Frequently Asked Questions

Please note that anything I say here is not to be construed as medical advice. I've been doing lots of research on the band and this is the stuff I picked up. Once you've selected your surgeon the most important thing to do is listen to what he or she says to do. Other good sources of FAQ-type information is Layla's Lap Band page and the bandsters home page.

Questions about my experience

Where did you have your surgery, and how much did you pay? I had my surgery in Pleasanton, CA with Dr. Gracia (http://www.4-anewyou.com). It was covered 100% in-network by United HealthCare. At the time of my surgery my BMI was 45 and I had minor co-morbidities - mostly relating to familial history for diabetes and blood pressure.

Pre-Op Questions

How is the Lap Band different from other weight loss surgeries? There are a few weight loss surgeries currently being done, and they differ quite a bit. The first thing to remember is that weight loss surgery is not magic. The goal of weight loss surgery is to reduce your caloric intake so you lose weight. Each of the surgeries approaches this a bit differently, but the goal is really the same. Surgeries can be restrictive (VBG, AGB), malabsorptive (DS/BPD) or a combination of the two (RNY). The most important thing to understand is that each surgery has its strengths and weaknesses, and you need to figure out which one is best for you.

The malabsorptive surgeries allow you to eat more food without absorbing the calories, but require you to supplement with vitamins and minerals to make sure you don't become malnourished. On the other hand, the restrictive-only surgeries like the AGB require more work on the part of the patient. If a patient drinks high-calorie liquids or does not exercise regularly, the weight loss can be compromised. Similarly, if the patient, pre-op, is not an overeater, the lap band may not be a helpful tool for their weight loss. Look at all the surgeries, ask lots of questions. The most helpful thing I did was to journal my eating and exercising for a week and take an honest look at my habits... after I did that I was certain the band was the right answer for me.

Why were the FDA trial results so bad? If you check out the research links on my links page, you'll find many European studies with much better results than the FDA results. Why is this? Largely due to inexperience. The lap band requires more experience and strong postop support from your surgeon in order to help you attain the best results. I have faith in my surgeon and fully expect to be an incredible success with the band. Many of the FDA trial surgeons converted their patients to bypasses after 6 months, because the results they were seeing weren't as quick as bypass results. What they failed to realize is that the band works slower than a bypass, but they "even out" at about 18 months out from surgery.

How can I find a Lap Band surgeon in my area? There is a list of lap band surgeons on the bandsters home page. The lap band is a difficult surgery to do well, so be sure you are comfortable with your surgeon and their ability to help you succeed. Many surgeons are more comfortable with other surgeries - the success rate for the lap band is generally better when the surgeon believes in its effectiveness.

How much does it cost? Costs for the lap band surgery vary widely. Some people have flown to France to get their surgery there, and come back only $6,000 out of pocket including travel expenses. The excellent mexican surgeons are generally less than $10,000 for the complete deal. US Docs can cost upwards of $30,000 but there is a huge range. Insurance is much less likely to pay for an international surgery.

Does insurance pay for it? Some insurance companies have covered lap band surgery. Now that the band is FDA approved, more insurers will be covering it, but the issue is a thorny one. Many insurance policies specifically exclude weight loss surgery, so you may have to fight with your insurance company to get them to cover this surgery for you. More information about getting insurance coverage can be found at the BandstersInsurance mailing list.

Surgery

My surgeon is making me do all sorts of stuff before and after surgery. Do I have to do this? Well, yes. Ideally, you selected your surgeon because you had confidence that he or she would do a great job for you, and part of that is having faith in their procedures. My surgeon requires 48 hours of clear liquids pre-op, a bowel prep the day before, and a month of clear liquids after surgery. Does this sound fun? No, not really. But I'm gonna just suck it up and follow the rules, because I have faith that my doctor is trying to improve my outcome the best he can.

Is there anything I should do to prepare myself for surgery? Everyone's level of comfort is different around this. Some people write up a will, some don't. Many surgeons ask you to take extra care of cleanliness before surgery in order to reduce bacteria in the waiting room. It's also important to try to keep active, if possible, to improve your recovery time.

Post-Op Dietary Questions

How long do I have to be on a liquid diet? This varies by surgeon. Follow your surgeon's advice, and ask them if you're having trouble sticking to the regimen. Various doctors require between 1 day and 1 month of liquid. One reason for the longer liquid diet is to jump start your weight loss, so think carefully if you really want to jump off that bandwagon before you really need to. Always check with your surgeon before going against their orders - if you need to eat food, your surgeon needs to talk to you about how to make the transition safely.

What exactly qualifies as a liquid? The short answer is "whatever can be sucked through a straw." You can make puddings, yogurt and mashed potatoes runny with extra milk, or blend your family's dinner in the blender with some broth. You can live on Jamba Juice if you want. Many surgical teams recommend that their patients drink protein drinks during the liquid phase so your energy level remains high.

What soft foods are good for the "soft food" phase? You want to eat foods which aren't likely to get stuck in the stoma, but which will help fill you up. Many people have had luck with things like chili, protein bars, cottage cheese, pasta (make sure it's got sauce), oatmeal, hummus... you get the idea. The most important thing to do when you're re-introducing solid foods into your diet is take it slowly, and chew carefully. You don't want to overfill your pouch.

What kinds of food are generally "band-friendly"? Most foods can be eaten, but some require so much chewing that many bandsters decide to live without them. Bread is a common culprit, especially after a few fills. But some people love bread enough to chew the bread enough. Other people have had bad luck with chicken, but in general if you have trouble with meat, lubricating it with some sauce or mayonnaise seems to fix the trouble.

Post-Op General Questions

Do I need a fill? This is a personal question, and one only you (and your surgical team) can really answer. The best way to answer this question is with another question: Are you still losing 1-2 pounds a week? If not, are you following the seven golden rules? If you're following the rules and not losing, it may be time for a fill.

How much should I get in my fill? Another very personal question. Some people have huge restriction with very little fill, and others find that they don't feel restricted at all even when they've had several fills. Your doctor will do their best to determine your optimum fill level each time you get a fill, and you should focus more on how the fill feels than what number it represents.

I'm still hungry! The fill didn't work. What should I do? Relax! I know you got this surgery and you really want it to work RIGHT NOW, but you are probably eating less than you did before you got the band, and if you're losing weight you're right on track. If your weight loss stalls, and you're still following the rules, you might just need a bit more of a fill.

How can I get the best results with the band? Read over the seven golden rules and follow them to the best of your ability. Don't let other people's experience drive your expectations - if you need to join weight watchers or use other tools to help you find your way, that's what you should do. The most important thing is that you feel like you're making progress.