Question:
lap RNY but lately Ive been reading about the adjustable band

that are beginning to confuse me. If the band is adjustable, isn't that a better option? I read so many post from RYN surgeries say they are hungry all the time and nothing can be done for them, if they had band surgery they could tighten it...right? Also, when they tighten the band, is that done by having another surgery? Thanks so much..MJ    — Mary Jane C. (posted on September 25, 2003)


September 25, 2003
I really know almost nothing about this surgery - but here was my thinking - if there is a band doing this for me, I know that I will feel like I can manipulate the situation and maybe even have it removed if I didn't care for it. When I decided to have WLS, I wanted something irreversible - one way only - so that I could not change my mind down the road and regain the weight. So, nothing "adjustable" would work in my case. Very happy with my lap RNY.
   — bethybb

September 25, 2003
First what I am going to say is not meant to push you towards an RNY as I truly believe it is critical that each person figure out which surgery they can work with best for the rest of their life and that's what they should get no matter what anyone says. <p>I do want to address the misnomer that many RNY patients are hungry all the time. First you need to look at how far out they are. Many of the surgeons plan use liquid diets for the first 4-8 weeks. Typically these are the people I have seen commenting about being hungry and not feeling full. It is logical too, because nothing is staying in their pouch to make them feel full. They are not doing anything wrong. There's just nothing to hold the liquid back. <p>I just do not see how someone is hungry when it takes so little food to fill us up. This assumes a person does not have an enlared stoma or staple line disruption, which would cause them to be very hungry and eat too much. It's important to find out the details of how your surgeon does the surgery. What does he do to help ensure the stoma doesn't get stretched, does he transect, what precautions does he take to prevent leaks etc. <p>I do not see people complaining of being hungry all the time in support group either. I realize this does not apply to everybody but I do feel it applies to the majority of RNY patients. The band does have some advantages (shorter surgery, no malabsorption, normal stomach function) but you need to learn everything possible about the good, bad and ugly of all the procedures so you can make an informed decision. For me the RNY was my best choice even though I was a SMO and some feel the DS is the only procedure for the SMO. It was not the right surgery for me and I am comfortable with the choice I made, but I did research both. Good Luck!
   — zoedogcbr

September 25, 2003
The band isn't tightened through surgery. There is a port just under the skin that is attached to the band, and saline is injected into the port, which expands the band and "tightens" it around your stomach. I think everyone has to do their own research and come to their own decisions about which type of operation is for them. I had an RNY and am happy with it, but I respect the decision of those who like the band because it is less invasive and less drastic. The general perception is that you'll lose slower on the band, but this isn't always true. I have two friends who had the band and one lost weight very fast, very similar to RNY numbers while the other is losing more slowly. You may have more trouble getting insurance to approve the band because the operation is fairly new in the States as compared to the RNY.
   — sandsonik

September 25, 2003
The decision is yours and do what you feel is best for you. That said, here's why I chose the RNY. Several years of research on my own then a friend in medical school sent an e-mail about a 5 year study done on WLS patients. Those that had RNY had better success rates because they discovered that the RNY surgical change to the size of the stomach completely stopped the stomach from producing the hormone that signals us to eat. They have known for years that in morbidly obese patients this hormone is over-produced, the RNY surgery is the only one that eventually completely disrupts its production. Do they know why? No, not yet, but it is very exciting news in the treatment of morbid obesity. There is a hugh race in the pharmaceutical community to reproduce this effect with medication but it is at least ten years down the road before any significant animal studies will even be attempted. Also, I know personally for myself alone, I need the most permanent physical behavioral modification available to me and that is the RNY. I can't have the option of adjustability or easy removal (as compared to a reversal of a RNY). The hunger thing you have read about is temporary in most cases and statistically goes away. Do your homework and YOU need to choose what is right for you - nothing is perfect for everyone. By the way, I'm pre-op, surgery scheduled for 10/13, ready to go, have occasional jitters but that is normal and expected. I look forward to my successes, regaining my health, rejoining life and hopefully to help others through support. Good Luck in your persuit of a healthier you.
   — Deborah F.

September 25, 2003
Like the others have said, each person needs to make their own decision. In my Obese family, I chose Lap-RNY my sister however, will be having the Lap-Band.
   — M B.

September 26, 2003
I think it's very wise of you to explore all of your options. The adjustability of the band was a big factor in my decision. Because it is adjustable, the window of opportunity for losing never closes. <P> The reduction in my appetite has really been amazing. <P> There are links to other lap band support boards on my profile, if you're interested. Also, feel free to email me if you have any questions. :)
   — TMF

September 26, 2003
I am almost 3 years post op and just wanted to address the hunger issue. I've never been hungry, even early on when it is somewhat common. I'm still not hungry. My stomach has never growled or felt empty. I eat because I need/like to. In fact, there have been several times recently when I've just not been able to eat lunch. I knew that dinner would be late as well. It just was not that big of a deal. I never worry that I am going to be faint or light headed. If I don't eat, it really is not an issue. Food/hunger is no longer in control. Shelley
   — Shelley.

September 26, 2003
Oops! Forgot to mention I had an RNY. Shelley
   — Shelley.

September 26, 2003
I have done extensive research and was planning to have the Lap Band and then this is what happened. A: Lap Band surgery is a new procedure and some insurance companies consider it still experimental so they are harder to get approval for. B: If you have a lot of weight to lose I wouldn't recommend it. RNY is more successful as the food no longer passer thru the duededom(spelling) where most absorption happens making the results of weight loss higher and faster. The Lap Band is reversible and can be adjusted however, it is possible to eat your way thru this surgery and since your body is still absorbing everything you eat you can actually gain weight if you don't stay on the strictest diet ever! Some people have success it just depends on what type of eater you are and how much you have to lose!
   — gina L.

September 26, 2003
This question comes up every so often, and what I wish is that people would NOT answer with information about a surgery that THEY DID NOT HAVE. This leads to old, outdated and frankly BS information being circulated like facts. I had a Band. I love my Band. My Band is working like gangbusters for me. I don't know much about the RNY so I won't debate it with anybody. You will, of course, make whatever decision is right for you, but be sure you research the options for yourself and don't trust any RNY patient's take on the Band or any Band patient's take on the RNY. In fact, don't trust any of our opinions. They don't count. Trust YOURS. Here's some forums for you to visit, if you like, people who live with the Band daily. They are a great resource. Best of luck to you. http://lapbandtalk.com/forum/ http://www.obesityhelp.com/morbidobesity/surgtype-forums/LapBand/ http://www.spotlighthealth.com/common/SG/topics.asp?m=1&sb=25 Jeanie
   — Jeanie

September 26, 2003
Forgot to mention .. Band adjustments are either done in the doctor's office, or in Radiology under flouroscopy. It's a quick procedure, generally less than 30 min. Jeanie
   — Jeanie

September 26, 2003
In response to this statement: "it is possible to eat your way thru this surgery" <P> Newsflash..It's possible to eat your way through ANY WLS. There is no cure for obesity. There are only tools. And any tool can be sabatoged if a person isn't mentally ready for a life changing procedure.
   — TMF

September 26, 2003
Hi- WOW, this one is always a touchy subject here. If it helps, I can tell you I was 100%, no turning back, getting a LapBand last fall. However, after more research, talking to Band people, and to 3 different (pro-LapBand) surgeons, I decided, and faced the fact, that I didn't have enough will power to use the LapBand correctly. With the LapBand, one can sabotage their weight loss by eating "around" the band. I used to have absolutely no will power- especially when it came to ice cream and shakes, so the Band would have failed me pretty quickly. I, of course, took forever to realize this because sometimes it's hard to admit our own weaknesses. The LapBand is a great WLS option, but according to my surgeon (who led the LapBand trials in my state) it's not a good choice for those who fail at diets because of lack of will power. I don't regret getting my RNY at all now, but I wish I was the type of person who could have lived with a LapBand. FYI- some other facts: 1) I'm another RNY person who is not hungry all the time...you've received some misinformation 2) the RNY can be reversed if absolutely medically necessary (as in life or death), but only by a few surgeons (mine happens to be one). 3)LapBanders can be successful, but statistically, not as successful as RNY or DS - this could be because there are so few Bands out there and it hasn't been around long enough to really compare. So I'd say, talk to a couple of doctors, talk to RNY and LapBand patients and research a TON until you make your decision. This IS FOR LIFE! Good luck!
   — toolio

September 26, 2003
I have the lapband and am thrilled with it! I am wondering if all the talk about hunger was about head-hunger instead of real hunger. I think with any surgery, you may have to battle the head-hunger. That is when your head said that it is hungery, but physically you aren't.<p> Whatever surgery you decide upon, realize that this is just a tool. With every surgery you can "eat around" it somehow. You have to totally change your eating habits. It takes a huge committment. If you don't change, and just rely on your tool, then you may not succeed. <p> One of the reasons why I chose the lapband was because I can adjust it for life. And I did do a ton of research and found that the lapband has great success if you see it as a tool. Don't just take the advise of American doctors because many of them are one-sided for various reasons. Many of the American doctors who were involved in the FDA trials did things poorly, like not filling the bands, and comparing results with the RNY after just a couple of months. The trials were a fiasco! Check the newer data coming out, and the International data. Don't rely on obsolete data.Sheryl (down 72 pounds in 5 months - Love my band!)
   — Sheryl W.

September 29, 2003
As my surgeon explained it to me, the band makes it much easier to cheat by drinking milkshakes, eating chocolate, etc. Also, the band will begin to deteriorate through the years. I opted for the RNY, myself.
   — Gail G.




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