Expert: John Pilcher, MD - 11/2/2007

Question
Hi Dr.  I am 30 weight 235 5'5".  I am thinking of doing something...  I have lots of pain in my legs and feet and am depressed because I have not been able to get weight off.  Have 2 little boys.  My Mom has Lupus and I have a high ana so it said no lap-band on a web-site.  Any other suggestions?
Thank you.  I am nervous about having problems years after surgey?

Answer
Kelly,
I think it is reasonable for you to consider surgery for your weight.  As a young woman, you are probably not yet suffering irreversible consequences of the weight.  However, as you can feel, the weight is likely to gradually create worse problems for you over time.  If you have reached a point where you beleive that you have taken nonsurgical therapy as far as you can go, then it is medically reasonable to consider surgery.

In spite of your family history of Lupus and your own elevated ANA, I would not automatically discount a Band in your case - most medical professionals do NOT believe that the Band material causes any increased problem with autoimmune disease.

A gastric bypass would also appear to be a very reasonable possibility.  Your appropriate concern about the lifelong consequences of surgery would point somewhat toward the gastric bypass, since it has been around for decades.

I recommend you find an excellent and well established bariatric surgical program in your area, and explore your options.  You can find Centers of Excellence for bariatric surgery at    www.asmbs.org

Best of luck!
Dr JP