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?