Why do people have gastric banding?
In many countries severe obesity is regarded as a chronic disease. Typically it is defined as having body weight more than 45 kilogrammes over your ideal. If you are more than 25 per cent above what is known as your Ideal Body Weight there is an increased risk of health problems such as varicose veins, heart disease, high blood pressure, back pain, diabetes and a host of other problems.

Overweight people may suffer from low self-esteem as a result of their appearance and feel frustrated by a consistent failure to lose weight by dieting.

Gastric banding is used to create a smaller gastric pouch that limits the amount of food the stomach can hold at any one time. The inflatable ring limits the flow of food from this pouch to the main digestive system. As a result the patient will always feel full after eating just small portions of food. As the pouch empties slowly, the patient has a limited desire to eat between meals.

Realistic expectations
You must have realistic expectations about what gastric banding can achieve for you. Of course you will undoubtedly lose weight but the operation is only a first step in a major change of lifestyle. It is vital that if you want to continue successful weight loss, it requires long-term cooperation with your surgeon and strict adherence to his advice.

Ideal candidates for gastric banding

• Gastric banding can be performed if you are more than 21 years old and have been overweight for more than five years.
• You do not drink alcohol to excess and have no history of heart or lung disease.
• You are not suffering from any other disease that may have caused your excessive weight or that may have a detrimental impact on the procedure.
• You are mentally prepared to follow the advice of the surgeon and make important changes in your lifestyle and eating habits.
• Your body weight is 45 kilogrammes over your ideal weight.
• You have been excessively overweight for more than five years.
• You have consistently tried to loss weight and failed.

Getting the most out of your consultancy
Often in cases where clients are unhappy with the results of surgery it is because they did not discuss their expectations thoroughly or were afraid to talk about the outcome or risks.

You have to make an informed decision before signing the consent form so make sure you ask plenty of questions. You want to feel relaxed and confident and completely understand what will happen during surgery.

You may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• About the extent of scarring and how it will change in time.
• What happens if anything goes wrong.

Preparing for surgery

• Avoid alcohol, aspirin, garlic and food oils a least a week before surgery as they can cause excessive bleeding.
• Do not eat or drink anything six hours before your general anaesthetic.
• The surgeon and anaesthetist needs to know your medical history and if you are on any medication.
• You will be advised of any health checks or X-rays required before your procedure.
• Prior to surgery you will be met by your surgeon who will assess you and discuss your queries
• Try and give up smoking a couple of weeks before your procedure as it interferes with healing processes.

What happens during gastric banding surgery?
Gastric banding operations are performed using a laparoscopic approach better known as ‘key-hole’ surgery. Tiny incisions are made through the abdominal wall and tubes installed to allow instruments access to the abdomen.

These instruments can then be monitored on a screen thanks to a miniature camera that is also passed through a tube.

The band is then fitted around the upper part of the stomach and ‘tightened’ to create an ‘hour-glass’ effect made up of two small pouches. There is no physical damage to the digestive tract, no ‘stapling’ or cutting.

The band can be easily removed at any time and the stomach will return to its original shape. Simply adding or removing fluid from the band makes the device easy to adjust.

How does the procedure work?
As a result of gastric banding you will feel full after eating just small portions because the band will restrict the flow of food from the new upper part of your stomach into the lower section.

The sensation of fullness will last several hours before you feel like eating again. By reducing your calorie intake you will dramatically begin to loss weight and also begin to change your eating habits.

All surgery carries an element of risk
Most people believe that the benefits of gastric banding far outweigh the risk. However before you sign the surgery consent form you should be aware of any possible complications and side effects.

Complications associated with any type of surgery include problems healing, the danger of infection and the potential formation of clots that may be life-threatening. Some patients may also have an allergic reaction to anaesthesia.

Deciding on gastric banding
It is important that you take your time to make an informed decision about gastric banding. Complications are extremely rare as this is a very common operation, however you must consider any potential outcome.

• After a successful operation you may feel sick due to the anaesthetic.
• There will be scars left by the tiny incisions, but these should be located in ‘hidden’ areas. Scars fade but do not necessarily disappear completely.
• There may be instances of nausea or vomiting. This is especially common when a patient eats more than is recommended after the procedure.
• There is a possibility that you may be intolerant to the silicone of the gastric band.
• Finally there may be a chance of stomach slippage or a dilation of the pouch above the band.

Complications are rare and depend greatly on individual circumstances. Your surgeon will be able to explain how the risks apply in your case.