Adjustable Gastric Banding

GENERAL INFORMATION:

What is gastric banding? Gastric banding is a type of weight loss surgery. It is done to help an obese (very overweight) person lose weight. During surgery, caregivers put a soft, hollow band around the top part of your stomach. This divides the stomach into one small pouch and one large pouch. When you eat, food collects in the small pouch. Because the pouch is very small, you will feel full quickly. There is a small opening (stoma) in the smaller pouch which allows food to pass into the larger pouch. Between meals, the food moves slowly into the larger pouch and is digested (broken down) normally. Over time, you may lose weight because you feel full sooner and cannot eat as much food during a meal.

How can my gastric band be adjusted?

• Your gastric band has a tube and "port" connected to it. The port is a small hollow pillow. During gastric banding surgery, caregivers attach the port underneath your skin in your upper stomach.
  
  
• About four to eight weeks after surgery, caregivers may "adjust" (change the tightness of) your gastric band. Caregivers tighten the band by injecting salt water (saline) into the port using a shot with a tiny needle. The saline flows through the port, up the tube, and into the gastric band. This causes food to pass more slowly out of the small pouch and into the rest of the stomach. Caregivers can make the band looser by removing saline from the port. This causes food to pass more quickly out of the small stomach pouch.
  
  
• You may need one or more adjustments to your band while you are losing weight. It is very important to work closely with your caregiver to keep track of your progress. After surgery you may need to visit your caregiver each month or between longer periods of time. How often you visit your caregiver will depend on the type of weight loss program that you have.

• Multiply your weight (in pounds) by 703. For example, if you weigh 300 pounds, this equals 210900.
  
  
• Multiply your height (in inches) by your height (in inches). If you are 65 inches tall, this equals 4225.
  
  
• Divide the first number (210900) by the second number (4225). This equals 49.9. This is the BMI for a person who weighs 300 pounds, and is 5 feet, 4 inches (65 inches) tall.

• You have tried, but have not been able to lose weight or keep weight off. You may have tried exercise, diets, and weight loss medicines.
  
  
• You have a BMI that is one of the following:
  
  
  • BMI greater than 40 (about 100 pounds or more overweight).
    
    
  • BMI greater than 35 with a life-threatening health problem that is related to being overweight. Examples of these health problems are heart disease, sleep apnea, high blood pressure, and diabetes.
  
  
• Your obesity causes problems with employment (getting or keeping a job), lifestyle, or movement such as walking.
  
  
• You are willing to change eating habits and make the lifestyle changes needed to lose weight and keep it off. You agree to work closely with a caregiver or weight management team. You understand what will happen during and after weight loss surgery, and you accept the risks.
  
  
• You will need to talk to caregivers to learn if you would be able to have bariatric (weight loss) surgery. You will need to meet with a surgeon to talk about surgery options. The surgeon may ask you to meet with other caregivers for exams and tests. For example, you may need to have a psychological (mental) test. You may need to talk with a specially-trained caregiver about your eating habits. Medical records and test results from other caregivers will help the surgeon decide if you should have this surgery.
  
  
• You do not abuse drugs or alcohol.
  
  
• Your obesity is not caused by a problem with your glands.

• American Society of Bariatric Surgeons (ASBS)
  100 SW 75th Street
  Gainesville, FL 32607
  Phone: 1-352-331-4900
  Web Address: http://www.asbs.org
  

• Gastric banding may help you lose weight by decreasing the amount of food you can eat during meals.
  
  
• Gastric banding is adjustable. This gives you control over how fast or slow food goes through your stomach. A gastric band adjustment can be done without your having to have more surgery.
  
  
• Gastric banding is reversible. This means that you may have the gastric band removed if you ever want or need to.
  
  
• Losing a large amount of weight may decrease or get rid of obesity-related health problems. These problems include diabetes, and problems with your heart, blood pressure, and joints.
  
  
• Losing a large amount of weight may increase a woman's ability to get pregnant.
  
  
• Losing weight may help you feel better about yourself, your body, and life in general.

• You may bleed too much or get an infection. You may get blood clots. Your esophagus or other organs may be injured during surgery. The gastric band may slip out of place, break or leak. The band may cause a scar or may erode (eat into) the stomach tissue. You may have problems during laparoscopic surgery that cause you to need a laparotomy (open surgery). After surgery, you may lose weight and then gain it back. You may not lose any weight. If you get pregnant while you are quickly losing weight, this could harm you and your unborn baby.
  
  
• If you often eat too much and do not follow instructions, you may stretch out your stomach pouch. If you eat too much, too fast, or do not chew well enough before swallowing you may have other problems. These problems include feeling sick to your stomach, having a stomachache, and throwing up. You may get acid reflux (heartburn) or a stomach ulcer. Food that is not chewed well enough may get stuck in your stoma (opening between the small and large stomach pouches). You may not get enough protein and vitamins from your diet, especially if you vomit a lot. This may lead to some hair loss, anemia or other medical problems. You may need another surgery later. As in any surgery, you may even die of complications.
  
  
• It is important to follow your weight loss team or caregiver's instructions for the rest of your life. This includes changing your eating habits and lifestyle, taking vitamins and supplements, and going to regular medical appointments. If you do these things, you will decrease your risk of problems after surgery.

• American Obesity Association
  1250 24th Street, NW
  Washington, DC 20037
  Phone: 1-202-776-7711
  Web Address: http://www.obesity.org