In all of my years as a personal trainer and my involvement in the weight loss industry, I think that the single most frequently asked question today isn’t “What piece of exercise equipment should I buy”?…and this was definitely THE question for many years. But lately, it is much more the question, “What do you think of getting the band for weight loss?”

The overweight/obesity epidemic is out of hand. The situation has now reached a point that the harm to the public health, which translates into harm for quality of life and definitely harm to everyone’s wallet has reached epidemic proportion, and the situation is not improving.

Recent studies tell us that if the obesity trends continue as they are now, by 2030 nearly half of all Americans will be obese. Consequently there will be an additional 6-8.5 million cases of diabetes, 5.7-7.3 million more cases of heart disease and stroke, and up to an additional 669,000 cases of cancer. Now get this—treatment for all preventable diseases will increase by $48 billion to $65 billion per year by 2030. We fully understand the problem and the terrible consequences of not reversing this trend. Nevertheless, instead of taking responsibility for ourselves and taking concrete steps to help ourselves, we still search for some easy way out. Taking a pill to lose weight would certainly be the easiest solution, but every weight loss pill to date has ended up with side effects so pronounced that they had to be pulled from the market. Out of desperation, we look for something invasive, such as bariatric surgery or gastric banding. However, even that is showing mixed results.

A new study done in Europe has questioned the long-term effectiveness of the LAP banding device, finding that many patients suffered major complications and half of them eventually had the device removed. The report, published Monday in the Archives of Surgery, focused on 82 surgeries performed between 1994 and 1997. Even though patients reported losing significant weight, complications such as band erosion and infections led researchers to conclude the surgery had “relatively poor long-term outcomes.” Four patients have died within the last two years following Lap-Band surgeries performed in Southern California, prompting medical malpractice lawsuits and investigations by the Medical Board of California. None of the patients involved in the European study died as a result of the surgeries. But 32 of 82 reported major complications, and 49 of them had additional surgeries, either to correct problems or because of a lack of weight loss.

What are the possible complications of the banding?

 Infection and migration. An infection may develop either in the port area or in the abdomen, and in some instances this may cause the band to migrate into the stomach.

Leakage. Leakage from the SAGB or from the connecting tube between the balloon and the port may require reoperation. The balloon is made of fragile material, and leakage can occur either shortly after surgery or many years later.

Slippage of the band and pouch dilatation. The band may slip, and the pouch (the part of the stomach above the band) may become too enlarged, and a reoperation may be necessary.

Punctures in the silicone band and port dislocation The injection port may dislocate and when injecting into the port, there is always the risk of puncturing the silicone tube.

Patients may vomit or feel pain after food intake. This can be caused either by a poor eating behavior, or by the narrowing of the SAGB following the injection of fluid into the balloon.

One more thing, nobody on the band will lose all the weight they may need to. They may lose enough weight to make a huge positive difference in their health, but you can’t lose it all that way.

If you your doctor suggested this procedure to you, be sure you have really tried everything else first. Have you done a course of behavioral therapy coupled with exercise and proper diet under strict supervision from qualified professionals? And just as important: HAVE YOU STAYED AWAY FROM THE WEIGHTLOSS GIMMICKS THAT PERMEATE OUR LIVES THROUGH ATTRACTIVE ADS BUT DO NOTHING FOR LONG TERM WEIGHTLOSS? An effective program to lose weight has you losing your extra kilos (pounds) at a slow, but steady rate. Extremely low calorie programs, supplements in the form of pills and hormonal injections just don’t do it—even if they tell you otherwise.

Invasive procedures into the body of any nature carry risk. But then again, so does being obese. But when “weighing” this decision, consider another finding from a study last year done in Holland.

Adjustable gastric banding achieves only modest weight loss, and even that benefit deteriorates over time in most patients. Edo Aarts, MD, reported at the American Society of Metabolic and Bariatric Surgery meeting that five years after surgery, about two thirds of patients maintained 25% excess weight loss. At 10 years the success rate dropped to less than a third (31%). Using 40% excess weight loss as the standard, resulted in a five-year success rate of about 50%, which declined to 20% at 10 years.

So if you are viewing this as an automatic fix to your weight problem, don’t. Fortunately, there is a risk-free and safe solution to the obesity epidemic. It takes longer and requires hard work but can reverse this dangerous trend permanently. And if you have a positive attitude towards it and have the patience it takes, then losing weight without the band might be the better way to go.

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 16 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at [email protected] www.loseit.co.il

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