Surgery

Gastric Banding Ensuring Post Operative Success



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Many people make the mistake of thinking that gastric banding (or lap-banding as it is commonly known) is the cheat’s way out of losing weight. The reality is that for the great majority of people who seek to have obesity surgery of any sort, is that it is the last resort of a long line of joining weight loss clubs, various diets, gym memberships, visits to the dietician, support groups and every other kind of weight loss method that is available.

For those considering gastric banding, they are at the point where they know, that if they don’t do something about losing the weight off their bodies, they will be dying a slow death, racked with chronic diseases such as type two diabetes, liver disease, gall stones, high cholesterol and cancer. They may perhaps even be facing the reality of a quick death from an exhausted and diseased heart trying to maintain a very neglected and sick body – sick from what is quite often the result of poor lifestyle choices.

And so, the person who has made it up in their mind that they are ready to take on the weight of such a decision as to undergo a risky surgical procedure, so that he or she may end up saving his or her own life – ends up in the surgeon’s office, discussing his or her predicament.

Granted too, it is a very expensive procedure, costing thousands – even with private health insurance.

The surgeon will outline the risks of the procedure, and then the potential gastric banding patient will be sent to a psychologist, to undergo an assessment as to whether the person is willing to undergo a permanent lifestyle change in order to be permitted to undergo surgery.

The surgeon will not operate on a person who is not fully committed to the lifestyle changes that he or she will make. Yes, a silicon gastric band is reversible, but quite often, when a gastric band is removed, the person quickly puts all of the weight back on, and then some more – undoing all the hard work that had been put into the weight loss. Thus, when one gets a gastric band, it is mutually understood between surgeon and patient – that it is for life.

So the decision is made, the person has approval from the surgeon, and the psychologist is happy for the person to undergo the surgery.

The patient gets about two weeks or so to consume a VLCD (very low calorie diet) usually something like Optifast, so that the glycogen is emptied out of the liver. The liver has to be significantly shrunk to allow the surgeon to get his instruments in behind it to be able to access the stomach – safely. It the liver is too large, there is too much risk of injury too the patient, and the surgeon will not go through with the procedure.

There have been cases such as when a person has been half-committed to following the VLCD and when opened up on the operating table by the surgeon, the liver was still large. The patient was stitched back up, and the surgeon gave the patient back her money, and told her to come back when she was more committed.

After a successful operation though – the journey has just begun. It is said among people who have had gastric banding done, that it takes a good two years to get the band “around your head.” It is very much a psychological process that must take place – the person must understand that losing the weight is not an automatic process – it takes discipline.

Guaranteeing the success of a gastric band post operation requires a team of people who will support the newly – banded patient on their weight loss journey.

A person who goes off unsupervised, and doesn’t follow up with significant lifestyle changes, and remains accountable to nobody is not likely to find having the operation of much help to him or her.

Take the personal gastric banding journey of a lady name Joanne* (*name change for anonymity).

Joanne at her heaviest weighed 140 kilograms (308 pounds). Her father-in-law's dying wish was that she go and do something about her weight, because he didn’t want her to die of obesity – related illness.

About seven months after her father in law’s passing, Joanne underwent gastric banding. She was sailing successfully. She lost 30 kilograms (66 pounds), and then her own father passed away suddenly. Also during that past 12 months, she had been in a serious car accident.

Joanne began working in a disability care service organisation, and fell into a deep depression – she worked two days per week, and on the days where she had to get up early – would consume sugary energy drinks, and litres and litres of cola. She was also eating lots of chocolate (which slipped easily through the band) and buying iced coffees all the time. She subsequently regained 18 kilograms (39.6 pounds).

Why did she regain the weight she had taken so much effort to lose? She says she had gone off on her own, lacking a support network, isolating herself socially. She then lost her job. Subsequently Joanne had to be admitted to hospital for depression. She felt defeated and dejected.

Soon after being released from hospital, she visited her primary health care physician. She was then referred to a mental health nurse to help her cope with the symptoms of her depression, and underlying eating disorder.

Joanne began to see a psychologist to help her deal with her grief over the loss of both her father, and father-in-law. She slowly became more and more interested in her personal health. Joanne, on a regular basis was being supported by her mental health nurse who was gently encouraging her to take more ownership in making healthy lifestyle choices, one step at a time.

Joanne began to minimise the amount of processed food that she ate. She cooked things from scratch, and began to incorporate more whole grains and natural foods into her diet such as fresh fruit and vegetables.

She served her meals off a small bread and butter plate, and was no longer finding it difficult to keep down her meals. Her health was improving significantly. Slowly the weight began to come off.

Joanne’s psychologist and nurse, and primary health physician helped her work through how she felt about herself. Joanne began to be able to find other ways to comfort herself other than with food, and sought comforting things such as getting a massage to ease away her stress. She was no longer consuming energy drinks and litres of cola.

One day when Joanne was in her doctor’s surgery, she noticed a brochure for an exercise physiologist. She discussed this with her mental health nurse, and was encouraged to make an appointment.


Joanne now works out around 3 times per week, whereas previously she was not exercising at all. She now views parking her car further away from the store as an opportunity for movement, rather than an inconvenience.

Slowly, steadily, Joanne’s sense of self has improved. She is more self confident, and treats herself kindly – she believes that she is worthwhile taking care of. She has enlisted caring, supportive allied health professionals, as well as her primary health care physician to assist and encourage her in her endeavours. They help to keep her accountable. She is also now seeing a dietician, and keeps a food and exercise diary.

In sharing Joanne’s story it is hoped that for people considering having gastric banding, that they will understand the significance of having a support network – and that the lack of a support network can adversely affect the outcome of having had the operation performed.

In Joanne’s case – it demonstrates that the support network in her case has helped her get back on track and is being conducive to her ongoing weight loss. Since the gradual introduction of her support network over the last 12 months, Joanne has lost 14 kilograms (31.8 pounds). She also has excellent liver function, perfectly normal blood pressure, and excellent cholesterol levels. She is happy, healthy, and more confident. There is now a lightness and spring in her step. She smiles more readily and is looking forward to a long and healthy future.

It is not an easy journey, but for those considering it, or those wishing to help and support a loved one who wishes to undergo it, never underestimate the importance that a group of support people (such as a therapist to deal with the psychology of eating, a dietician to monitor food intake, and an exercise physiologist to encourage regular and safe exercise) will have on ensuring the chances of success and lack of complications post operation.

It may just come down to also saving that person’s life. 

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