Choosing Lap-Band OR REALIZE Band for Young Adults
I recently saw a patient in my office who I’ll call Cindy. Cindy is considering weight loss surgery as a young adult. She is 21 years old and has been struggling with being seriously overweight ever since she was about eight years old. She had worked very hard at staying as trim as best as she can, but at age 21 and at 5’4”, she weighs right around 205 pounds and struggles mightily to ever get below 200.
Cindy is very active. She works out three times a week. She participates in dance and swimming and she describes herself as a real “go-getter” at work. She reports that her friends are amazed that she is as overweight as she is given how active she is. Cindy is very concerned about her genetic tendencies for weight gain and poor health. Her own mother has almost become almost completely sedentary and weighs close to 300 pounds. Many family members have early heart disease and diabetes, and Cindy just does not want to go there. Cindy has made the decision to address her weight loss issue through bariatric surgery and has been considering what surgery to pursue.
For someone in Cindy’s shoes, it can be a tough choice. On the one hand, she is quite young, and as I have counseled her, it is an advantage to do something that is potentially reversible for someone who is so young. Since nobody knows what kind of good weight loss options will be available in 20 or 30 years, it makes a lot of sense for a young person to keep those options open. One of the underlying truths of medicine and surgery and science is that the pace of change and innovation continues to accelerate. So just in the last few years we have seen FDA approval of a number of new devices and techniques including the Lap-Band, the REALIZE, Stomaphyx, and many others are on the way. Imagine in 20 or 30 years what kind of new innovations may be possible. (My own hope is that we have a highly effective safe and durable weight loss medicine or appetite suppressant that finally works well without side effects!) So for a young person, one of the first considerations should be to consider not avoiding some of the irreversible procedures such as gastrectomy, biliopancreatic diversion, and to some degree, Roux-en-Y gastric bypass.
The Roux-en-Y gastric bypass, on the other hand, is extremely effective in preventing and resolving diabetes, a condition that runs in Cindy’s family. And while it is technically “reversible”, the surgery that would be required to reverse it would be fairly invasive, fairly major and may very well require open incision or scar.
So is there one simple single right answer for choice of weight loss surgery in young adults? No, I do not believe there is. I do think it requires weighing all of the considerations (which are discussed in other blogs, as well as in the book, Outpatient Weight Loss Surgery, Safe and Effective Weight Loss With Modern Bariatric Surgery.