Gastric banding is a weight loss option for people who have not been successful using non-surgical weight loss methods, such as supervised diet, exercise or behavior modification.
Gastric banding is a surgical procedure to reduce the size of the stomach for weight loss. In this procedure, a silicone band is placed around the upper portion of the stomach to create a small pouch. Afterwards, the stomach is smaller, so people feel full more quickly, eat less and in many cases lose weight.
A gastric band is intended to be a long-term implant. Most people lose weight with the gastric band, but a gastric band is not a permanent device. Many people require another operation to reposition, replace or remove the gastric band due to complications or because they have not lost weight.
Gastric banding requires a lifelong commitment to eating less and following a doctor’s recommendations. People who are not able to do this may not be able to achieve or maintain weight loss, and may experience severe complications.
Gastric banding devices are approved for patients with the following characteristics:
- 18 years and older AND
- BMI of 40 or higher OR
- BMI between 30 and 40 with one or more obesity-related medical conditions, such as high blood pressure, heart disease, diabetes or sleep apnea
The FDA has not approved any gastric band for use in patients under 18 because the agency has not reviewed the safety and effectiveness of gastric bands in patients of this age.
People with certain stomach or intestinal disorders, those who take aspirin frequently, or those who regularly use alcohol and certain drugs should not have gastric banding.
If you are considering whether to have gastric banding surgery, the FDA recommends that you do the following:
discuss your medical conditions and any medications you are currently taking with your surgeon.
read the device patient labeling, which provides information about the risks and benefits. If your surgeon does not provide you with a copy of the patient labeling, ask for it.
ask your surgeon any questions that you may have before you agree to the procedure.
Gastric banding is usually performed using laparoscopic surgery. The surgery is performed while the patient is asleep (general anesthesia). The surgeon makes one to five small cuts (incisions) in the abdomen. A small camera and surgical instruments are placed through the cuts into the abdominal cavity.
During the surgery, the surgeon places an adjustable silicone band around the upper part of the stomach to create a small pouch. The band is connected with tubing to a port near the skin. Once the device is in place, the camera and surgical instruments are removed and the cuts are closed with stitches.
The surgery usually takes about an hour to complete. Patients are usually sent home the same day as the procedure and are able to return to their normal activities, including returning to work, a few days later.
Following surgery, the doctor can adjust the band, without the need for additional surgery, by adding or removing fluid through the implanted port. These adjustments tighten or loosen the band, allowing less or more or food to fit in the stomach.
Risks of Gastric Banding
It is important that you know and understand the risks of gastric banding before deciding to have the procedure. Advertisements for a device or procedure may not include all of the risks, so it is important for you to read the patient labeling and talk to your doctor.
Any surgery involves risks, including death. There are risks from the surgical procedure and the medications or anesthesia used during surgery. Risks from surgery are greater when a patient is obese or has other serious health conditions.
In addition to the risks of surgery, you could experience any of the following complications after gastric banding surgery:
- vomiting or spitting-up food you just ate
- difficulty swallowing
- gastroesophageal reflux disease (GERD)
- indigestion or upset stomach
- abdominal pain
- leaking of the gastric band
- stretching of the new stomach pouch, so it no longer restricts the amount of food you can eat
- moving of the gastric band from its original position, requiring another surgery to reposition it
- erosion of the band through the stomach wall, and into the stomach, requiring additional surgery
- stretching of the esophagus.
If you experience any of these complications, you should talk to your doctor right away. Some complications may lead to more operations or removal of the device.
Benefits of Gastric Banding
Gastric banding has demonstrated benefits for people who have not been successful using non-surgical weight loss methods. This surgical procedure may help patients lose weight and maintain the weight loss, and it may help improve their health.
Some patients who have received gastric banding have reported the following benefits:
- Decreased waist and hip circumference
- Improvements in obesity-related conditions, like diabetes, hypertension, and sleep apnea
- Improvements in general health
- Improvements in quality of life
Another benefit of gastric banding is that it can be performed in a minimally invasive manner using laparoscopic surgery. Compared to other surgeries used to treat obesity, laparoscopic gastric banding is less painful, uses smaller incisions, usually has a shorter surgery recovery time, and allows patients to go home from the hospital sooner after surgery.
Patients who are committed to making major, lifelong changes to their eating habits are likely to have better weight-loss outcomes with gastric banding than those who do not.
Lifestyle Changes after Gastric Banding Surgery
Gastric banding is not a “quick fix.”
In order to be successful in losing weight with gastric banding, you must make major, long-term changes to your eating habits. The smaller pouch that is created at the top of your stomach will only be able to hold about a quarter cup of food at a time. If you eat too much, you may have complications such as nausea and vomiting.
For the first month or two after surgery you will be able to eat very little and will have to slowly add foods to your diet. Your surgeon and/or dietician will work with you to:
- make smart food choices
- teach you about changing how you chew and swallow your food
- advise you on what foods to avoid
- help you recognize when you are full
- increase your physical activity
In addition to making changes to your diet, you will need to make regular follow-up visits to your doctor to monitor your progress and make any adjustments to your band.