For millions of Americans, being overweight is more than just a problem of carrying around a few excess pounds. For this population, being overweight is a significant hindrance to living a normal life, and is a risk factor for serious health problems. This condition is known as morbid obesity.

How Is Morbid Obesity Defined?

Typically, the term “morbid obesity” is defined as being 100 pounds or more over one’s ideal weight, or, alternatively, having a BMI (body mass index) is 40 or greater. BMI is calculated according to the following formula: BMI = [Weight (lbs) ÷ height (in)²] x 703

What Is the LAP-BAND?

The LAP-BAND is an implantable device consisting of an inflatable band (a silicone ring), which fits around the upper part of the stomach.

How Does It Work?

The LAP-BAND, once implanted, is inflated with saline solution through an “access port” placed under the skin. This causes the band to become tighter around the upper part of the stomach, creating a smaller stomach pouch. When you eat, the pouch fills up much more quickly because there is simply less physical space. It will take time for food to move from the newly-formed pouch to the rest of the stomach. You will therefore feel full faster and eat less.

What Does the Surgery Involve?

Implantation of the LAP-BAND is a minimally invasive procedure. This means there are no large incisions necessary. Your surgeon uses a laparoscopic technique (hence the name “LAP-BAND”), which involves >making a few tiny incisions and inserting a laparoscope (a tiny camera) to guide the placement of the band in the appropriate position as the surgeon views it on the video monitor. The band is then locked securely in place.

Adjusting the LAP-BAND

One of the most appealing features of the LAP-BAND is that it’s adjustable. Your doctor will insert a thin needle into the access port located beneath the skin, and either withdraw liquid to loosen the band or inject more saline to tighten the band, depending on your response to the therapy and your comfort level. If you find the band is so restrictive >that it causes significant discomfort, it will be loosened; if you find yourself eating too much and/or not feeling full, it will be tightened to allow further restriction of food intake.

When is the LAP-BAND Considered Appropriate Therapy?

The LAP-BAND should only be used in cases of severe or morbid obesity. The cutoff should be a BMI >30. It is not indicated for patients who are mildly or moderately overweight. The LAP-BAND is not indicated as first-line therapy; it should be considered only after normal measures of caloric restriction and exercise have failed.

What Are The Advantages of the LAP-BAND?

• Minimally invasive procedure
• No large incisions or scarring
• No cutting or stapling of the intestines or stomach
• No surgical bypass is created
• Significantly less pain post-op
• Lower risk of complications and mortality
• Fully adjustable and removable
• Clinically proven to maintain long-term weight loss.

After Your Surgery

You will be able to go home the same day, and will likely be able to return to work or school within one week. You will start to notice weight loss gradually, but the cumulative results will be impressive. Most patients lose 50-80% of their excess weight within the first year after surgery. You need to follow your surgeon’s instructions closely so that your procedure will be a success.

A New Way of Eating

Your “new stomach” will require special treatment. In the first few weeks following surgery, you will be placed on a liquid diet. After that, you will eat only soft or pureed foods, and then finally regular solid foods. You will find that you get full very quickly compared to before your surgery. this is normal, and to be expected. When you eat, you should not drink a large quantity of liquids with your food. This will advance the food through the pouch and into the rest of the stomach, defeating the purpose of the pouch.

Other Lifestyle Changes

Most of what will be advised is common sense: you should have some sort of physical exercise or activity. Being sedentary burns fewer calories than being active. If you drink alcohol, you should limit your consumption for general health reasons, but also because alcohol has a surprisingly high amount of calories, and is absorbed directly through the stomach wall. The dietary modification and concurrent weight loss actually helps lower your blood cholesterol and triglycerides and can even reverse diabetes. If you diligently stick to a long-term regimen prescribed by your doctor, you will be pleasantly surprised at the results you will achieve.