Band vs. Bypass: the next round in the gastric surgery debate

Anonymous_1 on 23 Feb 2011 at 12:00am

Gastric surgery continues to be a red-hot topic. The band vs. bypass debate continues -- and now there's new research thrown into the mix. 

On the heels of the recent FDA decision to expand eligibility parameters for the Allergan Lap-Band device comes a study concluding that Roux-en-Y (RNY) gastric bypass is more effective for long-term weight loss in obese diabetics than the Lap-Band.

Gastric bypass surgery reroutes food around the lower stomach, reducing the amount of calories absorbed by the body, while Lap-Band restricts food at the top of the stomach, causing the patient to feel full.

The researchers found that overweight diabetics who had the RNY surgery dropped 64% of their excess weight in a year. In comparison, Lap-Band patients lost just 36%.

What's more, about 86% of the bypass patients lost over 40% of their excess weight. Comparatively, only about 31% of Lap-Band patients lost that much weight. The research appears in the February issue of Archives of Surgery.

For more on the difference between the two procedures, we turn to bariatric surgeon David Buchin of Long Island:

  • Roux-en-Y, he explains, works this way: "First, we create a small stomach pouch to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs."
  • In gastric band surgery, an inflatable band is placed around the top portion of the stomach, creating a small pouch. During meals, food accumulates in this top pouch, causing the stomach to feel full after only a small portion is consumed.

Regardless of debate, 96% of those who rated their gastric bypass surgery on RealSelf said it was Worth It.

What it's not? A quick fix.

Here's a comparison of band vs. bypass from New York bariatric surgeon Dr. Shawn Garber:  

(Photos courtesy of Dr. Garber)
Full disclosure: author has undergone a Lap-Band procedure.