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Lapband surgery: not the bandaid solution for obesity

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By Leisa St Ledger


Obesity

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Obesity Specialist

Dr Douglas Nicholson
Dr Douglas Nicholson

Lapband Surgery

Recently in the media there has been much talk about lapband surgery for obese people as a cost effective way for our health system to deal with extremely overweight patients.

Before you pick up the phone to book your lapband consultation, you need to know some very important things. Lapband surgery is a serious operation, with real risks, and for some people despite what they go through with the process, it won’t be a solution for them anyway.

Search the internet and you’ll find dozens of lapband, or bariatric clinics that perform the surgery, in the same way that you would if you were after a boob or nose job. Be sure to research the topic thoroughly and get your information from an independent source. Do not consider lapband surgery a form of cosmetic surgery, it definitely isn’t.

Currently, it’s estimated that around 10 percent of the Australian adult population is obese, that’s an alarming statistic. Associated health problems include diabetes, heart disease, hypertension, sleep apnoea, arthritis, and reduced mobility and life expectancy. Despite all these health risks, obese people should consider lapband surgery a last resort.

Lapband surgery is not the easy answer. This procedure alone won’t make people lose weight. They must also follow a vigorous diet and exercise regime, and will quite often suffer unpleasant side effects from the surgery, for example, regurgitating their food.

The laparoscopic gastric band assists weight loss by: firstly, pressing on the stomach so the brain feels it is full after a very small amount of food, and secondly, the band creates a smaller stomach so less food is required. The band reduces the size of the passage through which food passes, thus taking longer to digest.

This results in a feeling of satisfaction and the loss of hunger after a small, solid meal is eaten. If more food is eaten in the next hour or two, an overfull and bloated feeling will be experienced and regurgitation may occur.

The procedure is normally only offered to people who are extremely overweight, with a BMI of 35. Many doctors prefer the BMI to be closer to 40.

Your BMI (or Body Mass Index) is used to categorise the degree of obesity.
To calculate your BMI, divide your weight in kilograms (kg) by your height in meters squared (m2). For my international readers '1kg' is equivalent to '2.2 pounds'.

The categories are as follows:

  • Less than 20 - underweight
  • 20 to 25 - normal weight range
  • 25 to 30 - overweight
  • 30 to 40 - obese
  • 40 to 50 - morbidly obese
  • More than 50 - super-obese.

Other surgical procedures available to the morbidly obese also include: stomach stapling, bowel bypass or jaw wiring. A walk around the block followed by some carrot sticks doesn’t sound so bad, does it?

The band can be adjusted if there are problems with eating. It can also be loosened by an injection through the abdominal wall, or if insufficient weight has been lost, the band can be tightened.

Complications can include; infection, leakage from the stomach, thrombosis or embolism, problems associated with the medications and methods used during the procedure, or even death. While these complications are considered uncommon, they are certainly not unheard of.

Outspoken Australian youth worker Les Twentyman is currently in a critical condition in an induced coma in The Alfred hospital after undergoing lap-band surgery in late February.

In 2007 a New Zealand woman died after travelling to Malayasia to have lapband surgery. After the surgery she went to a resort to recuperate, where she collapsed and died.

Lapband surgery is completely reversible, however weight will inevitably be regained as the genetic tendency resulting in obesity can never be cured and is only modified by surgery.

The kicker is, that if you do have successful lapband surgery, and go through all the unpleasantness post surgery, you may not get the results you’re after. The weight loss will only be successful, and long lasting if the patient sticks to healthy eating habits and regular exercise.

Now, from this perspective, doesn’t it seem so much easier just to eat healthy food and go for a walk every day? Lapband surgery is not a road to be lightly traveled.

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