Gastric Bands: Good news, Bad news

Article created in collaboration with: Shaw Somers BSc(Hons) MD FRCS - Consultant Surgeon & Director at Streamline Weight Loss Clinics

The gastric band is essentially an inflatable silicone plastic ring. It is a simple concept for helping reduce the size of meals eaten on a daily basis.

During keyhole surgery, the gastric band is carefully placed at the top of the stomach, meaning swallowed food has to pass through this narrowing before arriving into the stomach to start digestion. The operation is safe, simple, and relatively non-invasive. The gastric band is connected via a thin tube to an inflation port implanted deep under the skin, usually on the left side of the tummy.

Tightness of the band can be adjusted after surgery by inserting a small needle through the skin into the port and inflating with fluid, or deflating as required. This helps control the speed of eating and can also increase the feeling of satiety (fullness and satisfaction) with smaller amounts of food.

Most patients will require 4 to 6 adjustments of a gastric band in the first year following insertion. Once a satisfactory level of restriction is achieved, and weight loss is progressing steadily, at about 1-2 kg per month, the band is left alone. Adjustments are only then required if the band needs to be released due to illness, or tightened again if it becomes too loose.

Is there an ideal gastric band patient?

Experience has shown that different weight loss operations suit different people. In our experience, gastric band surgery works best in younger, more active patients. It is also better at tackling overeating and poor portion size control. The band is not good for older, less active patients, or those who have a grazing or snacking habit.

What about the facts?

Evidence from published medical literature on gastric bands is mixed. Some groups reported excellent long-term results up to 15 years after gastric band implantation. These groups tended to have excellent after-care programs with easy access for patients to gain follow-up adjustments and advice. Their results indicated that gastric bands can achieve similar rates of weight loss to sleeves and bypasses at the 10 year mark. than with sleeves or bypasses, but these are mainly due to simple problems detailed below. Although, there was a recorded a high rate of gastric band satisfaction, with most patients achieving at least 50% of excess weight lost by 2 years.

Other groups have however reported poor outcomes, with high rates of gastric band problems (50% patients) and removals. These experiences tended to be characterised by poor patient preparation, poor after-care, and poor follow-up.

What can go wrong?

It‘s fair to say that every gastric weight loss operation has a risk of long-term problems. The gastric band is no different. One of the main issues is that as a plastic device, it can be prone to problems from the body reacting to the device itself.

Here are some of the most common problems: