Your Backstage Pass to The Band, Part 1

 

                                                                                                    Photo by M Clock

   And now for a few posts on the Band.  The other Band - not DMB.

   Gastric Banding is one of the surgical options we offer for weight loss, and it does have a role in Diabesity as well.  There are patient factors to consider, both behavioral and medical, as you (their PCP) either guide a patient to or from this choice as an appropriate surgical option.  Again, as detailed earlier, the surgeon that sees the patients before surgery go over each option with your patient, centering on the patient's choice and why, and their medical history and what can be expected from their desired procedure.  Rarely do they "talk them out of" their procedure of choice.

   Occasionally a patient has done their research and ONLY wants a Band, due to the "extreme" nature of the other options that require either intestinal "rewiring"(Gastric Bypass), or removal of a good part of their stomach (Sleeve Gastrectomy).  For these patients, it's likely a Band or nothing else.  Interestingly enough, other patients choose "anything but the Band" due to their worries about the safety of a long term implant.  Obviously, both have their merit.

   Is there a perfect patient for the Band that will definitely have long term success?  No.

   We have many Band patients that do well, sometimes losing over 100 lbs over 1.5 to 2 years, and love their Band.  We have some lesser BMI patients that plateau or don't lose much, usually owing to poor followup- which is the most important way to "guarantee" success with the Band.  Let's face it- the advantage of adjustability with the Band is also it's greatest downfall in that if the band is not adjusted properly, and/or  the patient does not "adjust" their lifestyle and dietary practices to the Band, suboptimal results will be realized.

   Furthermore, if you ask a patient how they are doing with their Band, and they have realized a modest weight loss, have newfound control over their dietary intake, and have either an improvement in quality of life or their medical co-morbidities, they definitely feel like they are on the road to success (See previous posts on Success in this Blog).  Again, all it takes, in most cases of obesity, is a sustained 10% weight loss to see modest benefit in quality of life and associated medical conditions.

   So, yes, the Band has a definite role in the surgical treatment of Diabesity.  In the next post, I will detail the Diabetes benefit and how the Band assists in that realm.