Gastric banding – A weight loss strategy for the morbidly obese

If Dr. Lance Tin had his way, diet soft drinks would be outlawed. “Diet drinks promote obesity. They have no calories themselves but they intensify the need to seek out sweet-tasting foods rather than nutritious, healthy eating habits.”

He says people have a strange way of justifying their eating habits. They will go to a fast-food restaurant and order a double-cheese burger, super-sized fries and a diet cola. He a says that kind of behaviour puts teenagers on a dangerous course to future health problems such as type 2 diabetes.

Canada’s rate of obesity is about half that of the United States. What’s alarming, says Dr. Tin, is the rate of growth of obesity among teenagers. “Our rate exceeds that of the U.S.,” he says. “I predict there will be a pandemic of obesity among the next wave of young people.” In order to stop the wave, he says we need to move away from fast food and our sedentary lifestyle.

As the chief of surgery at The Credit Valley Hospital, Dr. Tin sees the desperation of many morbidly obese patients who, after years of failure dieting, come to him as a last resort to surgically limit their ability to eat. The surgery is called gastric banding. A band is placed around the inlet of the stomach. It is connected to a tube and a port which is placed deep under the skin. The port is injected with saline to tighten or loosen the band dependent upon the patient’s subsequent ability to lose weight.

Gastric banding is meant for patients who have a body mass index (BMI) above 45 (normal is 20 to 25) or a BMI of above 40 with co-morbidities such as type 2 diabetes, high blood pressure, arthritis and who without it, will likely have a shorter life span.

Although gastric banding is a relatively new surgical technique in Canada, it has been performed in Europe for the last fifteen years. It is safer than other surgical weight reduction procedures such as gastric bypass because it is does not involve any alteration of the intestinal anatomy and it is performed laparoscopically (minimally invasive surgery) on an outpatient basis. The procedure takes about an hour and half followed by a couple hours of recovery. The patient is discharged home on the same day.

Dr. Tin sees the patient for regular follow-up care. The band is adjusted periodically to achieve the desired weight loss.

It is a life-altering surgery. “Patients have to learn to live with the band,” Dr. Tin cautions. “I advise them to change their ‘taste’ and rediscover water. If they indulge on intensely sweet drinks with a high calorie count such as chocolate shakes, it won’t work.” Otherwise gastric banding patients have no special diets to follow after surgery. They are encouraged to eat normally – meat, vegetables, bread – but in smaller quantities. They need to eat slower, chew well and eat normal, healthy food.

He says gastric banding forces the patient to eat about 40 per cent less. If they follow good eating habits, they will be able to lose about 60 per cent of their excessive weight.

Dr. Tin performs two to three gastric bandings each month. The procedure is not covered by OHIP – patients pay approximately $15,000 for the surgery.