It is usually a long and frustrating sequence of failed diets and exercise attempts that leads people to consider adopting a surgical approach to weight loss. But for many people who have been unable to lose weight by managing their food intake on their own, bariatric surgery can provide an effective solution.
Even after making the choice to seek surgery, patients face a decision about what type of procedure will be best for them, however.
Gastric Bypass or Gastric Band?
The more familiar gastric bypass surgery works in two ways–by restricting the amount of food that can be eaten and also by surgically altering the digestive tract to keep the body from absorbing excess calories.
The newer gastric banding procedures also work to forcibly restrict the amount of food a person can eat, and thus their calorie intake. Banding does not cut or reconnect part of the stomach or intestine, however, and because banding doesn’t fundamentally restructure the digestive process, patients don’t experience all the nutritional deficiencies and restrictions that follow gastric bypass surgery. Gastric banding can be reversed, and because it is performed laparoscopically, it is less invasive (though still major surgery), which naturally appeals to many people.
The Lap Band in Action
So how does the laparoscopic adjustable gastric band—better known as Lap Band—actually work?
In the video below, noted bariatric surgeon Dr. David Provost shows what the Lap-Band is and demonstrates clearly how gastric banding works to enable people to feel full while eating very limited calories, and thus lose weight relatively easily. As Dr. Provost explains:
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“The laparoscopic adjustable gastric band is just a band that is placed around the top of the stomach to create a small little stomach pouch that allows you to get full with less food. The inside of the band itself is like a balloon. The band is snapped around the top of the stomach—the stomach is the size of a little football. We put the band around the top so you have a little small pouch, maybe a golf-ball’s worth of stomach above the band.
“When the patient eats, food comes down and hits the band, fills up the little pouch, and gives you the feeling of fullness or satiety that you would expect if you had filled your whole stomach up with food without the band there. So you eat less, you’re not hungry in between meals, and you lose weight.
“The key to the band is the fact that it is adjustable. Inside the band there is a balloon. By adding fluid to the band we can make it tighter and by taking fluid out we can loosen it, and that determines how much a person can eat.
“It’s adjusted through this port. The port is placed on the abdominal wall beneath the skin. You can’t see it, you have to push hard to feel it, but in the office we can adjust it very quickly—it usually takes about 5 minutes—and it is that adjustment that really determines how much a person can eat and what their weight loss is.
The band, when you’re losing weight, is really not any different than your pants. When you lose weight, your pants get loose, and you have to tighten your belt so your pants don’t fall down. Well the band’s getting loose too. You have fat around your stomach just like you do around your waistline, and you’re losing it in both places. If you don’t come back in to have the band adjusted, the band’s going to get loose, you’re going to find yourself eating more, you’re going to stop losing weight, and you may actually start gaining your weight back.
“So we need to see people on a regular basis. We need to try to get people in every four to six weeks while they’re losing weight in order to ensure that we keep that band adjusted at just the right point so that they can have the best weight loss.”
An advisor and commentator for the Weight Loss Surgery Channel, Dr. Provost has more than 20 years of experience in bariatric surgery and was formerly Medical Director for the Surgical Management of Obesity at the University of Texas Southwestern in Dallas, Texas.