I have definetly decided on the RNY versus the lap band. After sitting here in front of my computer for a ridiculous number of hours reading medical journals, news articles, and personal accounts, I really think that the band is just not restrictive enough for me. I had a vertical banded gastroplasty in 1988, after which I lost over 100 pounds. It is a solely restrictive procedure, like the band. I maintained that loss for about 7 years, but now I've gained what I lost and then some. My staple in has "broken' and the surgery just doesn't do what it was designed to. In fact, alot of the reading I've done indicates that many people with my surgery have had similar problems. So, here I am, ready to have another surgery to do what I thought the first one would; give me a tool to have lasting weight loss.
RNY , as I'm sure you know, has both a restrictive component as well as a malabsorption component. Thats a big factor in my opinion. My experience has shown me that a restrictive component alone isn't enough.I didn't get in this position because I have the kind of control a lap band requires. From everything I've read, this surgery can kind of "gives you a nudge" when you eat things you shoudln't. I actually am hoping to have dumping, to help me keep on the straight and narrow. (Please feel free to remind me of that AFTER my surgery
) Also, from what I've read, the amount you can expect to lose after a lap is much less than with RNY.
All that said, the most convincing piece of evidence so far is the ghrelin factor. Simply stated, (mostly because my understanding of the subject is pretty simple) ghrelin is one of the hormones that regulate hunger. In non- surgical obese people that have lost a considerable amount of weight, ghrelin levels can be 4 times normal. This fact really makes it easy to understand why we gain weight back so easily after losing. Our bodies are fighting us!
Ghrelin is secreted by cells in our stomachs. Many studies have found that post RNY patients who've lost a considerable amount of weight don't show the same increased levels of ghrelin that people who haven't had surgery do. It's thought that this is due to the fact that the surgery alters the stomach is such a way that ghrelin cells dont function the way they did before. It's postulated this is one of the reasons that RNY patients tend to have more success at maintaining their loss. (Actually, in the interest of balance, there are also studies that post op patients have higher levels, but a study I just read the other day kind of explains why these studies have shown such vast differences. Here's the link if you're into the geeky stuff...
http://jcem.endojournals.org/cgi/reprint/88/7/2999 )
Sorry for being so long winded...hope that helps. Good luck in your journey.