Diabetes Self-Management Blog

Gastric banding is all the rage. Seems like everybody’s banding. But how safe and how effective is this surgery? Does it “resolve diabetes,” as surgeons claim? I used to think so. But I was wrong. As years go by, complications and failure become more and more common.

Internet, television, magazines, and billboards advertise surgeries with slogans like “$2500 down!” “Comprehensive, Safe Weight Loss Surgery Program,” or “Let Your New Life Begin,” as one center in Beverly Hills claims. This clinic was in the news in 2009 and 2010 because of the deaths of several people receiving gastric bands at the facility shortly after surgery.

Who is all this marketing aimed at? You. Some studies are claiming dramatic improvements in diabetes and hypertension with banding. A study by the Dalton Surgical Group in Georgia (a group that does banding surgeries) found that “Dramatic improvement in — and frequent resolution of — diabetes and hypertension have been observed as a result of weight loss after Lap-Band surgery.” People with diabetes are now receiving gastric bands at body-mass index of 35 or below.

But the Dalton study, and some others showing benefit, only followed people for 1 to 2 years. Other studies show that gastric band problems increase over time. Bands may erode into the stomach. They may cause the stomach to become infected. They may slip out of place.

Some countries, such as Finland, no longer allow gastric banding surgery after studies concluded that as many as 40% of people had to have follow-up operations to treat complications. One study found that “The failure rate increased from 13.2% after 18 months to 23.8% at 3 [years], 31.5% at 5, and 36.9% at 7 years.” It may well go much higher after that.

A study published this year in Archives of Surgery reassessed about 80 people who had gastric bands inserted between 1994 and 1997. They reported that “because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), [banding] appears to result in relatively poor long-term outcomes.”

Even in people who had no major complications, many suffered pain and other serious discomforts. Dr. David Urbach of Toronto Western Hospital told CTV News he has treated patients who were “left in severe pain when their bands caused their stomachs to twist.” In other cases, the band’s plastic material had eroded into the stomach. In others, they slip because of vomiting or overeating, so the pouch size and shape changes, causing problems.

How does the surgery work? A band made of silicone, gortex, marlex mesh, or some other inactive substance is wrapped around the stomach near the esophagus. According to the British pro-surgery Web site Gastric Band, “The placement of the band will create a small pouch at the upper part of the stomach that will hold about 3.88 to 7.76 ounces of food for each meal.” So you will fill up faster and eat less.

Comedian Stephen Colbert had a funny but accurate take on this procedure, complete with video animation, which you can see here.

According to About.com, the new mini-stomach cannot handlemany foods. [A person may] “not be able to eat high fiber vegetables such as celery and sweet potatoes, meats like steaks and pork chops, spicy foods, fried foods, possibly citrus fruits, and certain spices including cinnamon, pepper, onion or garlic salt.”

About.com also says, “[Your medicines] may need to be adjusted following Lap-Band surgery since you will not be able to swallow pills that are aspirin-size or larger, or capsules or irregular-shaped pills.”

Surgeons say the studies finding high long-term failure rates are based on older bands and older techniques. They say more recent surgeries are less likely to have problems. But we won’t know for ten years, will we? We do know many people will experience nausea, vomiting, and constipation; many also experience hair loss, and infections are fairly common.

According to About.com writer Tracee Cornforth, who had a gastric band applied in 2010, “Eating after Adjustable Gastric Lap-Band surgery means taking tiny bites, and eating very slowly. You should think of your new stomach as a “baby” stomach. You’ll be drinking protein shakes and relearning eating skills much the same way as a new baby eats formula (or breast milk), and slowly adds new foods from blended baby foods to chunkier baby foods.” You also have to maintain a high protein intake (over 50 grams a day), which must be hard if you can’t eat meat. The band, in the words of one Canadian woman who lost 100 pounds, but suffered several infections and needed two replacement bands, is “quite unpleasant to live with.”

I used to think gastric bands were worthwhile for some people. They are less invasive and less dangerous than the bypass surgeries that change your intestinal plumbing. They are reversible if they cause too many problems. But if nearly 50% of them need to be reversed, and almost everyone is uncomfortable for life, they no longer seem worth it to me. What do you think?

POST A COMMENT       
  

Comments
  1. I have never thought this surgery was a good idea. I don’t think it is really less invasive than gastric bypass because of the materials used. I would certainly not want to be one of the guinea pigs when they’re trying to improve the materials to prevent all these problems.
    What the band does do is force people to eat very unnaturally and to forego many very healthy foods.
    I don’t think any of these gastric surgeries provide a “cure” for diabetes, either.

    Posted by Deb |
  2. Excellent and detailed information.

    I can see how a band drops volume of food.

    To suggest that fixes all in diabetes is ludicrous and very brave thinking.

    Banding cannot solve endocrine orgran aging and degredation and defects in that area.

    I have held my nose and interest on this one and see nothing but real trouble monkeying with human anatomy this way. Too dangerous.

    Posted by jim snell |
  3. This is quite accurate and in agreement with several reports, starting with the FDA trial that led to approval. That trial was reported briefly in JAMA and noted a high incidence of vomiting and a significant incidence of stomach necrosis. Nonetheless, the device was approved because people lost weight in the short term.
    The band does not cause malabsorption, but as you note food intolerances and freaent regurgitation can compromise nutritional status.
    Necrosis of the stomach is the most worrisome side effect. This results because the tight band cutt off the blood supply to the underlying stomach. It can take months to years to develop.

    Posted by Paul Ernsberger, Ph.D. |
  4. I wonder if the lining of the small intestine with a piece of teflon tubing is a safer and equally effective operation ?

    Posted by calgarydiabetic |
  5. I was under impression that first part of intestine has special absorption sites for certain mutrients. Here again monkeying with human organs is dangerous.

    Posted by jim snell |
  6. I had this surgery in 2005, not 2010 as noted in this article. In the first year, I had so much trouble eating enough protein that I lost a lot of hair and my naturally curly hair has turned straight. I now have to use anti-nausea medication constantly, but there are still days when I vomit up to 16 times in one day. Since this surgery, my teeth have almost all fallen out so it’s doubly hard to get nutrition between the lack of teeth and the restriction of the band. Unfortunately, my main food now is Little Debbie Swiss Cake rolls - eating one roll at a time (a whole package of 2 is too filling) - I am definitely lacking good nutrition.

    I also became uninsured about 3 years ago, so now I cannot afford to even see my surgeon. The band may be removable, but not without insurance or a huge amount of money, so I’m basically stuck. I thought this was the greatest thing ever, but after 7 years, I would not recommend this to anyone else.

    Posted by Tracee Cornforth |
  7. A Teflon coat on the small intestines would be similar to removing parts of them. The first part of the Duodenum is where large amounts of vitamins are absorbed, perticularly B12, a lack of which can cause many different nerve issues. Each part of the small intestines has it’s role in assimilating what we eat so that it can be used by our bodies. The entire digestive tract has a purpose and removing or altering parts can cause varying amounts of harm.

    I remember doing research about gastric bypass surgeries in my first year of med school and thinking, “how can anyone with a passing understanding of physiology think that altering or removing healthy portions of the stomach or small intestines is in any way smart? Even if they do, how is it that they are surprised when their patient is malnourished or dies from lack of nutrition???” iIt seems as though our fear of fat has made us all a bit stupid, which, in turn, is making us dangerous.

    Posted by DeAun |
  8. Tracee, I think you’d have a strong case (legally) to require your surgeon to remove the band at no cost or minimal cost. I would call the surgeon first, and if they don’t co-operate, try a lawyer.

    Posted by Carla |
  9. I’ve always thought if you follow the post-surgery diet, you’d lose just as much weight even without having the actual surgery. True or false?

    Posted by Carla |
  10. Thanks for sharing your story, Tracee. I’m sorry things have been so tough for you. I hope you can find some help with getting the band removed.

    Posted by David Spero RN |
  11. Good question, Carla. I wonder if anybody knows.

    Posted by David Spero RN |
  12. OK, I had this done in Aug. of 2009–3 years ago– and it was the best thing I ever did. Down 85 pounds, no more asthma, and my blood work is almost the best my doctor has ever seen. I thank God every day that thing is in there to prevent mass quantities of food to enter my belly!

    Posted by Mike V. |
  13. Me again (see positive review above). Anyone considering the band might google “gastric band reveiew” and see what the people with positive experiences (85% +) have to say, then compare the risk/reward of the operation to the risk of remaining grossly obese. I hope you make the right “business decision” and good luck! Just find the most experienced physician you can. Best, Mike

    Posted by Mike V. |
  14. Great Article!! All Weight loss surgeries carry complications but when the Band has 50% complications that’s NOT A VIABLE OPTION!!!
    I personally know too many people that have experienced, erosion of the stomach, Achalasia, Severe left shoulder pain with nerve damage, Daily vomiting,living with a feeding tube,pouch enlargement,and all the other complications that are due to lap Banding…ANYONE that loves their band BEWARE it’s only a matter of time and your’s too will need to be removed.
    YES,I had a band and I’m thrilled that it’s removed, however I still suffer to this day due to the Complications that are DUE TO THE BAND.

    Posted by Jackie O |

Post a Comment

Note: All comments are moderated and there may be a delay in the publication of your comment. Please be on-topic and appropriate. Do not disclose personal information. Be respectful of other posters. Only post information that is correct and true to your knowledge. When referencing information that is not based on personal experience, please provide links to your sources. All commenters are considered to be nonmedical professionals unless explicitly stated otherwise. Promotion of your own or someone else's business or competing site is not allowed: Sharing links to sites that are relevant to the topic at hand is permitted, but advertising is not. Once submitted, comments cannot be modified or deleted by their authors. Comments that don't follow the guidelines above may be deleted without warning. Such actions are at the sole discretion of DiabetesSelfManagement.com. Comments are moderated Monday through Friday by the editors of DiabetesSelfManagement.com. The moderators are employees of Madavor Media, LLC., and do not report any conflicts of interest. A privacy policy setting forth our policies regarding the collection, use, and disclosure of certain information relating to you and your use of this Web site can be found here. For more information, please read our Terms and Conditions.


Weight Loss
Techie Tools to Help With Weight Loss (08/18/14)
What Color Is Your Fat? (07/21/14)
Eating White Bread Ups Obesity Risk (06/10/14)
The Power of 5–10%: A Little Goes a Long Way (05/12/14)

 

 

Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.