gone and the  patient has lost up to 10 or 15 pounds. The clothes they wore before the surgery don’t fit anymore. Women start wearing the “thinner clothes” stored in the closet and men have tightened their belts to holes that they haven’t used before.

Six weeks after surgery comes along and the energy is skyrocketing. Suddenly 6 hours of sleep is all that’s needed. The benefits of the exercise are paying off. By this time, most patients report that their walking distance has doubled or tripled and they are feeling physically stronger every day.

As the months pass, patients lose about 5-8 pounds a month, all the while, losing fat and gaining muscle mass. It’s important that muscle mass be tracked, along with the fat%, because it’s the muscle mass that burns the fat during sleep. Oftentimes, patients are shocked when they see that the weight loss on the scale doesn’t seem to match the massive difference in size that they are experiencing. This is because muscle weighs more than fat. This is why it's critical to choose a surgeon who provides guidance about exericse, because the muscle tone helps keep the weight off in the long run. So a patient might lose “only” 5 pounds one month, but when we look at the fat vs. muscle mass, they have lost 9 pounds of fat, and gained 4 pounds of muscle. They look like they’ve lost significantly more weight than they have, because they’re gaining bone and muscle mass. They’re taking boxes of clothes to the thrift stores at this point. Goodwill stores love patients who have had weight loss surgery!

By the time the 6 month mark approaches, patients typically say they’ve never felt better. They’re in a solid exercise program, which they’ve discovered that they actually enjoy. They are getting compliments left and right on their appearance. Skin conditions like eczema and acne have improved, migraines and seasonal colds are gone, sex life has drastically improved, and patients’ social and professional confidence is at an unprecedented high. They look forward to holidays, class reunions and family get-togethers with renewed enthusiasm. The patients are about one-quarter of the way to their goal at this point and they say that they regret not doing the surgery sooner. 

Will I feel deprived or hungry?

If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel overly hungry or deprived. 

Will I be able to eat whatever I want?

You may eat most foods that don’t cause you discomfort.  Some patients have difficulty with steaks/chops, breads and some raw vegetables. Because you can only eat a little at any given time, it is important to include foods rich in important vitamins and nutrients – foods such as those recommended by your surgeon and/or dietician. 

Why is the Gastric Band considered adjustable?

Once placed around the stomach, tubing connects the band to an access port fixed beneath the skin of your abdomen.  This allows the surgeon to change the stoma (stomach outlet) size by adding or subtracting saline or salt water, inside the inner balloon through the access port.  Adjustments are performed without any additional surgery. 

Does the Band limit physical activity?

The Band does not limit or hamper physical activity.  You should be able to do everything from simple stretches to strenuous exercises.  In fact, exercise should become a regular part of your postsurgical routine.  Remember, the Band is simply a tool that helps you lose weight – diet and exercise are still required.  Always check with your doctor about the amount and type of exercise that is best for you. 

How long will it take me to recover from surgery?

If the surgery is performed laparoscopically, as it most frequently is, patients typically spend less than 24 hours in the hospital.  It takes most patients about a week before they can return to work, and a month before they can resume unlimited exercising.  In the case of open surgery, or if there are complications, recovery may take longer.

It generally takes about six weeks before the fatigue of surgery wears off, however most people go back to desk-type jobs about two weeks after surgery.  You are not allowed to lift anything more than 10 pounds for one month after laparoscopic surgery and for six weeks following open surgery. 

Who is eligible for Gastric Banding surgery?

The gastric band can help adults, at least 18 years old, who are 100 pounds over their ideal weight or have a Body Mass Index (BMI) of 40 or greater.  People with a BMI of 30 or greater with weight-related health problems are also be eligible for gastric banding. 

How much food will my new stomach hold?

An average meal will be about ½ to 1 cup of food, however, different foods move through at different rates, depending on the consistency. 

What kind of nutrition program will I have after surgery?

You will be on a special eating program designed to allow your stomach to heal, while you receive the protein, vitamins and minerals you need.  You will begin with liquids for about a month and then progress to soft and, finally, solid foods over the next two weeks.  Your surgeon will help guide your eating plan throughout your recovery and will teach you about your new eating program. 

Can I be healthy eating the recommended amounts of food and fewer calories?

Family members may voice concern about the small amounts of food and fewer calories that patients eat after Bariatric surgery.  However, this low-volume, low fat and low sugar-eating program is designed to meet your body’s nutritional needs. Dr. Ellner will teach you this program after your surgery.  You will learn how to keep protein in your eating plan and about the multivitamins you will need to take.  A well-balanced nutrition program is very important after surgery because your stomach will be smaller and hold less. 

Are there any foods that I will never be able to eat after Gastric Banding Surgery?

Food tolerance is very individual.  Some people eat almost everything they ate before surgery that is low in fat and sugar.  However, they chew more carefully and eat smaller portions.  

Frequently, patients find there are foods they do not tolerate well after surgery.  Foods that can provide difficulty include fibrous meat, doughy bread, rice, pasta and some vegetables. 

How will surgery change my eating habits?

The surgery will help you change the way you eat and will reinforce a new eating plan.  Because your new stomach is smaller, you will feel full after eating less food.  Your new stomach pouch will not be able to grind food as it once did, so you will need to eat small bites and chew food very, very well. 

Why do I need to drink 64 ounces of water daily?

Drinking water keeps you from becoming dehydrated.  This is particularly important after weight loss surgery.  Drinking plenty of water allows the body to be effective and efficient in ridding itself of the excess fat, reduces food cravings, protects the kidneys and increases metabolism.

Since you will not be able to drink water as quickly after surgery, you will need to sip small amounts of water throughout the day.  Carry a water bottle for convenience and to remind you to keep sipping.  The water bottle should become a familiar sight in and out of your home.  If you do not like your tap water, treat yourself to bottled water.  A slice of lemon or fresh mint leaves can add flavor. 

Can I drink coffee and soft drinks for my fluid requirements?

If the surgery is performed laparoscopically, as it most frequently is, surgery. 

What is the Adjustable Gastric Band?

It is not recommended to drink soda, tea or coffee, as they dehydrate your body by acting as a diuretic and they stimulate your appetite.  Also, avoid carbonated beverages during the first six months after your surgery.  Carbonation can cause gas that can be painful. 

Avoid the use of straws.  With a straw, you can drink large amounts of fluid without realizing it and overfill your stomach pouch.  In addition, straws lead you to swallow air that can cause discomfort. 

Can a person drink alcohol after weight loss surgery?

It is not recommended to drink in excess, as alcohol intake slows down a patient’s weight loss.  It contains lots of calories and does not have nutritional value. 

Can I smoke after surgery?

Absolutely not.  Smoking stimulates gastric secretions that can irritate the lining of the stomach.  This irritation can cause chronic gastritis and ulcers in the stomach.  The same applies to second hand smoke. 

Why do I need to take multivitamins on a regular basis?

Since you are eating less food, smaller amounts of vitamins and minerals are entering your system.  Do not prescribe vitamin supplements yourself. Many are toxic in larger amounts. It is very important to follow the vitamin guidelines provided by your surgeon. 

When should I weigh and measure myself?

We recommend that you weigh once a day. Plan to weigh and measure yourself on a regular schedule, at the same time of day and in similar clothing. 

Will my weight loss ever hit a plateau?

During the period of weight loss, you may hit a plateau when you notice you are not losing pounds. Your body may simply be adjusting to the chemical and biological changes that occur during weight loss. 

If plateaus continue for more than a few weeks, review your nutrition plan and activity level. Are you following the nutrition guidelines for portions, protein and fluid intake and limiting fats and sugars in your food selections? Decreasing your activity level can also contribute to a weight plateau.  Review your activity level and see if your level of physical activity can be increased. If you are weight training, remember that muscle weighs more than fat, and while you are building muscle, you are still losing inches even though you are not losing pounds.   

Do not be concerned if your weight plateaus more than once during your weight loss.  If a plateau continues for more than a few weeks, speak to your surgeon in your monthly follow-up. You may need a tightening of your band to help you off the plateau. 

Why is activity so important to me after surgery?

Exercise maximizes weight loss and is the most important part of keeping the weight off. Muscle burns fat in your sleep, and is your army fighting against weight gain. The right kind of exercise increases muscle tone and bone density, not only keeping the weight from coming back, but also helping to avoid osteoporosis.  After surgery, you not only need good nutrition, you need to take the time for regular exercise. It is critical that you choose a surgeon who will provide exercise counselling and guidance, as well as referrals to personal trainers. 

Cadeucus