How Bariatric Surgery Works: The Band


I've been writing this newsletter for a couple of years now, and although I discuss bariatric surgery and other 'health related' topics, I have never really formally reviewed all the procedures we do and how they work to help patients lose weight.  There are basically three different procedures we do in bariatric surgery…the band, the 'sleeve', and the 'gastric bypass'.  Today I will discuss the band and the next two newsletters will discuss the sleeve and then the bypass.  If you know anyone who is interested in bariatric surgery, feel free to forward this newsletter to them…

Of the three bariatric procedures we do patients tend to have the least amount of weight loss with the band, as I describe how the band works I hope you will get a sense of why that is.  In the proper patient the band can be effective, but for the wrong patient the band is ineffective and frustrating.
One of my reasons for writing these newsletters is so patients will get a sense for themselves which procedure would be best for them.  There are two different companies marketing bands right now and I think their advertising has given many patients the impression that the band is as effective as other bariatric procedures…in my opinion, this is simply not true.

Over the course of this, and the next two, newsletters I will be discussing the many ways that bariatric procedures help patients lose weight…for instance a procedure can restrict the amount of food a person can eat, a procedure can affect how the body absorbs nutrients, a procedure can literally have chemical or hormonal effects which decrease a persons appetite etc.

Of the three bariatric procedures we do the band is the simplest and it does only one thing to help a patient lose weight.  The only thing a band does is to restrict the amount of food that a person can eat..that is all.  It is purely mechanical restriction and forces a patient to eat smaller portions, but as we'll see it only really restricts certain types of foods..not all foods.  The band is a ring which goes around the stomach and creates a narrowing at that one spot (picture an hourglass).  So, in the same way an hourglass slows down the passage of whatever you put into it, the band will slow down the passage of whatever food you eat.  The band, however is slightly different from an hourglass because we can adjust how narrow it is.

As I mentioned earlier the band is a ring, but this ring has a balloon on the inside and that balloon can be inflated which makes the opening the food passes through more and more narrow. Another way I describe the band to patients is that it is a speed bump in your stomach.  The thing about speed bumps, however is you can always drive around them!  There are plenty of ways to get around the band if you want to…so what are some of those ways?

The first way is liquids (again, picture the hourglass…if you pour water into an hourglass it will go right through).  Most of us have no idea how many calories are in liquids (hint: it's often ALOT!)…although if you read my recent newsletter on fruit juices, hopefully you have some idea! (you can read that newsletter on juices here  if you want).  Ok, so if you consume high calorie liquids you won't lose weight and the band doesn't really do anything to prevent you from drinking high calorie liquids…what are some other 'pitfalls' with the band?

Remember the way the band works is it makes it somewhat difficult to eat, it forces you to eat small portions, eat very slowly, and chew your food very thoroughly.  The same way a speed bump forces you to slow down when you drive or an hour glass slows down the passage of whatever you put in it.

So, the other pitfalls with the band are sweets and junk foods, because these foods are generally easy for band patients to eat!  These types of foods pass through the band very easily.  If you are someone who eats sweets (ice cream, chocolate, cakes, muffins, donuts etc) or junk foods (chips, fries, the type of food you would get out of a vending machine) the band will do nothing to prevent you from eating those foods!  What the band will do is force you to eat smaller portions of 'regular foods' like bread, rice, pasta, meats etc.

In a nutshell, the reason the band doesn't work for some patients is that once you have a band it will be easier to eat a bowl of ice cream than to eat a bowl of pasta!  The other thing that is critical for band patients to be successful is to exercise.  If you are a patient who cannot, or will not, exercise the band will not generally be successful for you.  For example, if you have arthritic hips or knees or significantly decreased mobility it can be very difficult for that type of patient to lose weight with the band.

At the beginning I said for the right patient the band is who is the 'right' patient for the band?  The ideal patient for the band is someone who eats relatively healthy foods (no junk foods, no sweets) and who only needs portion control, it should be someone who is able to exercise and only needs to lose 70-80 lbs (it is very rare for a patient to lose more than 150 lbs with a band).  If you would like more information on how the band works you can find it here: which is our home page.

The next newsletter will be about the sleeve and I hope to be able to show how the sleeve does what the band does (restriction) plus some other effects as well.

Support Groups

Going forward we are going to have one support group per month.  The summer schedule is as follows:

Wednesday June 8th:  We will have a guest speaker, Gary Goldberg, licensed psychologist

Wednesday July 13th: Plastic Surgery Options after Weight Loss Surgery

Wednesday: August 10th:  Nutrition Topic: Eating on the Run and Dining Out Tips

All sessions will be held at the Ambulatory Care Center, 200 South Orange Ave, Livingston, NJ from 6:00 PM until 7:30 PM

Pt Information Seminar:

If you know anyone who would like to find out more information about all the different options for weight loss surgery we have two information seminars currently scheduled.  Both are free and open to anyone, the first is this Wednesday May 25th and will be at our Millburn office, 225 Millburn Ave, Suite 204, Millburn, NJ starting at 6:30 PM.
The second is next Wednesday, June 1st and will be at the: Ambulatory Care Center, 200 South Orange Ave, Livingston, NJ (same place we have support group) and will start at 6 p.m.
If you ever have any question about informational seminars please don't hesitate to call the office or email us at: or to find out when we are having a seminar.

Hope everyone has a great Memo
rial Day weekend next week and I'll be back in two weeks to talk about the sleeve.

Michael Bilof


Contact Information

web site address:
phone: (973) 218-1990

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