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Extreme weight loss

by Dr Sarah Brewer

a woman eating salad There's been a lot of fuss surrounding Fern Britton and her gastric band, but what exactly is the procedure and how does it work?

During gastric banding an adjustable, silicone band is placed around the upper part of your stomach to create a small pouch. This pouch quickly fills up when you start eating, so you feel full and can only eat small meals. The operation involves a general anaesthetic and, if possible, the band is fitted using keyhole (laparoscopic) surgery rather than an open operation.

The band contains a fluid-filled balloon that can be tightened or loosened by adjusting the amount of fluid it contains. Fluid is added or removed via a tube that runs to a reservoir implanted under the skin below your rib cage. Saline is added or removed from the band using a special needle inserted into the reservoir. The tightness of the band is adjusted after swelling settles down a couple of weeks after the operation, and whenever necessary to balance the amount you can eat against optimal weight loss.

The procedure does not involve cutting or removing any part of the stomach, making it safer than some other procedures, such as gastroplasty, where the stomach is stapled to make it smaller, or a by-pass, where the stomach is made smaller and food is sent on a different route through the intestines so less is absorbed.

As with all surgery however, there is a risk of side effects with gastric banding, especially as those involved are obese, which makes any operation more risky. Potential complications include those of general anaesthesia (eg aspiration pneumonia) and of surgery (eg haemorrhage, wound infection, deep vein clots, intestinal puncture).



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