Fear of Surgery: How the Lap Band Is the Most Gentle and Best Choice by Dr. Paul O'Brien

Obesity is such a downer. You hate it. You probably spend a bit of each day thinking about the problem of being obese – from the very first thing in the morning.

You wake up feeling tired. You may not have slept well because of sleep apnea and you have woken up dozens of times during the night because you couldn’t get enough oxygen.

You get out of the shower and you just do not want to look in the bathroom mirror. You think you look revolting. You remember twenty years ago and cannot believe what has happened to that attractive person.

You think about what clothes you will wear – you despair as there is nothing that will hide that shape. You pick something loose and flowing but underneath, it is you and you know it.

You have been told you should eat breakfast, you are hungry and want to eat breakfast but you know that the last thing you need is more calories. You have stored enough fat to last for a year without eating. But you just want to eat.

And so on through the day. At almost every point, there is something that reminds you of your problem. People with the disease of obesity hate their problem more than almost any other disease. When compared with people who have terminal cancer, severe generalized arthritis or paraplegia, those with obesity will rate their problem worse.

There has to be a solution. We can put a man on the moon. For God’s sake, surely all those smart people can think of something that can control my weight. Diets don’t work. You have tried a hundred. Sure, you lose some weight but it comes back and often with extra. All the commercial weight-loss groups take more weight from your hip pocket than the rest of you. The pills haven’t helped and the dietitian, the psychologist, the naturopath and all the others make promises but nothing changes.

The gastric band is a solution. It is proven to work. It does require you to work as a partner but, because it does the one thing you really need, it does make a difference. It controls your appetite. It takes away your focus on food, your interest in food, your thinking about food. Food becomes less important. You are not hungry all the time. In fact, you are not hungry much at all. If the band is adjusted properly you may be a little hungry before a meal, but a small amount of food satisfies. And you then don’t even think about food for hours. You forget meal times. You forget to shop for food. You are not spending time each day in planning meals, thinking about where to go and what to eat. The focus on food is gone.

But, I can feel you thinking, this gastric band is surgery. Isn’t that dangerous? Aren’t you putting something in me that wasn’t meant to be? Haven’t people died from having it done?

Well, yes. Definitely. It is serious stuff. But compare it to the alternatives of either continuing the way you are going or having the much more radical options like gastric bypass. The path you are on is not leading to happiness or health. You may already have or soon will have diseases caused by your obesity. You are worried about getting more diseases and dying prematurely. These worries are all real. They have been well documented and they will happen.

The risk of gastric banding is very small. It has proved to be a remarkably safe procedure. Far safer than stapling procedures such as bypass. Far safer than almost any other surgical procedures. Even safer than having your appendix out. And far safer than being obese which is now leading to at least as many deaths as smoking.

This is an outpatient procedure. A two to three hour length of stay. You are in hospital for less time than for an angiogram. Less than a liver biopsy. About the same time as you would for a colonoscopy. Certainly less than for the truly major operations like gastric bypass or heart bypass. Add something about special anesthesia and recovery.

And as for the “foreign body”. Well, get over it. We have been placing silicone in people for various reasons for more than 50 years and it has proved to be the safest of all the implants we use. Think of stapling procedures like bypass. There are hundreds of stainless steel staples placed. Many more “foreign bodies” than you get with the band. And no reason at all to see these as any safer than silicone. There are now dozens of situations in surgery where we place something “foreign” - heart valves, stents in arteries, vascular grafts, plates on bones, new hips and knees, lenses in eyes. Implants are a part of medicine in the 21st century and we would be lost without them.

If you don’t have much of a problem with your obesity, that’s fine. If there is no problem, you don’t need a solution. Worry about these things like “safety”, “surgery”, “foreign bodies” and decide that the disease is easier to cope with than the cure.

But, if your obesity is hurting you, making you ill, ruining your quality of life and threatening your length of life, this small risk is an easy price to pay. Consider the cost of the obesity to you and consider the benefits of losing much of your excess weight. And then make a decision. For most it is very clear which is the best path.

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