Question: 

I have an adjustable gastric band, and it's not working for me. What should I do?

Answered by bariatric surgeon Corrigan McBride, MD:

Unfortunately, many people who have had laparoscopic adjustable gastric bands are finding that they are not turning out to be the weight-loss tool they hoped for, either because of adverse side effects or because they are not losing weight. 

The key challenge with adjustable gastric bands is finding the right balance by tightening the band enough for weight loss without causing severe reflux or swallowing issues. This "sweet spot" is often difficult to achieve, making many patients feel the band is not working for them. We’ve also found the bands tend to slip, move, erode, or cause terrible reflux or painful swallowing.

What should I do next?

This personal decision is best discussed with a bariatric specialist. If you are in the minority that has an adjustable gastric band and it’s working well, there is no harm in leaving it in with regular checkups. 

However, if it isn’t working, you have options depending on your health goals. 

• The band can be laparoscopically removed, usually resolving problems like heartburn, reflux, or painful swallowing. Removing an adjustable gastric band is generally a low-risk laparoscopic procedure.
• An alternative bariatric procedure can be explored if you want to lose weight. If everything looks good at the time of removal and another surgery is deemed safe, a laparoscopic sleeve, gastric bypass or duodenal switch may be considered.
• Talk with a bariatric specialist about alternative options to surgery, such as weight-loss medications, the New Direction Meal Replacement Program, counseling, help with lifestyle changes and ongoing support.

What does adjustable gastric band erosion feel like? 

The two most common ways we see erosion are if people can still eat a lot more than they think they should be or if an infection is present, causing redness, tenderness or warmth. 

What if my adjustable gastric band slips? Will it fix itself?

If you used to be able to eat and drink at a certain level but now cannot, it usually means you’ve experienced a slip that needs to be addressed. While there are things we can try, not all solutions have proven successful, as the re-slip rate is high.

Make an appointment with the bariatric center if:

• If you experience a slip that gives you terrible heartburn or reflux.

Go to the emergency room, ideally at a location that has a bariatric center, if:

• You were doing OK but now are getting things caught in your throat, are vomiting, and have severe upper abdominal pain with swallowing even if you drink water. Head to the emergency room if you experience any of these, especially if it happens with every bite.

The Nebraska Medicine Bariatrics Center was designed by physicians trained in medical weight management and bariatric surgery. Because your weight-loss journey is unique, our team is dedicated to helping you achieve your personal goals with your best-fit treatment options.

Call 402.559.9500 to make an appointment.