Gastric Banding: not a permanent solution for "obesity"
 A Big NO for Teenagers.
"Last year, 34 teenagers underwent procedures such as gastric band fitting and
stomach stapling on the NHS – up from ten in 2007." according to spokesman for
eating disorder charity (source:
dailymail.co.uk)
Gastric band surgery involves fitting a band near the top of the stomach,
restricting the amount of food that can move down into the lower part. The top
part of the stomach fills up quickly, making the patient feel full. According to
Susan Ringwood, chief executive of eating disorder charity Beat: ‘Having a
gastric band fitted is a very serious operation that has long-term, permanent
consequences, yet we know young people are not always being given this
information and that is very concerning.’ The final
weight loss
with gastric banding is about one-third to one-half of the extra
weight
you are carrying.
|
The Food and Drug Administration (FDA) has approved use of an adjustable
gastric band (or AGB) for patients with
BMI
> 30 who also have at least one
condition linked to obesity, such as
heart disease or
diabetes. |
In normal circumstances, as food moves along the digestive tract, digestive
juices and enzymes digest and absorb
calories and
nutrients. After we chew and swallow our food, it moves down the esophagus to
the stomach, where a strong acid continues the digestive process. The stomach
can hold about 3 pints of food at one time. When the stomach contents move to
the duodenum (the first part of the small intestine), bile and pancreatic juice
speed up digestion. Most of the iron and calcium in the
food
we eat is absorbed there. The other two parts of the nearly 20 feet of small
intestine absorb nearly all of the remaining calories and
nutrients. The food particles that cannot be digested in the small intestine
reside in the large intestine until eliminated.
However before going in for a surgical option, you should make sure you
understand the advantages and disadvantages of surgical weight loss procedure.
It is essential that you have a clear idea of what are your expectations of
surgery to lose weight and if the results of this surgical procedure will be
able to respond effectively to the desired results. A
weight loss surgery is not an answer to all your problems and the patient
need to maintain their health and numbers in the future by following a healthy
diet and adequate exercise plans.
Factors you need to Cover:
Preparing for weight loss surgery starts with making a lifelong
commitment to the dietary and lifestyle changes necessary for success.
Weight
loss surgery is not a quick fix, nor is it a decision to enter into
lightly. Once you have made the decision together with your surgeon and your
family members, the preoperative evaluations can begin. These include:
-
 Meeting
with a registered dietician to discuss how the diet needs to change both
before and after weight loss surgery.
-
A comprehensive psychological evaluation.
-
An upper endoscopy exam or barium swallow to make sure there are no
polyps, tumors, ulcers or bacteria that cause ulcers in the stomach.
-
Additional pre-operative evaluations for the heart and lungs, if deemed
necessary.
Tell your surgeon about any medications you are taking or plan to take
throughout recovery. Vitamins, minerals and
herbs also interact with medications. Don't leave anything out.
Some of your lifestyle changes will begin before surgery. They
include:
-
Quitting
smoking for at least 30 days before and after weight loss surgery.
Smoking can increase the risk of complications, including potentially fatal
blood clots. Smoking can also affect healing of the incisions and increase
the risk of infection.
-
Not drinking alcohol for at least 48 hours before weight loss surgery.
-
Losing 5 to 10 percent of excess body weight. People who lose a moderate
amount of weight before weight loss surgery have a shorter hospital stay and
more rapid postoperative weight loss, according to a study in Archives of
Surgery.
-
Practicing
eating slowly, which includes chewing each morsel of food 15 times and
putting the fork down between bites.
Post-surgery Risk Factors:
Risks for gastric banding are:
-
 Gastric band erodes through the stomach (if this happens, it must be
removed)
-
Gastric band may slip partly out of place
-
Gastritis (inflamed stomach lining),
Heartburn, or stomach ulcers
-
Infection in the port, which may need antibiotics or surgery
-
Injury to your stomach, intestines, or other organs during surgery
-
-
Scarring inside your belly, which could lead to a blockage in your bowel
-
Your surgeon may not be able to reach the access port to tighten or
loosen the band (you would need minor surgery to fix this problem)
-
Vomiting from eating more than your stomach pouch can hold
Benefits
Because the band is removable, adjustable and does not permanently
alter the anatomy, it provides an option for patients who may not otherwise
consider surgery for treatment of their
obesity.
Other advantages include a shorter hospital stay and no effects on the
absorption of nutrients.
A Study
In one recent study carried out by the New York
University School of Medicine a total of 53 teenagers (41 girls and 12 boys)
between the ages of 13 and 17 showed some impressive result after undergoing
laparoscopic adjustable gastric banding.
The teenagers, who on averaged weighed 297 pounds before surgery and had an
average body mass index (BMI) of 47.6, had lost some 50 percent of their excess
weight 18 months after surgery. Additionally, all came through the surgery
without complications and only 5 developed minor complications following
surgery, which were treated on an outpatient basis.
It is impossible ofcourse at this point to say what the long term results
will be for this group of patient and only time will answer that question.
Nevertheless, these early results are encouraging.
In spite of these encouraging results many doctors still see one problem
which they consider to be a major obstacle to the use of the lap band operation
in teenagers and that is the fact that the long term success of surgery
depends upon patients making dramatic changes to their lifestyle and also
adjusting to a strict
diet.
|
Obesity surgery seems unethical in children unless all conservative weight
control methods had been tried first.
Content Support:
yourbariatricsurgeryguide.com
-
WF Team
Dated 15 October 2011
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