What are the Expected Outcomes of Gastric Band Surgery?

Weight Loss

Weight loss with the gastric band is usually sustained for the long term. This should be the case whether you have a Lap Band ® or Swedish Band which are the most well studied systems, and probably for the other brands on the market currently.

Success in weight loss is often looked at in terms of “Excess Weight Loss”. Your excess weight is the difference between the weight you are now, and the weight you would be if your BMI was 25 kg/m2, which is in the most healthy range. For example, if you currently weigh 120kg, and your “ideal” weight (at BMI 25) was 70kg, your excess weight would work out to be 50kg.

If you take a large group of people who have undergone gastric banding and you take the average of all their weight loss outcomes, the result is approximately 50% of Excess Weight Lost (EWL). So the patient above would lose 50% of their excess on average – therefore they would lose half of 50kg, which is 25kg. This would get them down from 120kg to 95kg. This weight of 95kg should be sustained in the long term barring any technical issues with the band.

Graph: Typical weight loss graph of a 120kg gastric band patient over 12 months


The reality is that whilst losing 50% of Excess Weight is the average, there is a large variety of results in a typical gastric banding series. So many people will succeed in losing more than 50% EWL and many will lose less. The chance that you will get 50% EWL or more with the gastric band is itself about 50%.

Medical and Health Improvements

Improvements in medical problems such as diabetes does not always require massive weight loss.

Diabetes Improvement

Successful weight loss with the gastric band almost always leads to improvements in type II diabetes. If you are on tablets for diabetes you may need a reduced dose or even no treatment at all, depending on the extent of weight loss and the severity of the diabetes. Diabetes that has been present for longer is harder to resolve than newly diagnosed diabetes. If you are on insulin for type II diabetes you may be able to significantly reduce the amount of insulin required each day, or even forgo insulin completely. The most important thing is to ensure that your diabetes is under the best control possible, and this is not always best achieved by ceasing medications.

For type I diabetics who are obese, weight loss may potentially reduce the amount of insulin required to control blood sugar levels.

Obstructive Sleep Apnoea

Gastric banding leads to excellent resolution rates for sleep apnoea, successful in around 80-90% of cases. It is common that the CPAP mask is no longer required after weight loss with the band, although cessation of treatment should be done in partnership with your respiratory physician.

Hypertension (high blood pressure)

This often improves after gastric banding surgery. If you are becoming dizzy in the weeks and months following surgery, one of the possible causes is that your blood pressure medication is now too strong for your needs and your blood pressure is going too low. Consult with your treating doctor regarding reducing doses of anti-hypertensives

Cardiovascular disease risk

The risk of heart problems such as heart attacks or angina will often be reduced with successful gastric banding surgery

Fertility

For women who have been trying to get pregnant, rapid reduction in weight from gastric banding often improves fertility rates. The pregnancy and birth should be less complex and dangerous if you have lost weight. We do not recommend getting pregnant in the early stages after gastric banding whilst you are actively losing weight.

Osteoarthritis

Arthritis of the back, hips or knees cannot be reversed with weight loss but the pain and impediment to mobilising may be reduced with weight loss. If you are requiring joint replacement surgery, this may be more successful after weight loss.

Will I live longer??

There is some evidence that obese patients undergoing weight loss surgery have less deaths from all causes over many years compared to those who have not had surgery. Possible improvement in lifespan depends on many factors including your age and medical conditions.

Graph: Mortality curves from Swedish Obese Subjects Study. Over ten years, obese patients who underwent weight loss surgery are dying less frequently than those who didn't. (Ref - Sjöström et al. NEJM 2007 357(8): 741-752)

Quality of Life Improvements

There is no doubt successful weight loss with the band usually improves quality of life dramatically. This is evident from the increased energy, confidence and self esteem that patients possess from being thinner. Formal studies using quality of life measures such as the Short Form 36 assessment tool confirm that marked positives changes in both physical, mental and emotional functioning will often occur after gastric banding. (Ref: International Journal of Obesity. 31(8):1248-61, 2007 Aug.)

• Better mobility
• Less breathlessness
• Ability to choose wider range of clothes
• Improved personal hygiene
• Improved self esteem
• Reduction in depression
• Improved job prospects
• Improved relationship prospects

For many patients, quality of life improvement from weight loss is just as important as health gains.