The adjustable gastric band is a type of weight loss system placed surgically to help patients who struggle with obesity. There are different types of bariatric surgery — the global term used for weight loss surgeries — and physicians evaluate patients and recommend the most appropriate type of surgery for each candidate. The adjustable gastric band, Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and biliopancreatic diversion with a duodenal switch — all forms of weight loss surgeries — have pros and cons that should be taken into consideration prior to any decision.
For the adjustable gastric band, the treatment is based on the placement of an inflatable band around the upper part of the stomach. The band, which is adjustable, is inserted during a laparoscopic surgery, meaning that the surgeon will make small incisions in the abdomen instead of an open surgery. During following consultations, the physicians will adjust the band to limit food intake, which will make patients feel full faster and with smaller amounts of food.
Adjustable Gastric Band Pros and Cons: Advantages
According to the analysis of the American Society for Metabolic and Bariatric Surgery, there are many advantages to using an adjustable gastric band placement as a way of fighting obesity. The amount of food that can be held in a patient’s stomach is greatly reduced with the device in place without the need to permanently remove parts of the stomach or re-rout the intestine — a feature considered to be the most attractive compared to more invasive weight loss procedures.
The average achievement for the gastric band is 40 to 50 percent of excess weight loss, which can result in improvement of comorbidities like insulin resistance, type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease, hyperuricemia, gout, and osteoarthritis, and overall health.
The surgery also requires a shorter hospital stay, usually less than 24 hours, with some centers discharging the patient the same day as surgery, while it is among the FDA-approved bariatric procedures with the lowest rate of early postoperative complications and mortality, as well as lowest risk for vitamin and mineral deficiencies. In addition, an adjustable gastric band is a reversible and adjustable process, unlike other bariatric surgeries that are permanent.
Adjustable Gastric Band Pros and Cons: Disadvantages
However, the gastric band also has cons, starting with the fact that the device is associated with slower and later weight loss than other surgical procedures, which can sometimes impact patients’ motivation to remain compliant with the program. Similarly, some patients that use the adjustable gastric band fail to lose at least 50 percent of excess body weight compared to the other surgeries commonly performed.
In addition, it is one of the methods that requires patients to hold a foreign device inside their bodies, which can be uncomfortable and a “strange” experience for some patients. Several side effects are also associated with the band, including band slippage or band erosion into the stomach, which occurs in a very small percentage of patients, as well as dilatation of the esophagus if the patient overeats.
Patients may also suffer mechanical problems with the band, tube or port in a small percentage of patients and it requires strict adherence to the postoperative diet and to postoperative follow-up visits in order to guarantee successful results and avoid potential side effects related to the band. However, due to complications that need to be surgically corrected, adjustable gastric band is also the bariatric surgery with highest rate of re-operation, according to the society.
What is critically important for patients considering the gastric band to remember is that the vast majority of complications and ineffective weight loss are the result of a lack of patient compliance. Gastric bands have been approved by the FDA and continue to pass rigorous post-approval safety and efficacy studies. However, if patients continue to overeat or fail to follow the indications of the device, it will not be effective. For this reason, patient compliance is critical to the success of the gastric band in obese patients.