Gastric band surgery

Your health expert: Mr Stephen Pollard, Consultant General Surgeon
Content editor review by Victoria Goldman, September 2021
Next review due September 2024

Gastric band surgery is a common type of weight-loss (bariatric) surgery for people who are very overweight or severely obese. It involves putting an adjustable band around the top part of your stomach, so you can’t eat as much.

How does a gastric band work?

A gastric band is placed around your upper stomach to create a small pouch of stomach above the band, with most of the stomach lying below the band.

You can still drink liquids and eat small amounts of food. But you can’t eat lots of food in one go. When you eat, the small pouch fills up quickly, so you feel full earlier than normal and for longer. This means you eat less, and eat more slowly, helping you to lose weight.

Your surgeon can tighten or loosen your gastric band by injecting liquid into it through a port which sits just under the skin of your tummy. This affects how quickly food passes from the pouch into the lower part of your stomach. This will make sure that you steadily lose the right amount of weight.

How well gastric band surgery works depends on how well you’re able to follow a healthy lifestyle after the operation. You’ll need to change your eating habits and be more active. You also need to be careful with high-calorie drinks including alcohol because these can still pass through your gastric band.

Who can have a gastric band?

You may be able to have gastric band surgery if you:

have a body mass index (BMI) of 40 or more, or between 35 and 40 with a health condition such as diabetes or high blood pressure
have already tried all other treatment options such as dieting, exercise and weight-loss medicines (as advised by your doctor)
are generally fit enough to have a general anaesthetic and surgery
are committed to long-term follow-up, including regular check-ups and making lifestyle changes
are prepared to attend regular follow-up appointments

You may not be able to have gastric band if you have certain long-term health problems. These include inflammatory bowel disease, heart disease and psychological disorders. You may need to have a psychological assessment if doctors are worried about your mental health.

If you’re very overweight (obese), your GP may refer you to a specialised obesity management service that can check if surgery may help you. If gastric band surgery may be right for you, you may be able to have it on the NHS. But this depends on whether or not it’s available in your local area. You may be able to have the surgery privately.

Deciding on gastric band surgery

Gastric band surgery is a major operation. It’s important to understand exactly what it involves, including any possible complications, and what to expect afterwards.

If you’re thinking about having a gastric band, your doctor will discuss this with you. They’ll also talk to you about other types of weight-loss surgery, including a sleeve gastrectomy and gastric bypass. Your surgeon can help you decide what’s right for you.

Here are some points to consider.

A gastric band may help you to lose weight. It may also help to lower your risk of various health conditions, including diabetes, high blood pressure and high cholesterol. Or, if you already have these conditions, it may help to control them.
Everyone loses a different amount of weight but most people lose about half their extra weight over about two years. Not everyone loses as much as they want to.
Some research shows that other types of weight-loss surgery may work better in the long term.
You may need to have your gastric band removed or replaced. This may be because the band slips down the stomach or erodes into it. For more information, see our section on complications of gastric band surgery.

Losing weight after a gastric band surgery is usually a positive thing. But you may find it hard to adapt to your lifestyle and appearance after the operation. Talk to your GP or surgeon if you’re struggling to cope. They may suggest a patient support group, where you can get advice from other people who have had the same operation.

Take some time to make sure you’re happy with your decision to have a gastric band. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed, so you feel comfortable to give your consent for the operation to go ahead. You may be asked to do this by signing a consent form.

Bupa Weight Management Plan

The Bupa weight management plan is designed for people with a BMI over 30 (or over 27 if you have a weight related condition). The plan is designed to empower you to achieve and maintain a healthy weight in a sustainable way.

To book or to make an enquiry, call us on 03452660566^∧

Find out more about our Weight Management Plan

Preparing for gastric band surgery

You’ll need to have some assessments and blood tests to check you’re fit for the surgery. These may also show whether or not you have any health conditions related to your obesity.

Your diet and habits will need to change after you’ve had the surgery. You’ll be given information about what to eat and drink after your procedure, and your doctor will discuss this with you before you go ahead.

If you smoke, you’ll be asked to stop – usually a few weeks before your surgery. Smoking can make you more likely to get a wound infection and can also lead to complications. You may be asked to follow a low-calorie, low-carbohydrate diet for a short time before your operation. This will help to shrink your liver and make it easier and safer to put the band in place.

A gastric band operation is done under general anaesthesia, which means you’ll be asleep during the operation. You need to fast before having a general anaesthetic. You’ll be given clear instructions about when to stop eating and drinking. It’s important to follow this advice.

On the day of your procedure, your surgeon will meet with you to check you’re well and are still happy to go ahead. The staff at the hospital will do any final checks and get you ready for surgery. This may include asking you to wear compression stockings and/or having an injection of an anticlotting medicine to help prevent deep vein thrombosis (DVT).

What happens during gastric band surgery?

Your gastric band will be fitted using keyhole (laparoscopic) surgery. Your surgeon will do the surgery using instruments inserted through several small cuts in your tummy, rather than one large cut.

Your surgeon will place the band around the top part of your stomach creating a small pouch of stomach above the band. A piece of fine tubing connects the band and an injection port which is placed just under the skin on your tummy. Your surgeon will use this port to inject fluid into the band to tighten or loosen it. They’ll stitch the tubing into place just under your skin.

Your surgeon will then close the cuts in your tummy. This is usually done with dissolvable stitches but they may use clips, which will be taken out a week or so later.

What to expect afterwards

At the hospital

You’ll need to rest until the effects of the anaesthetic have worn off. You may also need some pain relief to help ease any discomfort.

You’ll have a drip into a vein in your hand or arm to give you fluids until you’re well enough to drink. You’ll be encouraged to get out of bed and move around as soon as you feel you can. This will help to reduce your risk of getting a chest infection and the risk of getting blood clots in your legs. Your nurse will give you advice about caring for your healing wounds before you go home and give you a date for a follow-up appointment.

Going home

You’ll usually be able to go home later on the day of your operation or on the following day. Make sure someone can take you home and if possible, stay with you for a day or so while the anaesthetic wears off. You can carry on taking over-the-counter painkillers at home, as you need them.

Your gastric band will be partly filled during surgery, so you’ll have to be careful about what you eat straightaway. Your surgeon or dietitian will tell you when you’ll be able to start eating and drinking anything.

It may take you a week or two to recover from gastric band surgery and get back to your normal activities. But everyone’s different, so it’s important to follow your surgeon's advice. If you’re struggling to cope, speak to your GP or surgeon. You could also find a local patients’ support group.

You’ll need to go for regular follow-up appointments after your surgery to have your gastric band adjusted. This will make sure you steadily lose the right amount of weight.

Your long-term health

After your surgery, you’ll need regular reviews with a doctor or nurse. They will let you know how often. You may need to have blood tests to make sure your liver is working well. You may need to have your vitamin and mineral levels checked regularly too.

You’ll need to make changes to your diet after gastric band surgery. A dietitian can help you make the right changes for you. You may also need to take a general daily vitamin and mineral supplement to make sure you get all of the nutrients you need.

You’ll be given printed information about what to eat and drink after your procedure, and your doctor will discuss this with you.

Getting pregnant

You can get pregnant after gastric band surgery. But you should wait a year or so, until you have reached a stable weight, before you try for a baby. If you do get pregnant, your doctor will keep a close eye on your weight gain and check that you're getting the right nutrients. You’ll probably have checks around every three months and may need to see your dietitian more often. You’ll also need to have your band adjusted during your pregnancy or perhaps deflated altogether. If you're planning to get pregnant or have found out you’re pregnant, speak to your doctor for advice.

Complications of gastric band surgery

Like all types of surgery, gastric band surgery can cause some complications. These include:

an unexpected reaction to the anaesthetic
too much bleeding
a blood clot (deep vein thrombosis – DVT)

Gastric band surgery can cause other complications too. These include:

an infection around your gastric band, the tube under your skin or in one of your wounds – your skin may be red or sore if this happens
an injury to your stomach or other nearby organs, such as your oesophagus, during surgery
your gastric band slipping out of place, leaking and deflating or slowly working its way through your stomach wall – if so, it will need to be moved, taken out or replaced
gallstones if you lose weight too quickly – these can hurt, and you may need gallbladder surgery to take them out

Contact your doctor or surgeon if you get any symptoms after your surgery, such as:

a high temperature (fever)
finding it hard to swallow
tummy pain
chest pain
finding it hard to breathe
being very sick

Not everyone loses as much weight as they want to after the operation. Some people put weight back on after losing it. If this happens, your surgeon may suggest other treatments, such as gastric bypass surgery.

If you have complications, you can have your gastric band taken out. Or you may decide you don’t want it anymore. Some people choose to have their band removed because they find it difficult to live with the band and a very restricted diet. Removal of a gastric band can usually be done with keyhole surgery. But if you have your band removed without having a different weight-loss procedure, you're likely to put back on any weight you’ve lost. If there’s a problem with your band after it’s fitted, you may be able to have another band fitted. Or you may be able to have a different procedure such as a gastric bypass operation or a sleeve gastrectomy.

After gastric band surgery, you may have folds of extra skin on some parts of your body. This can be uncomfortable or embarrassing. The skin may get inflamed, sore or infected. You can have cosmetic surgery, such as a tummy tuck or breast uplift surgery, to get rid of the extra skin. But you’ll usually have to wait 12 to 18 months after your gastric band surgery. And this procedure isn’t usually available on the NHS.

Everyone loses a different amount of weight. This may depend on what you’re eating and how much exercise you’re doing after your surgery. For more information, see our section on what to expect afterwards.

If your gastric band is causing problems or you don’t want it anymore, you can have it taken out. But you may put the weight back on if you don’t have another weight-loss procedure. For more information, see our section on complications of gastric band surgery.

You can get pregnant after having a gastric band. But it's best to wait at least a year or so, until you have reached a stable weight, before you try for a baby. For more information, see our section on what to expect afterwards.

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