Gastric banding surgery for weight loss
A gastric banding procedure involves an adjustable band being placed around the top of the stomach via keyhole surgery, and an access port inserted deep under the skin which is connected to the band by special tubing. From six weeks post-surgery, adjustments are performed at two to four-week intervals until the optimal level of restriction is reached.
How does gastric banding aid in weight loss?
The gastric band allows you to eat much less, while still enjoying your food and feeling satisfied, by:
- Portion control: it allows you to feel full and satisfied with smaller meals, preventing overeating.
- Hunger control: you feel less hungry in between meals.
Initially, very little to no fluid is inserted into the band to allow the band to ‘settle in’ after the operation.
Six weeks post-surgery, band adjustments begin. A small amount of fluid is injected into the access port to expand the band and increase restriction on the stomach. Adjustments are made at two to four-week intervals until optimal restriction is reached. This is the so-called ‘sweet spot’, where you will be able to eat a small amount of most foods without obstruction, but also without feeling hungry after or between meals.
Through all of this, patients work closely with our dietitians and psychologist to make the lifestyle and behavioural changes needed to achieve and sustain their weight loss.
How much weight can I expect to lose after gastric banding?
On average, patients lose 50 per cent of their excess weight. By comparison, non-surgical weight loss options achieve an average weight loss of 5 to 10 per cent.
The best results are achieved when a multidisciplinary team supports patients through both surgical and lifestyle options.
Our patients have lost up to 100 per cent of their excess weight with our program.
What are the potential benefits of a gastric band?
Gastric banding is very safe. It is safer than other forms of weight loss surgery. No surgery is completely risk free, but remember that chronic untreated obesity also has risks.
Gastric banding is popular because:
- It is removable
- It does not involve stapling the stomach, removing part of the stomach or bypassing parts of the intestine
- When patients follow a balanced diet, it does not lead to deficiencies in vitamins and minerals since food is absorbed exactly the way it was before surgery. If however, there are problems with over-restriction, the patient will start to develop dysfunctional eating patterns with an unbalanced diet and they can develop nutritional deficiencies
- Gastric banding has a proven track record. It has been performed in Australia since 1992 and long-term results are available
What are the potential disadvantages of a gastric band?
The average weight loss after gastric banding is lower than after a sleeve gastrectomy or gastric bypass. Typically, excess weight loss after gastric banding is 48 per cent compared with 67 per cent after a gastric sleeve or bypass.
Weight loss is less predictable. After a gastric band, the amount of weight loss varies from person to person as the patient learns to use their gastric band as a tool to assist them with behavioural and lifestyle changes. There is a wider range of weight loss after a gastric band compared to after a sleeve or bypass, because a band is more dependent on patient behaviour.
Gastric band has the highest rate of re-operation over the long term. Up to one in five people who have had a gastric band will require a further operation. This re-operation rate is much higher than after a sleeve gastrectomy (approximately three in 200 people) or gastric bypass (15 in 200 people).
A gastric band does not alter metabolism. It restricts the capacity of the stomach but does not affect the complex biochemical pathways regulating appetite and metabolism, therefore patients typically do not experience the same shift in food preferences, away from sugary or fatty foods, as with a sleeve gastrectomy or gastric bypass.
After gastric banding, re-operation may be required for:
- Infection of the port or the band
- Slippage of the band and pouch dilatation which, if untreated, leads to weight gain and indigestion or gastro-oesophageal reflux
- Leakage of saline from the connecting tube or the balloon of the band
- Dislocation of the port
- Erosion of the band through the stomach wall
- Insufficient weight loss
- Obstruction of the band where it may suddenly become over-restricted or obstructed. This frequently requires an urgent adjustment. Under these circumstances it is best to be close to an appropriate facility that is familiar with gastric bands and can perform an adjustment competently. For this reason, a gastric band is less suitable for people living in remote areas, or for those who travel to remote destinations
- Less effective at resolving obesity-related health problems including type 2 diabetes. After a gastric band, only five out of 10 patients have a remission of their disease – compared to eight out of 10 people after a sleeve gastrectomy or bypass. Resolution after gastric band is dependent on weight loss and takes longer compared to sleeve or bypass procedures
Am I eligible for gastric banding?
The general requirements are:
- Your BMI is above 40
- Your BMI is above 35 and you already have one of the medical conditions associated with obesity
- Your BMI is above 30 and you have difficult to control Type 2 Diabetes and an increased risk of heart disease
- You do not have an underlying medical disorder or medication causing your weight problem
- You do not live in, or travel to, remote locations
- You are prepared to participate in ongoing follow-up visits
- You have lost weight through diet and exercise in the past, but have regained the weight
- You are over 16 years of age
Who gets the best results from gastric banding?
People who get the bests results from gastric banding are those who:
- Do not need to lose a very large amount of weight
- Have been able to lose weight quite easily in the past with diets and exercise, but struggle to keep the weight off
- Are well motivated to make behavioural and lifestyle changes with the support of our multidisciplinary team