Expert: John Pilcher, MD - 3/23/2010

Question
I have had the lapband since Dec. 2005. Had originally lost 125 lbs. Now I have gained 40 lbs and can't seem to lose it. I eat very little and my doctor has suggested I get the sleeve. I just don't understand how, if I eat very little, how would the sleeve help me get the "punch" to start losing again. The dr. advised me of the hormonal effect with the sleeve. Am I to understand, that with the sleeve it would give me the punch needed to start losing again?  I am hoping to have this surgery within 2 weeks if I can get answers on how the sleeve can get me started again. And with the lapband, do we usually start gaining weight regardless of what we eat?

Answer
Christina,
This issue of weight regain following bariatric surgery is a vexing one for patients and their physicians alike.

There does seem to be a real rate of weight regain after Band surgery, and for most patients who change from a Band to sleeve or bypass there is substantial renewal of the weight loss effect.  I take it seriously when you say you eat very little, but still the revision to a different type of surgery can often give patients a weight loss boost.  It may be a difference in hormone production, or different type of food taken with the different operation, or other factors that we don't know about.

In short, most patients I have changed from Band to sleeve have been very happy with the change.

Best of luck!

Dr JP