How long to keep the band in after it is deemed ineffective?

by Jennifer Conway
(Bahrain)

I had gastric band fitted over 6 years ago. I’ve failed to lose more than 10 kgs (22 lbs) total after a year and spending a lot of money and time visiting the surgeon to have my band filled and adjusted. I’ve finally given up.

My main disappointment was that I never felt full. I was told I would not be able to eat a lot anymore. My meals where the size of a fishcake, but I always felt hungry.

I maintained my weight loss by willpower alone; I didn’t really need the band at all. Now 6 years on I am experiencing a burning sensation in my mouth and throat and a slight gurgling sensation in my stomach, not much discomfort really.

I went to the doctor and he gave me a bottle of antacid! I know I don’t have an upset stomach.

First, how long do patients typically wait to have the band removed after it has been deemed ineffective?

I’m also afraid that the reason the band isn’t working is that the band has grown into my stomach. Is this life threatening?

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Response to ineffective Lap Band

by: Dr. Marc Bessler, Center for Metabolic & Weight Loss Surgery at New York Presbyterian Hospital/Columbia University Medical Center

Dear Jennifer,

I am sorry to hear about your struggle to keep weight off with the band.

Unfortunately Lap-Band seems to have the least success. You are right to say that controlling hunger is what a weight loss operation should do and it seems like less than half of Lap-Band patients get hunger control.

Most concerning is the reflux you describe which means your band is too tight or has slipped. You should have the band loosened and perhaps removed.

If the band is in good position you could consider just loosening it and trying again with better guidance. You might also consider a gastric bypass or sleeve gastrectomy.

For the up to one third of patients like you who do not lose weight well with a band I usually recommend gastric bypass and loosen or empty but leave the band in place if it is in good position. If the band is not in good position I would remove it and then do gastric bypass.

Sleeve is also an option especially if weight loss was good with the band but even if not. Most people who do not do well with band still do very well with bypass and perhaps a bit less well with sleeve.

Best of luck.
Marc Bessler, M.D.

long island bariatric surgeon

P.S. If you've found my recommendations or this website helpful, please share on your favorite social media platform or tell a friend about us. Thank you!

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Determine the Real Issue

by: Lap BAND GROUPIE

If you've been having regular ongoing appointments with your Doc for six years and have never had proper restriction, and you've been following all your Doc's instructions/Band rules, then you need a new Doc. If you are following the Band rules, then either you're not at the right fill level (which your Doc should have solved in much less than six years…and I do have to note that you mentioned 'a year' and many Banders take a little more than a year of fills to get to the right restriction depending on their Doc's fill schedule/amounts and their own anatomy), or you have a Band complication that your Doc is not addressing…either way, if you've pressed this issue with your Doc (if not, go back to your Doc with a list of questions and possible tests), then you need a second opinion. I would have expected by now that at least you would have had: a complete empty and refill (first test for a Band leak to see if the saline is all still all there), then a barium swallow and a fill under fluoro as well, to show exactly how your restriction is and to confirm that there are no complications…no slip, erosion, Band leak, or esophagus problems like enlargement (most likely suspects for no restriction)…they may need more detailed x-rays as well and perhaps a scope/endoscopy/EGD. Mild reflux is a very common side-effect of Banding and as long as it's completely under control it shouldn't be an issue. The first step for mild reflux is an antacid like your Doc gave you (for the acid burning, not an upset stomach). I will also mention that if your esophagus has enlarged (caused by overfilling the pouch) that can effect how well the flap at the bottom of your esophagus can keep the normal stomach acids from coming up the esophagus and causing reflux. Yes, erosion can be life-threatening as the opening in your stomach wall can get infected, but it isn't likely that this has happened (much more likely that you just never got to the proper fill level). You need a Doc that will figure out what is going on. The Band can be removed at any time, but whether insurance will pay for the removal and under what circumstances would have to be discussed with your insurance company. Best Wishes!

Could your band have slipped?

by: Lonicera The Bandit

I wonder if your band slipped a long time ago, say after the first year - I'm surprised your surgeon didn't eliminate that option early on. Certainly he doesn't sound as if he's doing the right thing by you. There's only one thing you can do for yourself now, before anything else, and that's to find out what's going on inside. Only then will you know whether to remove the band, or have it adjusted properly. I think the only way it could become dangerous to you is if it stopped you eating most foods, and (more importantly) it stopped you drinking altogether... and you did nothing about this. But you clearly suspect something's up anyway, so that won't happen. If it has slipped and they can put it right, then you've lost a few years, but it's not the end of the world. I hope you'll let us know how you got on. Lonicera The Bandit

Mine does not work either

by: Mindy

I had my band about 6 yrs ago as well. After losing 125 Pounds and going in for fills and unfills and slipping it twice I found out I can no longer get fills or my esophagus will get closed off due to excess scar tissue from the slips. My band is still in, and unless i come up with $16,000 to have it removed or it becomes and emergency situation it will stay there ! What kind of concerns me about your situation is your having acid reflux, which you should not be . If your having it all the time and your doctor does not take it seriously I would get a second opinion, it typically means something is too tight some where, you may not be able to feel it but its not "right". The first sign something is going wrong w/ my band was acid reflux.Your band slipping CAN be life threatening if its not treated right away when things go wrong. If i were to throw up a lot over and over again and my stomach get swollen i could have to have it removed in an emergency . So I would get a second opinion for sure ! Hope that helps Mindy

Research related to your questions

by: Jeff

Hi Jennifer,

There is a lot of information on this site that should help to answer your questions.

The following pages are a good place to start (be sure to follow any links within the following pages to learn even more)...

1) Lap Band Surgery Results - the good and bad outcome possibilities
2) Lap Band Surgery Failure - the main reasons why lap band surgery fails, including lap band erosion (the problem that you asked about)
3) Lap Band Problems & Lap Band Complications - a complete list of potential issues with the band I hope that helps!

Take care,
Jeff

Lap Band Failure

by: Gina L.

I got my lap band 7 years ago and got pregnant shortly after. After having a healthy baby, I went to focus back on my weight loss journey and kept going in for fills. They were doing very minimal fills and it was seeming like a money gimmick.

After severe vomiting, I was emptied completely and lived life for several years without any real issues until this past year. I developed really back acid reflux and heartburn. Initially I thought it was because I had taken ibuprofen too often, come to find out after several appointments and several medications, my stomach had prolapsed and I had a bad case of esophagitis due to the reflux.

Dealing with this, this past year has been terrible. Heartburn and vomiting everyday no matter what I ate or drank. Vomiting in my sleep that could be life threatening, and having to stop all medications because they were not being properly digested. I have had to drink liquid antacid for months, just to try to live normally.

Who knows what damage Im causing to my body with that stuff. After being initially denied by my insurance for band removal, by the grace of God, my appeal was overturned in my favor. I should have my band removed within a months time. Wish me well.

i lost 40 kgs

by: Fatima

Hi,

I had my lap band 2009. I lost 50 kgs in total, and i gained 10 the past 4 years, wich is normal considering i am now 38 - heheh.

I did not only rely on the band, but also was trying to exercise in order to minimise the effect of having sagging skin. 80% worked!

in the beginning i was eating whatever, but i was still losing weight. Then i started learning how to eat healthier as well.

It was not a super easy journey, but i learnt to listen to my body carefully and find solutions for all the side effects. It worked!

I have to admit that I developed gluten allergy, but to be honest it is ok, less reasons to eat sweets ;)

However, this year, i feel i am not comfortable with it. Not sure about the reasons. I am doing more muscles related exercises, so perhaps my body is changing and developing kind of pressure on the items? I have to go to the doctor.

I also started experiencing some vomiting or need to vomit. and discomfort with the valve part. Either my body now is tired of having a strange object, or my muscle formation is changing .. i don't know.. perhaps something else anyone can advise me about?

I feel now that i would like to take it out. 10 years in my eyes is enough period to keep a strange object inside my body. That is also why i like lab bands: it can be reversed and I still have my stomach.

I am optimistic that i will be able to maintain good eating style. It will be challenging in the beginning because eating will become an easy thing, but with exercises and remembering the kilos i shred, I am confident I will do well.

Any comments?

Lapbamd not working cause insurance company won't pay for fillers

by: Sonia

My lapbamd did not work or perform as it suppose to due to the fact of my insurance company would not pay for fillers. I've gained all my weight back and some, however it seems to help control my intake, but my thighs has inlarge.

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