Failure to Lose Weight with the Gastric Band

Gastric Band failure in general is usually a situation where significant weight loss does not occur or there are complications or intolerable side effects leading to its removal.

Reasons for failure of the gastric band

The gastric band can fail for technical reasons.

These include:

Gastric Band slippage:

in other words, the gastric band has moved out of its normal position and may be partially “strangling” the stomach. Slippage is usually associated with an increase in food restriction, vomiting, reflux and sometimes pain. It may be found incidentally on a plain xray.

Gastric Band erosion:

the gastric band can erode into the stomach wall all the way to the inside of the stomach. In this case the band will need to be removed. Symptoms include upper abdominal or chest pain, fever, loss of food restriction and weight regain.

Balloon leak:

the balloon can leak fluid, preventing further restriction from gastric band inflation. This is a rare occurrence.

Hiatus Hernia:

a weakness in the diaphragm at the top of the stomach can allow the gastric band and stomach to move out of correct position. This might cause vomiting, food intolerance, reflux or pain

Failure to lose significant weight with the gastric band:

This may be due to the band being too loose. Careful attention to band adjustment by the surgeon may enable weight loss to get back on track

Dietary maladaption.

Because it is harder to eat many good foods with the gastric band, such as meat, bread and rice, some patients change the types of food they eat dramatically. These people often end up in the habit of eating biscuits, crackers, cheese, ice-cream or confectionary, all of which is still quite easy to get down with the band. Clearly these types of maladaptive food choices are incompatible with long term weight loss.

Inability to adjust eating habits appropriately.

Many patients find that they are incapable of eating in a slow, measured way and chewing their food properly. Others are unwilling to modify the types of food they have been eating for years into forms that are suitable for the gastric band (e.g. Porterhouse steak may need to be replaced by mince burgers for some patients)

Consumption of high calorie liquids.

Ongoing high consumption of drinks such as soft drinks (non-diet), alcohol, fruit juice, Boost juices and milkshakes is easy to do with the gastric band and will make significant weight loss difficult or impossible

Gastric Band intolerance.

Sometimes the band and its recipient simply don’t get along. No matter how the gastric band is adjusted some people cannot tolerate its restrictive effects or are plagued by persistent vomiting or reflux without any identifiable technical reason

Dietary Maladaption occurs when a patient finds it difficult to consume good quality foods and chooses foods that are easy to get down which are often high in calories and lead to weight gain

See Link to Dietary Maladapation PDF Brochure.

For all of the above reasons, regular contact with the clinic staff including the surgeon or dietician when appropriate is essential for success with the gastric band. Problems may be identified and fixed quickly and discussion about maladaptive food choices and correct eating habits entered into to reinforce successful behaviours.

Getting Back on Track

If you have been absent from clinic appointments for awhile and your weight loss has stagnated we can try to get you back on track with the gastric band. This usually involves a series of appointments with the surgeon, dietician or other ancillary staff to tackle issues of dietary habit, food choices, eating patterns and a general motivating discussion.

Often we will ask you to undergo a contrast swallow to check the position of the band to rule out gastric band slippage.

Occasionally there may be need for gastroscopy to ensure there is no erosion.