LAP-Band surgery is not a guarantee of weight loss, but new research shows that the number of post-operative adjustments can greatly impact a patient’s success. Conducted by David A. Nguyen, B.A., Grace J. Kim, B.A. and Carson D. Liu, M.D. of Skylex Advanced Surgical practice in California, the study analyzed the medical records of over 600 LAP-Band patients.
“For the patients who are able to make it back to their surgeon’s office, the adjustments are the key answer to continuing weight loss,” Dr. Carson Liu told DietsInReview in an interview.
The LAP-Band creates a small pouch at the top of the stomach, which allows patients to feel full after eating a small amount, roughly a half cup of food. The contents of this upper compartment then slowly pass through the band’s opening and are digested normally. “Once patients start to lose 30 to 40 pounds, a lot of the fat that is around the stomach and within the stomach wall is burned off, and they need to have that band filled,” said Dr. Liu. Each time the band is adjusted, it’s filled with a saline solution of isotonic salt water, tightening the opening.
Dr. Liu likens a banded stomach to an hourglass: “If you can envision an hourglass with the sand going through it, the patients themselves really get to control how fast that sand will go through in order to induce a feeling of satiety.” A LAP-Band can help patients feel full more easily, but following a portion-controlled diet and increased physical activity are still essential for weight loss success.
The study’s findings showed that patients who returned to their doctors for adjustments at least three to five times in the first year following surgery and six to eight times by the second year were the most successful in losing weight and attaining their goal BMI. The frequency of adjustments was found to be the most important factor in the success of weight loss as compared to simple clinic check-ups, support group attendance, or visits with dietitians and psychologists. Dr. Liu hypothesizes that regular appointments for adjustments may act as a more compelling motivation for patients than other aspects of weight-loss counseling.
For anyone considering LAP-Band surgery, a doctor’s availability for post-operative care should be taken into consideration. Surgery candidates should avoid having their operation at a hospital or medical office where it will be difficult to follow up with the doctor. Once a band is inserted, malpractice insurance policies will most likely prevent you from changing doctors, another factor that makes researching your options so important.
“As a patient, always get a second and third opinion,” said Dr. Liu. “Try to get a feeling of which doctor you like the most and which office you like the most. This is a long-term relationship. We see our patients three, four, five years out from surgery.”
June 23rd, 2011