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Gastric Banding: What You Need to Know

There are two types of weight loss surgery procedures: malabsorptive and restrictive. A malabsorptive procedure reduces your body’s absorption of calories, protein and nutrients, but also decreases the amount of food intake at one time. It does this by shortening your digestive tract, thereby limiting the number of calories and nutrients that your body absorbs. This type of procedure alters your body’s normal digestive process. A restrictive procedure reduces the amount of food your stomach can hold, thereby decreasing the amount of food intake at one time and promoting a feeling of fullness faster with a smaller amount of food. Restrictive procedures do not affect normal digestion.

All weight loss surgery procedures require commitment to lifestyle change and self-discipline in order to lose weight, keep weight off, and avoid malnutrition and nutritional deficiencies. In terms of which procedure is best for you, that depends on your weight and BMI, comorbidities and general health, your weight loss goals, your lifestyle, and other factors. This decision is best made following consultation with an experienced weight loss surgery specialist.

The laparoscopic adjustable gastric band is a purely restrictive surgical procedure in which a silicone band is placed around the upper most part of the stomach, dividing your stomach into two portions—an upper, smaller portion and a lower, larger portion. Creation of the smaller stomach restricts the amount of food that can be consumed at one time. The band also slows the passage of food from the stomach into the intestine, causing a prolonged feeling of fullness following eating. The procedure is reversible, and the band can be adjusted as needed after surgery to increase or decrease restriction. There is less risk of the complications associated with the more invasive weight loss surgery procedures, as well as less risk of postoperative nutritional deficiencies and malnutrition; likewise, there are risks that are specific to the banding procedure, such as band slippage, erosion or deflation, stomach obstruction, dilation of the esophagus, and infection. Disadvantages include that the procedure generally achieves lower weight loss over a longer period of time, and it requires placement of the band (a foreign body), frequent follow-ups and adjustments, and strict dietary changes.

Patients who undergo laparoscopic adjustable gastric banding lower their BMIs significantly, lose a significant amount of excess weight,and experience improvement in several comorbidities, including type 2 diabetes, high blood pressure, sleep apnea, high cholesterol, and acid reflux.

In terms of whether the band is right for you and will result in successful weight loss, it depends on your own personal health situation and goals for surgery, as well as the advice of a doctor. You should seek advice from a weight loss surgery professional who has a multidisciplinary team in place to help you with all aspects of pre- and postoperative banding care.  Your surgeon should not only be experienced in placing bands, but also should have a follow-up program and team in place that sees you through your entire weight loss journey. Talk to an experienced surgeon who can listen to your personal health situation and goals and can discuss the laparoscopic adjustable gastric band with you.

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