John Pilcher, MD

Fiona,

Your are a young person with a serious weight issue.  You've written (appropriately) that you've tried everything to lose weight, and I'm going to assume that includes diet ("Plan A") and exercise to the best of your ability ("Plan B").

In the context of serious metabolic obesity disease, it's common for diet and exercise to have little effect that lasts.  Medically and logically, when these interventions don't work and you still have the problem, it is reasonable to move on to Plan C without any major delay.  When I refer to Plan C, I mean bariatric surgery of some type.  The most established operations worldwide these days are Gastric Bypass and Gastric Sleeve.  It definitely makes sense for you to meet with bariatric surgery experts in your area to decide what's right for you.

Best of Health,

Dr JP
San Antonio

Kaceety,

You're too young to have your joints destroyed by your weight!  Also, you may not feel it but I'm certain that your other organ systems are under strain from the weight as well (heart, lungs, liver, pancreas, etc.)  It sounds like you've already tried to lose weight with non-surgical interventions; if those had worked then it would have been a good place to stop but since they did not work it is completely sensible to try a more intense therapy like bariatric surgery.

I think gastric bypass is a great choice for younger people because it has been proven to last for decades, but I also think it's important for you to get an individualized recommendation from an experienced bariatric surgeon in your area.

Best of luck!

Dr JP

Yes, revising from Band to Gastric Bypass is likely to be medically appropriate.

In fact, you're not alone.  Many people have Bands that work for a few years and then quit working, or never help with significant weight loss at all.

Your odds will be best with a surgeon who has plenty of experience with revision surgery, since the Band inevitably creates scar that distorts the anatomy and gives a higher chance of complications.

Best of luck,
John Pilcher, MD
San Antonio

Connie,

You aren't alone with this problem.  Bariatric surgery can be a powerful tool to get control of the metabolic obesity disease, but unfortunately there is no intervention that will fully cure the problem.  You would definitely be helped by engaging with an experienced bariatric program in your area; typically the team will check your anatomy as well as your metabolism and discuss options from there.

Frankly, revision from gastric bypass to Sleeve is not usually a very powerful intervention.  You and the surgeon may want to look at revision of the gastric bypass or perhaps conversion to a more intense operation like the Duodenal Switch.

Best of luck!

Dr JP

The information you've given about your height and weight indicate that you're in a range where Sleeve IS a worthwhile intervention for your weight and your health.

And, younger people have advantages in bariatric surgery.  Younger people have lower risk of surgery, and they have a better chance of getting back to actually normal health with the help of surgery.

Best of luck!

Dr JP