Dr Steve Wilkinson’s answers to weight loss surgery questions

A: Weight-loss results vary from patient to patient, and the amount of weight you may lose depends on several things:

  • The band being in the right position and being adjusted correctly
  • You need to be committed to your new lifestyle and eating habits

Obesity procedure is not a miracle cure, and the kilograms won’t come off by themselves. It is very important to set achievable weight-loss goals from the beginning.

A weight loss of around a kilo a week in the first year after the operation is possible, but half a kilo per week is more likely. Twelve to eighteen months after the operation your weekly weight loss is often less.

Remember that you should lose weight gradually. Losing weight too fast creates a health risk and can lead to a number of problems. Your main goal is to have weight loss that prevents, improves, or resolves the health problems associated with severe obesity.

A: If LAP-BAND® Procedure is performed laparoscopically patients typically spend less than 24 hours in hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

A: Quite the contrary! The LAP-BAND® makes you eat less and feel full in two ways – by reducing the capacity of your stomach and increasing the time it takes food to get through the digestive system. After a small meal, the amount of which varies from person to person, you should feel full. If you follow the nutrition guidelines when you choose your food and then chew it well, you should not feel hungry or deprived. Remember that the LAP-BAND® is a tool to help you change your eating habits.

A: The LAP-BAND® System limits food intake. If you feel nauseated or sick on a regular basis, it may mean that you are not chewing your food well or that you are not following the diet rules properly. However, it could also mean that there is a problem with the placement or adjustment of the band so you should contact us if this problem persists.

Vomiting should be avoided as much as possible as it can cause the small stomach pouch to stretch and can also lead to slippage of part of the stomach through the band, which would reduce the success of the operation. In some cases, it may also require another operation.

A: Adjustments are nearly always done at a visit to our office. Local anaesthesia may or may not be needed. A fine needle is passed through the skin into the access port to add or subtract saline. This process most often takes only a few seconds. Most patients say it is nearly painless.

A: There are no restrictions based on the access port. It is placed under the skin in the abdominal wall, and once the incisions have healed it should not cause discomfort or limit your movements or any physical exercise. The only sensation you may have from the port is when you go in for adjustments. If you feel persistent discomfort in the port area, let us know as soon as possible.

A: In the first year we will need to see you 4 to 6 times. After that we like to see you about once or twice per year. For patients in the north of Tasmania, Dr Stephen Wilkinson operates and carries out follow-up clinics in Launceston and Burnie about every 6 weeks.

A: Although the LAP-BAND® System is not planned to be removed, it can be if required. In most cases this is done laparoscopically as a day procedure. The stomach generally returns to its original shape once the band is removed. After the removal, though, you may regain considerable weight.

A: The LAP-BAND® does not affect or hamper physical activity including aerobics, stretching and strenuous exercise.

A: This is a fairly common feeling, especially for people with bands that are tight or just after an adjustment. During the day the water content in the body changes and this may cause the band to feel “tighter” some of the time. Some women have also noticed that the Lap-band® feels tighter during menstruation.

A: That is not always the case. As a rule, plastic surgery will not be considered for at least a year or two after the operation. Sometimes the skin will mold itself around the new body tissue. You should give the skin the time it needs to adjust before you decide to have more surgery.

A: One of the major advantages of the LAP-BAND® System is that it can be adjusted. If your illness requires you to eat more, the band can be loosened by removing saline from it. When you have recovered from your illness and want to lose weight again, the band can be tightened by increasing the amount of saline. If the band cannot be loosened enough, it may have to be removed.

A: Becoming pregnant can be easier as you lose weight. Your menstrual cycle may become more regular. If you need to eat more while you are pregnant, the band can be loosened. After the pregnancy, the band may be made tighter again, and you can resume losing weight.

A: You may. It’s possible you may not get enough vitamins from three small meals a day. At your regular check-ups, your specialist will evaluate whether you are getting enough vitamin B12, folic acid, and iron.

A: You should be able to take prescribed medication. You may need to use capsules, break big tablets in half or dissolve them in water so they do not get stuck in the stoma and make you sick. You should always ask the doctor who prescribes the drugs about this.

A: Order only a small amount of food, such as an entree. Eat slowly. Finish at the same time as your table companions. You might want to let your host or hostess know in advance that you cannot eat very much.

A: After your stomach has healed, you may eat most foods that don’t cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients such as those recommended in the nutrition section of this booklet and as advised by your surgeon and/or dietitian. If you eat foods that contain lots of sugar and fat or drink liquids full of ‘empty’ calories, such as milkshakes, the effect of the LAP-BAND® may be greatly reduced or cancelled.

A: Alcohol has a high number of calories. It also breaks down vitamins. An occasional glass of wine or other alcoholic beverage, though, is not considered harmful to weight loss.

A: There may be some reduction in the volume of your stools, which is normal after a decrease in food intake because you eat less fibre. This should not cause you severe problems. If difficulties do arise, let us know as soon as possible.

A: Sometimes the gastric bypass operation can produce fast weight loss in the first twelve months. It is important to remember however that gastric bypass is a permanent procedure that cannot be adjusted or removed depending on your life circumstances. Instead it is wise to focus on long-term weight loss and remember that it is important to lose weight gradually while reducing obesity-related risks and improving your health.