The Realities of Lap-Band Surgery – Are You Willing To Live With The Consequences?
As obesity becomes the leading cause of chronic disease in developed countries worldwide, everyone is looking for solutions and many people are desperate to lose weight.
Now, more often than not gastric banding (lap-band) surgery seems to be the go-to procedure.
Sure, the results seem impressive – radical weight loss in short periods of time with apparently minimal effort.
But what happens when it all goes wrong? What are the long term effects on health?
More importantly, what about the reasons why individuals become obese in the first place?
Can the benefits of a drastic surgery really outweigh dietary education, positive lifestyle changes and dealing with underlying psychosocial problems?
The Lap-Band Procedure
Lap-band surgery involves the placement of a gastric band around the upper part of the stomach, creating a small pouch that can hold only a small amount of food.
The band between the stomach pouch and the rest of the stomach controls how quickly food is passed through the stomach in an aim to increase satiety and limit the amount of food that can be eaten at one time. It also increases the amount of time it takes food to be digested.
To tighten the band following surgery, salt water is injected into the band via a port under the skin.
In Australia, lap-band surgery is usually a key-hole surgery day procedure, costing around $10, 000 through the private healthcare system.
A Life-Threatening Decision
While it may seem like a quick and easy fix for obesity, lap-band surgery carries considerable risks. In extreme cases, it can cause life-threatening complications or set you up for years in and out of hospital for corrective surgeries.
Apart from standard surgery risks, most of which are more serious when operating on overweight people, complications of the Lap-band procedure may include:
- Digestive symptoms including nausea, vomiting, heartburn and abdominal pain
- Gastro-oesophageal reflux causing increased rates of oesophageal cancer
- Lap-band slippage or erosion requiring follow up surgery
- Poor digestive function including difficulty swallowing, constipation
- Malnutrition causing anaemia and symptoms such as dry skin, hair loss and muscle wasting
- Bowel and gallbladder problems commonly leading to gallbladder removal
- Liver failure
- Kidney stones or renal failure
- Serious infections involving the surgery wound, lap-band or surrounding organs in the abdomen
- Excess loose skin following weight loss that may require surgical removal
A study published in 2011 showed that in a sample population of lap-band patients, 22% experienced minor complications, 39% experienced major complications post-surgery and 60% required lap-band removal or adjustment surgery, primarily due to band erosion in the 12 years following initial lap-band surgery.
Researchers concluded that despite substantial weight loss, lap-band surgery appears to result in relatively poor long-term outcomes.
Life After Lap-Band
General recommendations for post-surgery recovery include following a liquid diet for 2-4 weeks, followed by a vitamised (blended) diet for another 2-4 weeks as the lap-band settles into place.
Drinking enough fluids just to avoid dehydration will be a difficult task with your newly reduced stomach capacity, and vomiting is likely to occur if you drink or eat too fast or too much at once, and do not chew thoroughly enough.
Fluids must be restricted in the half hour before, during and after meal times to avoid overfilling the stomach.
Finally, once the band has settled and inflated, the post-surgery diet can move towards a more normal diet, however it is recommended to stick with soft and easy-to-chew foods.
Some foods such as pasta, rice and bread may need to be avoided permanently as they expand too much when they hit the stomach pouch and come into contact with gastric fluids.
While a normal stomach can hold up to 4 cups volume of chewed food, after lap-band surgery, only around 1 cup of chewed food can be help in the smaller stomach pouch, so meal sizes will need to be drastically reduced.
Snacking between meals should also be avoided and supplementation with multivitamins becomes an every day necessity to compensate for the lack of nutrients obtained from the diet.
Food getting 'stuck' in the entrance to the stomach pouch and productive burps or spit ups are common occurrences post-surgery which happen when a piece of food that is too big hits the stomach pouch and cannot be digested, so travels back up to the throat.
Risks Of Rapid Weight Loss
So you might lose a lot of weight after surgery and manage to reach a 'healthy' BMI (Body Mass Index), but does that mean you are healthy?
Quite the opposite!
Rapidly releasing so much stored fat from fat cells during weight loss, as well as the toxins that have built up over a lifetime and been stored in those fat cells can have disastrous consequences on health.
Firstly, the body and particularly the liver are exposed to more toxins than they can safely handle and eliminate from the body. This means the toxins end up circulating in the blood stream causing damage to body tissues and cells.
The liberated fats can also cause serious liver and gallbladder problems such as gallstones and fatty liver.
This happens because there is more fat in the body than the liver and gallbladder (bile-producing organs) can safely process and eliminate via the digestive tract.
Once gallstones are a problem, gallbladder removal surgery is often the next step in action, and can further exacerbate the problem causing worse reflux, fat malabsorption and ongoing unpleasant digestive symptoms such as diarrhoea.
You Can Still Gain Weight After Surgery!
If you stick to your old eating habits and eat larger amounts than recommended post-surgery, the smaller stomach pouch created by the lap-band can be irreversibly stretched.
This cancels out the restrictive effect of the lap-band on the stomach and appetite, and will require surgical correction.
Eating calorie-rich, nutrient poor foods like soft drink or chocolate bars in liquid form will slow or stop weight loss as well.
If you missed Australian Lap-Band patient, Kate Finlay's story on the recent 'Fat Fighters' episode of Insight, SBS, click on the following link to read about her fascinating but devastating experience with lap-band surgery.
It's Your Health And Your Responsibility
If you are considering having Lap-band surgery, educate yourself on the procedure and think very carefully about your decision.
You owe it to yourself to properly research the risks and benefits and make an informed decision as it is going to affect you for the rest of your life.
Maybe you need to look at why you have reached this point and what you could do to change the factors that are stopping your from losing weight non-surgically, whether they are lifestyle, dietary or psychological.
There is no denying that losing weight can be a very difficult process, even more so without the right assistance, but fad diets or rash decisions are not the answer.
Even with lap-band surgery, you will need to commit to changing poor dietary habits as well regularly exercising for permanent weight-loss success.
Ask yourself this, if you were to make these changes before having lap-band surgery, would you need the surgery at all?
To connect with an Integrative Healthcare practitioner and discuss healthy weight management options, click here.
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- Weight Management Resources
Himpens, J. et al. 2011, Long-term outcomes of laparoscopic adjustable gastric banding, Archives of Surgery, Vol. 146(7)