You may lose some weight in the first 2 weeks post-surgery, due to the liquid diet being low in calories. Your appetite may also be reduced due to the area around the band swelling initially after surgery. The swelling will then begin to subside, and your appetite will return. As a result, your weight is likely to plateau (stabilise), or even increase slightly, by the time you attend your first clinic appointment. This is normal.
As described above, the process of gastric band adjustments is required in order to ensure adequate compression of the stomach, and hence adequate control of:
- Mouthful size
- Amount of chewing that is required
- Speed of eating
and so reduce portion sizes and initiate weight loss.
Once the band is optimally adjusted, most people can lose 0.5 to 1kg (1 to 2lb) a week, providing they are eating healthily and exercising.
Men often lose weight faster than women, due to a higher percentage of lean muscle mass. Larger people tend to lose more weight at first, as do those who are more active.
Excess weight loss
Specialist bariatric surgeons, dietitians and nurses use the term ‘excess weight loss' as a measure of your progress following surgery. Excess weight is defined as:
Pre-surgery weight (in kilograms) minus ideal weight (in kilograms)
Your ideal weight is defined as your weight at a Body Mass Index (BMI) of 25kg/m2. This is calculated by multiplying 25 by your height in metres squared (i.e. multiplied by itself).
For example, if your height is 1.65m, multiply this by itself to make 2.7225 and then multiply this by 25 to obtain your ideal weight in kilograms (68kg).
Expected average weight loss
Studies confirm that gastric banding is a successful tool to aid weight loss, producing significant and sustained weight loss for up to 3 years. However, some patients may continue to lose weight after this period. A large systematic review conducted in 2019 showed a durable weight loss of 45.9% of excess weight maintained 10-15 years after surgery.
The average weight loss following gastric band is as follows:
- 1 year post-surgery: 30-42% of excess weight
- 2 years post-surgery: 39-52% of excess weight
- 3 years post-surgery: 44-55% of excess weight
Although the above figures are very promising, they are not exhaustive. Patients at The Hospital Group frequently achieve higher weight losses. We believe that one significant factor in this is the support we provide to all of our patients.
How to get the best results
In order to achieve the best results, you MUST stick to the eating regime AND follow the dietitian’s advice:
- Follow the ’20, 20, 20, 20’ rule and never binge eat. Poor eating technique can cause pain on eating and/or regurgitation (See Risks of Surgery, Potential Complications, Side Effects). This may jeopardise your potential to maximise your weight loss. These symptoms can also result in pouch dilatation and slippage (see Band Risks of Surgery, Potential Complications, Side Effects). These complications can usually be rectified, but we believe in prevention through education.
- Be realistic and be prepared to change your lifestyle, such as eating at regular intervals, eating a varied diet, cutting down on high calorie foods and drinks (including alcohol), and increase exercise.
- Actively ensure that you have regular follow-up appointments after your surgery. Let us know if proposed dates are not convenient, and we can reschedule them or arrange a telephone consultation.
What if I am not losing weight?
- Call us to arrange a face-to-face or telephone appointment with a dietitian. It may be that you need to change the way you are eating to work with the band, not against it. It may also be the case that you require a band adjustment. Discussion with the dietitian is important in the first instance, to ensure you do not undergo a band adjustment unnecessarily. Remember, dietitians working in weight loss surgery are there to help you get the best from the surgery, not just tell you how to eat healthily!
- Increase your physical activity.
- Keep a positive attitude and set realistic targets throughout your weight loss journey. Evidence shows that people who have something to focus on mentally often enjoy the best results. Maybe you have health problems and want to feel better, would like to be able to run around in the park with your children/grandchildren, or want to be able to buy clothes from a wider range of shops - whatever your situation, find a realistic goal that’s important to you and aim for it at all times.
You should be aware that surgery is not a quick fix or a magic cure for obesity; you will need to work with the band, and therefore there are no guarantees.