Purpose of Lap Band Surgery

In This Article
Table of Contents

Gastric banding (commercial trademarked as the Lap-Band procedure) is a form of weight-loss surgery that restricts the stomach to limit food intake. Most patients can expect to reduce excess body weight by 40% to 50% within two years following Lap-Band placement.

Unlike gastric bypass, the Lap-Band is adjustable and removable, resulting in faster recovery time and greater dietary flexibility. Lap-Band surgery is performed laparoscopically, by wrapping the upper portion of the stomach with a hollow silicone band. Saline is injected into the band, tightening it and creating a small stomach pouch.

As a result, patients feel full on smaller portions, making weight loss easier. The volume of saline can be increased or reduced based on the patient's rate of weight loss and tolerance to the band.

Lap band surgery model
 Capifrutta / iStock / Getty Images

Diagnosis Related to Lap-Band Surgery

In addition to reducing body mass index (BMI), Lap-Band surgery can help to improve several chronic health conditions.

Heart Disease and Hypertension

Cardiovascular health markers can improve dramatically after weight-loss surgery. Blood pressure and cholesterol levels tend to normalize once patients start losing weight. As a result, the overall risk of stroke, coronary heart disease, and peripheral heart disease are greatly reduced.

Sleep Apnea

Obstructive sleep apnea is a serious medical condition that affects 25% of men and 10% of women. Obesity is a major risk factor with 85% of sleep apnea patients classified as obese.

Lap-Band surgery is a viable option to fix the most common underlying cause of sleep apnea (excess body weight). If left untreated, sleep apnea not only disrupts sleep, but also leads to an irregular heartbeat, blood pressure fluctuations, and stroke.

Type 2 Diabetes

Bariatric surgery of any form produces well-documented benefits for blood sugar control. In a five-year study evaluating Lap-Band patients, hemoglobin A1c levels were reduced from a baseline of 6.1% (indicating pre-diabetes) to 5.8%.

For patients with diagnosed diabetes prior to surgery, over half had "excellent glycemic control" (meaning a hemoglobin A1c of 6.5% or less) within a year.

Joint Pain

Carrying extra weight is tough on the joints, especially knees. One of the most-effective ways to relieve joint pain is through weight loss. Chronic pain can be significantly improved for patients following Lap-Band surgery, preventing the need for pain medication and joint surgeries in the future.

Non-Surgical Alternative

Before considering any type of weight loss surgery, lifestyle changes should be encouraged. A medical weight loss program is a non-invasive alternative to surgery that can help patients develop healthy lifestyle habits and achieve major weight loss.

Medical weight loss programs typically include structured guidance for eating and exercise, emotional support from a mental health professional, and sometimes prescription weight loss medications under the supervision of medical staff.

Insurance Coverage

Insurance plans may or may not cover medical weight loss programs in the same way that Lap-Band and other types of bariatric surgeries are covered. Speak with your insurance carrier to find how which options are available to you for medical weight loss programs and surgery.

Criteria

The National Institute of Health offers guidelines for which patients should be considered for the Lap-Band procedure. Ideal candidates for bariatric surgery have a BMI of 40 or greater, usually indicating 100 pounds of excess body weight for men and 80 pounds of excess body weight for women. For those with a BMI of 35 or more, the presence of a serious health condition may warrant surgery.

An international surgery summit on type 2 diabetes offered recommendations that go a bit further. The panel of experts advises bariatric surgery for patients with a BMI between 30 and 34.9 when injectable and oral medications fail to keep blood sugar levels under control.

For Asian patients, the BMI guidelines are reduced by 2.5 (bringing the threshold down to a BMI of 27.5, given the presence of uncontrolled diabetes). The surgery summit noted that although the Lap-Band and other procedures may be considered, gastric bypass surgery is currently thought of as the procedure of choice for diabetes specifically.

To summarize the current FDA-approved criteria for Lap-Band surgery in the United States:

  • In 2001: The Lap-Band was approved for patients with a minimum BMI of 40, or a BMI of 35 plus the presence of at least one serious co-morbid condition.
  • In 2011: The BMI cut-off was reduced to 30 when obesity-related conditions are present.

Additional Factors

If you're a smoker, it is essential to quit smoking before any type of surgery. Smokers have a harder time breathing under anesthesia and don't recover as quickly from incisions.

Smoking places patients at higher risk of heart complications following surgery, with some studies indicating a 77% increased risk of a heart attack after an operation than non-smokers.

It's never too late to quit smoking. Even quitting 24 hours before surgery improves oxygen flow in your body.

Age is another consideration when assessing candidates for Lap-Band surgery. As with any surgery, your doctor will want to make sure the benefits outweigh the risks. For patients over age 75, an overall health assessment and the judgment of an experienced surgeon can help determine if Lap-Band is recommended.

Doctors are seeing younger and younger patients seeking bariatric surgeries. While some teens stand to benefit from the Lap-Band to reduce dangerous co-morbid health conditions, many doctors may advise waiting for adulthood or until other lifestyle interventions have been implemented.

At the very least, patients should be at their full adult height and have completed a six-month weight management program before moving forward with the Lap-Band or more invasive weight-loss surgeries.

It's essential to screen patients for eating disorders before approval for Lap-Band surgery. Patients who have binge eating disorder are not as likely to be successful with weight-loss surgery over the long term. Alcohol or drug use disorder issues must be also identified and treated before surgery to avoid dangerous complications down the road.

If you are experiencing a medical emergency, call your doctor or 911 immediately.

Tests and Labs

Your surgeon will require certain tests prior to surgery to assess your health status. These include blood tests and an evaluation by your primary care doctor for a complete physical exam and to determine whether any underlying chronic conditions are under good control (such as diabetes, blood pressure, and lung issues).

In addition, you'll be expected to meet with a dietitian and mental healthcare provider to discuss your nutrition plan and emotional readiness for surgery. Here, you should review future lifestyle changes that will be required following the procedure.

A series of classes should be provided to outline what to expect before, during, and after the surgery. Group classes can also be a great opportunity to connect with other patients who are embarking on a parallel journey.

A Word From Verywell

Keep in mind that Lap-Band surgery requires healthy lifestyle changes. This procedure is far from a "quick fix," and comes with potential complications and painful consequences for overeating.

Although the Lap-Band serves as a useful tool for weight loss, it's possible to regain weight over time without a longstanding commitment to physical activity, proper nutrition, and portion control.

Take your time to weigh the pros and cons of any weight loss surgery before making a decision. With the support of your medical team and a clear understanding of what the Lap-Band surgery entails, you can prepare for the long term changes that will give you the greatest likelihood of success.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Lap-Band.

  2. MedlinePlus. Laparoscopic gastric banding. Updated July 11, 2018.

  3. Ulrich P, Wolfgang ET, Peter R, Ann NE, Martin L, Rabee MN, Susanne R, LF, Felix MS, Daniela EV. Screening for psychiatric disorders in bariatric surgery candidates with the German version of the patient health questionnaire. Advances in Psychiatry. 2014. doi:10.1155/2014/165818.

  4. Cleveland Clinic, Bariatric and Metabolic Institute. Bariatric surgery for treating sleep apnea.

  5. Dixon JB, Eaton LL, Curry T, Lee PC. Health outcomes and explant rates after laparoscopic adjustable gastric banding: a phase 4, multicenter study over 5 years. Obesity (Silver Spring). 2018;26(1):45-52. doi:10.1002/oby.22050

  6. Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care. 2016;39(6):861-77. doi:10.2337/dc16-0236

  7. Cleveland Clinic. 3 reasons why smoking before surgery isn't an option. Updated August 5, 2020.

  8. University of Pittsburg Medical Center. Teen obesity and weight loss surgery options.