Frequently asked questions about the Gastric Band Procedure
Weight loss surgery is a life-changing event. It can help you help you lose weight and improve your health, but it requires a great commitment to living a healthful lifestyle. And, like any surgery, it involves both benefits and risks. Before choosing any weight loss treatment, ask questions and be sure that you understand your options. Below, we've included the answers to our patients' most frequently asked questions.
Q: Will I be sick a lot after the operation?
A: Gastric banding limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well enough or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement of the band, so contact your doctor if this problem persists. Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch. It can also lead to slippage of part of the stomach through the band and reduce the success of the operation. In some cases, it can require another operation.
Q: How long will it take to recover after surgery?
A: When gastric banding surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.
Q: How much weight will I lose?
A: Weight-loss results vary from patient to patient, and the amount of weight you lose depends on several things. The band needs to be in the right position, and you need to be committed to your new lifestyle and eating habits. Obesity surgery is not a miracle cure, and the pounds won't come off by themselves.
It is very important to set achievable weight-loss goals from the beginning. A weight loss of 2 to 3 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. Remember that you should lose weight gradually. 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 connected with severe obesity.
Q: How do the weight-loss results with gastric banding compare to those with the gastric bypass?
A: Surgeons have reported that gastric bypass patients lose weight faster in the first year. At five years, however, many gastric banding patients have achieved weight loss comparable to that of gastric bypass patients (1,2). 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. Tightening the band too fast or too much to try to speed up weight loss should be avoided. The stomach pouch and/or esophagus can become enlarged as a result. You need to learn how to use your band as a tool that can help you reduce the amount you eat.
Q: Does gastric banding require frequent visits to my doctor after surgery?
A: Check-ups with your doctor are a normal and very important part of the gastric banding follow-up. Many surgeons see their patients weekly or biweekly during the first month and every four to six weeks for the first year. Once patienst reach their "green zone", visits are scheduled every two months. Adjustments are performed during some of these visits. It is typical for follow-up visits to be scheduled every three to six months during the second and third year, depending on the individual case.
Q: Does gastric banding limit any physical activity?
A: Gastric banding does not hamper physical activity including aerobics, stretching and strenuous exercise.
Q: How is the band adjusted?
A: Adjustments are often carried out in the X-ray department. They are done there so the access port can be clearly seen. When X-rays are used, your reproductive organs should be shielded. Sometimes adjustments can be done in an outpatient clinic or office, and local anesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few minutes and most patients say it is nearly painless.
Q: Do I have to be careful with the access port just underneath my skin?
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, talk to your doctor.
Q: Can the band be removed?
A: Although the gastric band is not meant to be removed, it can be, in some cases laparoscopically. Surgeons report that the stomach generally returns to its original shape once the band is removed. After the removal, though, you may soon go back up to your original weight. You may also gain more.
Q: Will I need plastic surgery for the surplus skin when I have lost a lot of weight?
A: That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation as, sometimes the skin will mold itself around the new body tissue. Give the skin the time it needs to adjust before you decide to have more surgery.
Q: Is it true that the gastric band seems "tighter" in the morning?
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 changes and this may cause the band to feel "tighter" some of the time. Some women have also noticed that the gastric band feels tighter during menstruation.
Q: Will I feel hungry or deprived after gastric banding surgery?
A: Gastric banding makes you eat less and feel full in two ways - first by reducing the capacity of your stomach and second by increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that gastric banding is a tool to help you change your eating habits.
Q: What will happen if I become ill?
A: One of the major advantages of the gastric banding surgery is that the band can be adjusted. If your illness requires you to eat more, your surgeon can loosen the band by removing saline from it. When you have recovered from your illness and want to lose weight again, your surgeon can tighten the band by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.
Q: What about pregnancy?
A: Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After pregnancy, the band may be made tighter again and you can resume losing weight.
Q: Will I need to take vitamin supplements?
A: You may. It's possible to not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron. Your surgeon may advise you to take supplements.
Q: What about other medication?
A: You should be able to take prescribed medication, though you may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. Always ask the doctor who prescribes the drugs about this. Your surgeon may tell you to avoid taking aspirin and other nonsteroidal anti-inflammatory pain relievers because they may irritate the stomach. The problems these drugs may cause could result in band removal.
Q: What if I go out to eat?
A: Order only a small amount of food, such as an appetizer. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.
Q: What about alcohol?
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 (3).
Q: Can I eat anything in moderation?
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 full of important vitamins and nutrients as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of "empty" calories, such as milkshakes, the effect of gastric banding may be greatly reduced or even cancelled.
Q: Will I suffer from constipation?
A: There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fiber. This should not cause you severe problems. If difficulties do arise, check with your doctor. He or she may suggest you take a mild laxative and drink plenty of water for a while. Your needs will vary, but you should drink at least 6-8 glasses of water a day.
One final point:
It is important to ask your surgeon all the questions you have about gastric banding and other weight loss options. It is also essential that you follow his or her advice.
1. Clegg A., Colquitt J., Sidhu M.K., et al. The clinical and cost effectiveness of surgery for people with morbid obesity. Health Technology Assessment 2002; 6(12): 1-153.
2. O'Brien et al. LAP-BAND®: Outcomes and results. J of Laparoend & Adv Surg Techniques 2003; 13 (4); 265-270. (55% for the LAP-BAND vs. 59% for Gastric Bypass)
3. Dixon J., Dixon A., O'Brien P. Light to Moderate Alcohol Consumption: Obesity and the Metabolic Syndrome. Am J Bariatric Medicine 2002; 17(4): 11-14.