Central Texans, like most Americans continue to grapple with the challenges of maintaining their weight by managing calories and portion sizes. For those who have tried and failed, sometimes repeatedly, many turn to the newest approach to surgical weight loss, laparoscopic banding. Lap bands are less invasive, carry a lower risk of complications or death and are fully reversible. Unlike gastric bypass surgery, the stomach is not altered surgically and no sutures or staples remain in the body, eliminating the risk of leakage.
Lap bands were first introduced in Europe and have been approved by the FDA since 2001. They are popular with consumers because they require a shorter hospital stay, offer quick recovery and generally allow patients to enjoy a better eating routine. The trade off is that weight loss is not as rapid and patients have to work harder to retrain their eating habits. It sometimes takes as much as two years to achieve the same level of weight loss as surgical gastric bypass.
"A device is placed around the upper portion of the stomach," says surgeon Steven M. Fass , MD, Capital Surgeons Group, PLLC, who works with Seton Medical Center Austin's Weight Loss Surgery Program. "It has a balloon that can be inflated with saline solution. It restricts how much you can eat."
The surgeon can then inflate or deflate the balloon by injecting or removing sterile saline solution to control the size of the restriction. Lap bands work whether you heed nutritional advice or not, as long as you follow quantity advice.
"You don't have to eat better food on this diet, just less of it. Eating a balanced diet will help in other healthful ways, but it not required. It is not magic - it still requires a commitment to change, because a person can take in liquid calories such as ice cream, milkshakes or beer which will go right through," continues Dr. Fass.
But a growing number of people, over 170,000 last year in the U.S., are choosing this form of weight loss after failing at several other weight loss attempts.
"I think it's the choice of lots of younger people who are obese, but not by 200 or 300 pounds," observes a Seton colleague who asked not to be identified. "You can eat anything you want, just not as much. "We eat out often and I just eat a lot less than the others at the table, but many people don't even know I've had the procedure. One of the best parts for me is that the gastrointestinal problems I was having have completely disappeared. And it allows me to be much more active and comfortable."
Dr. Fass notes that most of his patients have tried some other diet approach in the past and may have been successful, but put the weight back on. "This approach is for someone who has a body Mass Index over 40 or over 35 if they also have at least one obesity-related health complication such as diabetes or heart disease."
It also affects the sensation of hunger and almost everyone has some food that causes them problems. "Most of my patients struggle to eat in the morning and almost never can eat bread. They also have to learn not to consume liquids with meals, such as water or iced tea, even beer or wine."
Dr. Fass often becomes close to some of his patients because of how involved he stays in their lives. When you select a bariatric surgeon, generally it is a commitment to a long-term relationship. "For this surgery, you are not just choosing a technician, but someone who is committed to an entire program to help patients change their lives. It requires frequent visits for possible band adjustments. We all do our own adjustments. Unlike patients who have other surgeries and possibly never see the surgeon again, these patients must have a surgeon as long as they have a band."
Seton provides a monthly support group that meets the second Thursday of every month. "We schedule speakers, select topics, plan activities and have a huge holiday celebration in December," says Weight Loss Surgery Program Director Linda Martin, RN, BSN, CNOR. "Our goal is to keep track of our patients for at least five years
Dr. Fass joined one of the patient support groups for a meal at a restaurant. It was amazing, he said. "Everybody got a to-go bag except me," he laughs. He also describes patients he has treated to completely change their lives. "It is heartening to see people come in with low self-esteem who lose weight. Some even have run marathons," comments Dr. Fass, who is a road biker and triathlete himself.
"If sometime in the future, science comes up with a magic weight loss pill, the lap band can be removed. But for the most part, experience has shown that people who have it removed go back to their old eating habits, so patients should count on having it for the rest of their lives."
Linda Martin and her staff at the Seton Weight Loss Center are available to answer questions at 512-324-3404.
Edie Morris' Story
Edie was a patient at the Weight Loss Surgery Program at Seton Medical Center Austin. Her surgeon was Mark Sherrod , MD, Capital Surgeons Group, PLLC. This is Edie's story:
"Tired and depressed." That's how Edie sums up her previous life when she struggled to control her weight. And with two active kids, ages 5 and 7, and a demanding job as Director of Finance, there was no time for feeling tired and depressed. Something clearly had to give. Edie attempted every weight control method available, with no lasting success. Food still had control over her.
Then she read about the Lap-Band procedure on Seton Medical Center Austin's Web site. She dug deeper, learned more and grew confident this was the procedure for her. She attended an orientation where a patient who had undergone the procedure spoke to the group honestly and directly, addressing the fears and misconceptions shared by the group. Edie's excitement grew even further - finally there was an ideal option for her.
Looking back, what amazes Edie most is how convenient and easy the entire process was for her. It only required a single day, and the Seton team took exceptional care of her every step of the way. Edie has shed a full 100 pounds, with plans to lose more. Rather than tired and depressed, these days you find Edie hiking and camping with her two children, whisking them to soccer and football, or exercising on her own.
"EVERYTHING I do feels more comfortable now," she says. "For the first time, I feel comfortable in my own skin."
Attend One of Seton's Free Weight-Loss Surgery Seminars
Find out about weight-loss surgery options offered at Seton Medical Center Austin, as well as risks, benefits and qualifications for weight-loss surgery. This free informational session will be presented by a surgeon who practices with Seton's Weight Loss Surgery Program. Reservations required. Register online or call (512) 324-4456.