In this episode of the Houston weight loss surgery podcast, Dr. Thomas takes on the topic of Houston lap band surgery. Dr. Thomas shares a different perspective than the other weight loss surgeons in Houston.
David: Hi this is David Dutton, I would like to welcome you to the Houston weight loss podcast. Today we are going to talk about lap band surgery, a very controversial topic and as usual I have the most respected bariatric surgeon in Houston on the phone with me, Dr. Clifton Thomas. Cliff are you there?
Dr. Thomas: Yes I am.
David: Thank you so much for doing the podcast. It’s always exciting to have you on as a guest. Today we are going to talk about lap band surgery. You have a different take on it. I thought it was very interesting when we spoke before. It’s a very popular surgery, a lot of people know about it, but you are going to give us a different take on it, in fact I believe you are going to give us five reasons why you should not do lap band surgery. So this should be an interesting podcast. I am going to go ahead and turn it over to you. Give us your thoughts on it first and then you can go ahead and give us the reasons.
Dr. Thomas: A lot of people are aware of lap band surgery. It has been out there for quite a while. The primary way that operation works is that it allows you to get full on a small amount of food, but it is a mechanical device and the stomach itself is not like a black box it is something that is very pliable, it’s like a balloon. It doesn’t have the same volume and shape all the time.
We would like to it to work very specifically always controlling the exact volume of food and the fact is it really doesn’t do that but it is a tool and if it was the only surgery that we had today to help people lose weight it would be so far and above anything you could do on your own, but we have two other procedures that are better.
So one of the reasons not to do it is to look at other procedures because we have 2 other procedures that work better and I will tell you why that is. The biggest issue with the lap band is that it is a mechanical device that doesn’t function exactly the same in everybody, but even more than that with these other procedures we get chemical changes in our body that actually drive us and help us and gets rid of those nagging drives to eat all kinds of bad food. We have chemical changes that work against that and the lap band doesn’t have that.
David: That’s something that a lot of Drs. Don’t talk about. I have not heard that before.
Dr. Thomas: It’s also interesting, I have been doing the lap band since 2002 . It was approved in the United sates in June of 2002 and I started in November so I have done it about as long as anybody in Texas. What I have found over time is that I have lots of success, but I also have had some failures.
So I have really been able to spate in my mind what are some of the things that make people successful with the lap band and what I have found out that is people who are really good planners and they are really focused on planning their day and actually and almost get a little anxiety if they can’t follow the plan of the day- they are almost OCD, having some obsessive compulsive behavior, it’s relative to being able to follow the plan.
Those people do excellent with the sleeve. It also requires someone that can make lots of office visits over the year whereas the other two procedures don’t require that. The people that have the band, even if they are good planners and are OCD need to come to the office at least twelve to twenty times over a year to be successful and start eliminating bad habits. And use the band properly.
In fact a lot of people aren’t OCD about planning and they live haphazardly, they will have good plans about doing things better, but they just don’t accomplish it. Those are people that really struggle being successful with the band
David: One of the things you actually mentioned was that the success rate was actually less than the sleeve.
Dr. Thomas: That’s right it is less than then sleeve and the gastric bypass and the reason is that they are simply better tools. They do more of the work for you.
David: Talk briefly about the two other types of surgery, the two other options that someone has.
Dr. Thomas: The gastric bypass has been around for a long time an we have learned a lot from it and the sleeve has been around for a shorter amount of time, but the longer we do the sleeve we realize it has most if not the same benefits of the gastric bypass, but being a less complex procedure which means less chance of having complications or issues.
So with both of these operations we are finding that there are all sorts of chemicals in our bodies that drive us to maintain our weight and if our body senses that there is something really wrong then we lose weight. We have all of these chemicals driving us .not to lose the weight that we currently have. The magic about both the sleeve and the gastric bypass is that they change those chemicals in our body immediately the day of surgery that stops that drive to maintain that same weight.
David: Oh wow, those are some interesting things. I know there are some other podcasts where we are going to talk about willpower and mechanisms. I don’t know what you call them, safety mechanisms or defense mechanisms that your body has. I know you have talked about them before and we’ll do that in another podcast. It’s a very interesting topic that people need to be educated about and know what is out there.
Dr. Thomas: So I mentioned the lap band and it is nothing more than an inner tube that we place around the top part of the stomach and inflate with saline and make it tighter or if it is too tight, make it loose. The problem with that is what we all have experienced, we know where to put it and how to put it in there, but nevertheless it doesn’t always function the same for everybody and on occasion the band slips out of position which is prolapse in which case it blocks the stomach and you have to go in and have that surgically repaired.
People think of the band as less invasive, but there is that issue of mechanical failure or prolapsed and slipping out of position that between five and ten percent of the time they have to go back to surgery and have the band removed because of that.
David: Which means more money and more time and people are trying to conserve that as is so that can be a huge problem.
Dr. Thomas: I do want to emphasize again that it is the least invasive procedure, in other words there is less risk of having a complication at the time of surgery, but the complications with the two other procedures are low, actually less that gall bladder surgery. The chance of having a mechanical issue that causes the procedure to not work well for you is higher.
David: Very interesting. Dr. Thomas, thank you so much for answering the lap band surgery question. I really appreciate the information you shared today.
Dr. Thomas: It’s been a pleasure.
David: If you want to contact Dr. Thomas, you can go to houstonweightlossdoctor.com you can actually ask Dr. Thomas your most important questions about weight loss surgery and he will answer it in a consultation. So go to houstonweightlossdoctor.com and check it out.