The Lap-Band helped him lose the weight. But keeping it off? That’s on him.
New Jersey Gov. Chris Christie is showing off a reported 85-pound weight loss after undergoing the adjustable gastric band surgery in February 2013, hinting to donors that he’s fit to take on the White House.
But Christie’s diminished baggage is by no means permanent. Roughly half of patients who have had the trademarked Lap-Band procedure don’t do well, said Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill Hospital.
Such patients aren’t weight loss success stories because they end up with complications post-procedure, Roslin said.
During a Lap-Band operation, a band is secured around the stomach, restricting its size. Patients, as a result, feel fuller on less food.
The surgery can greatly improve quality of life, bettering one’s heart health and reducing hypertension and diabetes risks. But the procedure also can cause acid reflux, vomiting and more serious emergencies such as gastric tears and cardiac arrhythmia.
Estimates say about 1 out of every 1,000 patients dies 30 days after a weight-loss surgery, though specific Lap-Band numbers aren’t available.
More typically, the operation needs to be repeated to adjust or remove the band.
“A lot of what we do are revisions,” Roslin said. “Sixty percent of my cases this week are revisions.”
Even without complications, the patient, not the band, still has to do all the work to drop the weight.
“The gastric band requires a lot of participation from the patient – what you’re eating, how you’re eating, chewing very well, choosing the right food, exercising,” said Dr. Jaime Ponce, former president of the American Society for Metabolic and Bariatric Surgery. He’s also a bariatric surgeon in Tennessee.
Patients tend to lose one or two pounds a week in their first year post-procedure, Ponce said. Weight loss over the years with a Lap-Band continues to trickle – it isn’t as drastic as that first or second year.
Christie, who started out tipping the scales at about 350 pounds, is “probably going to lose 120 pounds (total) – maybe 150 if he works hard,” Ponce said.
Ponce estimates that Christie’s presurgery body mass index was above 50 – well into the morbidly obese range. A body mass index, or BMI, of 40 or higher makes someone a bariatric surgery candidate, according to Dr. Andre Giannakopoulos, an obesity specialist and program director at the Center for Medical Weight Loss on Long Island.
“The best we can do for a patient who struggles with morbid obesity is surgery,” he said, “but surgery is only warranted when medical therapy fails.”
Rayya Elias, 54, ran into such barriers. In 2006, the Chelsea-based author couldn’t find a doctor to do bariatric surgery on her because her BMI, 31.4, was barely into the “obese” class considering normal BMI is 18.5 to 25. But she did find a doctor to do it in England – Dr. Franco Favretty, inventor of the gastric band himself.
But Elias was initially disillusioned with her results. The first month post-surgery, she was put on a liquid diet, and while she dropped pounds quickly, she wasn’t impressed.
“I lost a bunch of weight but could have lost (it) by drinking liquids anyway,” she said.
When she finally got around to eating solids, she dug into high-calorie mushy foods like mashed potatoes. Those were the only foods she could keep down, and it caused her to pack on the pounds.
“It was so stressful,” she said. “I thought, ‘Oh my God, I made such a huge mistake – I spent 20 grand and here I am throwing up if I eat anything or gaining weight because I’m eating fattening food that I can keep down.'”
It took Elias about two years for her to learn how to make the diet device work for her.
“When you’re willing to, and put in the work, then the Lap-Band is an amazing tool,” she said. “Still, I had to utilize it just like every other tool in the health arena. A crutch isn’t gonna (make) you stand up – you’ve gotta utilize it.”
With a BMI of 39.9, Alex Brecher, 36, barely made the cutoff for Lap-Band approval. But he had the procedure done in 2003 and has kept off 100 pounds over the last 11 years. He now runs a website on bariatric surgery and has authored four books on the subject.
“It’s my passion,” said Brecher, who lives in Midwood, Brooklyn. “I made it (an) entire life helping out other people that have had weight loss surgery.”
Giannakopoulos says he sees a number of patients post- procedure who either did not lose weight or gained it back. Some could be taking medications – like steroids, beta-blockers or anti-depressants – that have been shown to lead to weight gain. Or, they could have an underlying condition, like hypothyroidism, that makes losing weight difficult.
The surgery won’t fix any underlying psychological factors that contribute to weight gain, either, Giannakopoulos said. Five percent to 30% of the 140,000 weight loss surgery patients each year simply swap food addiction for another vice once their body changes, according to Obesity Action Coalition.
It often takes behavioral therapy to help a person keep the weight off, Giannakopoulos said.
“There’s a lot to manage after surgery,” he said. “The surgeons are good for the surgery, but they’re not great at spending the time in counseling and teaching people behavioral change.”
