Weight Loss Surgery
Everything you need to know about gastric band weight loss surgery, from experts in bariatric surgery.
What is a gastric band?
The gastric band is the safest weight loss procedure, and for many it’s also the best. With a track record stretching back 25 years, it’s proven to be safe and effective. A small, hollow silicone band is placed around part of the stomach which can be tightened or loosened as required to maximise weight loss. Our team has done over 20,000 band procedures and it’s an option everyone contemplating bariatric surgery should consider. Above all others, there are two key requirements for success with the band:
- Your commitment – To follow the diet and eating habits required for success
- Great aftercare – Clinic support and appropriate adjustment of the band
- Safe – gastric band surgery has a low risk of complications when performed by experienced band surgeons.
- Fully reversible – The anatomy of the stomach is not altered in any way. Unlike sleeve and bypass there is no cutting of the stomach.
- Successful – 50-60% excess weight loss (most in first year)*.
- Day case surgery – Over 90% of patients go home on the day they had their surgery.
- Fast recovery – Usually a 35-45 min procedure with minimal scarring. Most patients are back to work in a week depending on job.
- Adjustable – The band can be tightened and loosened according to your needs. This is helpful in the case of pregnancy. The band can be loosed during pregnancy and then adjustments resumed later.
The adjustable gastric band (also known as the Lap-band) has two main parts. The first is the band itself which is a small, hollow silicone band that is placed around the stomach. The other part is the access port which is small and disc shaped. It is usually about 0.5cm deep. The band and the port are connected by a tube.
So, when you have a band adjustment, we access the port by injecting into it with a syringe. We inject a small amount of saline (salt water). As we inject more fluid into the band it tracks up the tubing and causes the band to tighten around the stomach. Equally, by removing fluid from the band we can cause it to loosen around the stomach.
There are several high quality lap-bands available in the UK, and all have the necessary CE marks to prove their safety.
Am I eligible for the Gastric Band?
There are many factors to consider for eligibility but we generally offer the gastric band procedure to those with a minimum body mass index (BMI) of 30.
The eligibility criteria that apply in private healthcare are a little different than those that apply in the NHS.
The reason is that the NHS eligibility criteria that are set by NICE (the National Institute for Health and Clinical Excellence) have to balance the public health benefit with what the state can afford.
In the private sector, we are not faced with the same price restraints as patients are paying for their procedures. This means that we can make decisions based purely on the available scientific data. For that reason, we will generally consider patients with lower BMI than would be the case for the NHS.
The NICE guidelines state that patients will be eligible for bariatric surgery if they have a BMI above 40 or above 35 with at least one major co-morbidity. In addition, patients will need to follow and ‘pass’ a 6 – 12 month weight loss programme before they will be considered eligible for surgery. There will then usually be a waiting list.
The reality is that very few NHS Trusts apply these criteria and you may have read in the press that Trusts are applying their own, much tighter, selection criteria. This is because they do not have the resources needed to apply the NICE guidelines.
Some Trusts are limiting surgery to patients with a BMI over 50, to diabetics and/or to patients who don’t smoke.
At Healthier Weight, we generally consider band surgery for patients with a BMI of 30 and above. You will need to have tried and failed with diet plans as a way to manage your weight and your weight will need to be harming your everyday life.
If you are of Asian ethnicity and/or you are a Type 2 diabetic we would consider surgery at a lower BMI. We will explain the eligibility criteria in more detail at your face-to-face consultation.
How is the band implanted?
The gastric band is implanted laparoscopically (‘keyhole’ surgery) and usually takes around 30-45 minutes. The procedure is done under general anaesthetic. This is for two reasons; your comfort during surgery and also to achieve the muscle relaxation in the abdomen that is necessary. On this page we give a technical breakdown of how the procedure is done.
How much weight will I lose?
Not only is the gastric band a very safe procedure but it is also very effective. How successful you are with the band depends on how well you are able to adapt to the diet and eating regime required for success. Our team is here to help you with that every step of the way.
Your weight loss will vary according to how well you are able to follow the rules for band success. They are to eat slowly, to eat foods of the right texture and to cut out high-calorie soft foods and drinks. As a guide, you can expect to lose 50-60% of your excess weight over the first 2 years although many patients will do much better than this (see before and after photos and stories from successful gastric band patients here).
For a woman who is 5 foot 5 inches tall and who weighs 18 stone at the time of her band procedure this means that she could expect to lose, on average, about 4 stone. This would vary up or down according to how well you are able to develop the eating habits required for long term success with the band.
Taking an example of a man who is 5 foot 10 inches tall and weighs 21 stone at the time of surgery, we could expect weight loss, on average, of about 5 stone.
Anita and Melissa’s Story
Lost 9 and 6 Stone
“It’s more than just weight los surgery, it’s the biggest confidence boost I’ve ever had.”
Lost 6.5 Stone
“I shared my story on Facebook and the response I had was amazing”
Lost 8 Stone
“If you just follow the guidance, read your packs and take in all the advice available to you, you will succeed.”
A 2013 review of 101 gastric band patients showed that at their first lap band adjustment 5 weeks after surgery, their average weight loss was 1st 8lbs (8.6% of starting weight). That’s before their band had even been adjusted!* You can expect to lose more weight with Healthier Weight because we’re weight loss specialists. Our whole team is dedicated to your success and our expertise in medical care, behavioural support and nutritional advice directly shows in your results.
Healthier Weight is proud to have published our gastric band outcomes in numerous publications over our 16 year history, including the largest ever study into gastric band outcomes for UK private patients. It’s important to ask whether your provider publishes their results and we recommend you ask to see their data to ensure that the expected outcomes they quote are accurate and not based on average results achieved elsewhere.
What about 10+ years from now? Since the first laparoscopic gastric band procedure in 1993, evidence shows lasting weight loss for most people and the device itself does not degrade in any significant way. This is especially true of the latest generation of devices. Although we don’t yet have studies showing what happens to gastric bands after 30 or 40 years, we have no reason to doubt that the lap band will function perfectly well for decades.
Weight loss outcomes are impossible to predict at outset and, more than any other procedure, your weight loss success with the band will depend on how well you adapt to the dietary regime required for success. If you are able to do you may be one of those people who is able to lose all of their excess weight and take yourself out of the ‘obese’ category. At the other extreme, as with all procedures, there will be a failure rate and about 1 in 10 patients will be unable to lose weight with the band.
What are some health benefits of weight loss surgery?
Gastric banding has a major, often dramatic, impact on a wide variety of obesity associated health conditions. In addition to the health benefits, gastric banding is shown to improve quality of life and increase life expectancy.
- Approximately 60% of type II diabetics are cured
- 70-80% of patients with high blood pressure reduce or stop medication
- 80% will have improvement in cholesterol levels
- 90% will have improvement in reflux symptoms
- Most people with sleep apnoea are cured
- Mobility improves dramatically and joint pain decreases
- Improvements in mood and self-esteem
Most patients experience marked improvement or complete resolution of symptoms
Infertility and PCOS*
90% of patients experience correction of underlying hormonal problems and restored fertility
Patients with asthma see marked improvement in symptoms and a reduction in medication
Liver Disease (NASH)
80% of patients will have complete resolution of liver disease
Back Pain and Arthritis
Patients experience marked reduction in joint and back pain and increased mobility
Reduced depressive symptoms and anxiety, improved social interaction and overall quality of life
Gastric Band cost and finance
The fixed price for a standard gastric band package will depend on the location of your procedure. Most band cases are day cases (you go home on the day of surgery), but there will be some patients for whom it is necessary to schedule an overnight stay, for example if you are a diabetic patient or need a longer period of observation for some other reason.
In order to help as many people as possible gain access to our services, we have developed a number of finance plans tailored to the needs of our patients.
It is no exaggeration to say that aftercare is the key ingredient in your gastric band success. You’ll need the right band adjustments, coaching and support to develop the habits needed for success. Our team is dedicated to providing you with that support.
Put simply, to get good and safe long term weight loss from your band it needs correct adjustment. That means adjustments at the right time, of the right amount and by a properly trained bariatric (weight loss) nurse.
As a Healthier Weight band patient, you’ll receive free of charge band adjustments for 2 years. Those adjustments will be carried out by our specialist team of bariatric nurses. You are likely to need 3 band adjustments in the first 6 months to get your band working just right for you.
Gastric Band Procedure
A tube attaches the band to a small port which will sit just underneath your abdominal wall.
Our range of nutritionists, Health Coaches and support team are here to help every step of the way
Videos and live classes on diet, fitness, retraining behaviours, body composition scales and activity tracker.
It is impossible to be precise because criteria vary between Trust areas. What we can say is that very few Trusts offer gastric band surgery. There are a number of reasons for this, the main one being that the patients they treat tend to be both heavier and higher risk than those we see in private practice, meaning that the gastric sleeve or gastric bypass is the better option. The other challenge that gastric bands pose for the NHS is that patients require long term follow up in specialist clinics and this can be a burden to maintain. The sleeve and bypass procedures certainly require less follow up.
If you are in a part of the country where your local NHS Trust does gastric band surgery, and your GP refers you, you are likely to have a BMI of 45kg/m2 or over and have one or more weight related co-morbidities, e.g. type 2 diabetes. It’s important to remember that patients only become eligible for weight loss surgery on the NHS when they have followed a long term non surgical weight loss programme. This can pose a very practical barrier for most patients. These obstacles are not present for private practice patients.
Your long term success with your procedure is dependent on high quality aftercare. Anyone who has had weight loss surgery will tell you this is crucial. All too frequently, overseas surgery packages have no aftercare.
In the UK surgeon outcomes are monitored closely. There is a duty of candour and transparency. In many overseas countries the same standards do not apply.
We have seen many botched procedures from overseas that come with limited aftercare and warranties. You won’t receive any support from any serious problems that arise post-op, and you will ultimately go onto the NHS waiting list for your procedure to be put right.
Based on our patient data, the risk of gastric band slippage with Healthier Weight is 1% (1 in 100) although the national average is 4-5% (4-5 in 100). By following our post-op diet recommendations both immediately after surgery and then in the long term (eating small portions, slowly), you can reduce your risk of slippage.
With a gastric band, you may eat most foods that don’t cause you discomfort. However, because you can only eat small amounts, it is important to include foods which are rich in protein but low in fat and sugar. We encourage you to eat vegetables, fruit, whole grains, lean meat and fish. You will receive detailed nutritional information following your band surgery.
There are not really any foods that you should avoid, and that is one of the benefits of the gastric band. In order to maximise your weight loss, however, it is important to avoid or reduce the calories you consume through soft foods or liquids. When you are eating soft foods the ‘squeezing’ of food through the stomach doesn’t occur and you will not get the early feeling of fullness that you want. So, a band gives you complete flexibility but you need to be careful about the textures of what you eat. Following the advice that we provide on eating with a band will give you the best possible chance of successful weight loss, and minimise eating discomfort.
All content on this page is reviewed by a multi-disciplinary team led by Prof Rishi Singhal.
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