Disadvantages of Lap Band Surgery: 5 Short-Term and 5 Long-Term Risks

For quite a while, the Lap Band (also known as Laparoscopic Adjustable Gastric Banding  - LAGB) seemed like the “gentle” option in the weight loss surgery space. People were drawn to it because it promised something less permanent than a gastric bypass or gastric sleeve, but still brought results. It was adjustable, reversible, and didn’t involve cutting or rerouting the stomach. Sounds great, right? So did many patients struggling with obesity.

But the reality turned out differently for some of those who chose it. At first, the results looked hopeful. Then, over the years, complications started to appear. Some patients struggled with chronic discomfort. Others didn’t lose much weight at all. And many eventually needed the device removed altogether. After years of gathering results, we can now see that more than half of all Lap Bands are taken out within 7–10 years.

Because of this, bariatric surgeons have largely shifted away from recommending the Lap Band. Procedures like gastric sleeve and gastric bypass have proven to be more reliable, both for weight loss and for long-term health.

If you’re considering weight loss surgery or simply curious about why the Lap Band fell out of favor, it helps to look at the full picture—the early appeal, the short-term drawbacks, and the long-term problems that made doctors reconsider. Below, we’ll walk through the most common disadvantages patients face after Lap Band surgery.

5 Short-Term Disadvantages of Lap Band Surgery

While the Lap Band procedure is minimally invasive, patients often experience challenges in the first weeks and months after surgery. These issues are sometimes temporary but can still have a big impact on recovery and quality of life. We will first go through the short-term disadvantages of lap band surgery.

1. Nausea and Vomiting

One of the most common early side effects is nausea and vomiting. It happens because the stomach pouch created by the band is much smaller, so patients must adapt to eating slowly, chewing thoroughly, and taking very small bites. This can be challenging, and those who are still eating too quickly or swallowing food that’s too large can trigger vomiting, can experience these side effects more commonly.

Patients often need to work closely with a dietitian to learn new eating habits that minimize this risk.

2. Postoperative Pain and Discomfort

Although laparoscopic surgery is less invasive than open procedures, patients cannot avoid pain and discomfort for the first few weeks. This means there will most likely be:

• Pain or tenderness at incision sites
• Abdominal bloating from the gas that is used during surgery
• Soreness or pressure near the band placement

Even though the discomfort is usually temporary, it can interfere with daily activities like walking, sleeping, and eating. It is important to know these challenges in advance, because some patients report that the recovery period was more challenging than they expected.

3. Difficulty Swallowing (Dysphagia)

Dysphagia, or difficulty swallowing, is something that often occurs after Lap Band placement. Here is why:

• Swelling narrows the stomach opening even further.
• Solid or dry foods (like bread, rice, or meat) can therefore become “stuck.”
• If the band is adjusted too tightly, swallowing problems worsen.

This condition can cause discomfort in the chest, pain when eating, and the sensation of food being lodged in the throat. While it often improves with adjustments and dietary changes, it can be quite a distressing thing during the recovery.

4. Band Slippage or Improper Adjustment

It can happen that the band slips out of place soon after the surgery. Improper initial placement or overly aggressive adjustments increase this risk. How to notice when that happens? The symptoms may include:

• Severe nausea
• Vomiting
• Sudden abdominal pain
• Difficulty eating or swallowing

Sometimes, deflating the band helps. But in other cases, unfortunately, an urgent surgery is needed to reposition or remove it. The fact that a complication like this can occur so soon after surgery highlights one of the major weaknesses of the Lap Band system.

5. Infection or Port-Related Problems

The Lap Band is connected to a small port placed under the skin. This port is used for adjustments, but having it, comes with some risks:

• Infection at the port site, causing redness, swelling, or discharge
• Fluid leaks that prevent the band from tightening or loosening properly
• Pain or irritation from the device under the skin

Some of these problems require antibiotic treatment, while others may even need another surgery to repair or replace the port.

5 Long-Term Disadvantages of Lap Band Surgery

The short-term issues can be frustrating, but the long-term disadvantages are even more concerning. These are the main reasons why Lap Band surgery has lost favor in the medical community.

1. Inadequate Weight Loss and Weight Regain

You decide on weight loss surgery because you want to lose weight, so poor weight results are probably the biggest drawback. If we compare the Lap Band to the gastric sleeve or bypass:

• Lap Band patients typically lose less than 50% of their excess weight.
• Many fail to reach even 25–30% excess weight loss, which is considered the minimum threshold for success.
• Weight regain is common, especially after the first few years.

Why does this happen? Unlike other surgeries that also affect hunger hormones, the Lap Band works only by restricting food volume. It doesn’t reduce appetite or cravings. Over time, patients may find ways to eat around the restriction, especially by choosing calorie-dense soft foods.

This lack of durable results is one of the most common reasons patients eventually choose to have the band removed or converted to another surgery.

2. Band Slippage and Device Failure

Band slippage isn’t just a short-term risk—it’s also a long-term problem. Over the years, the band may move, twist, or cause part of the stomach to prolapse through it. Symptoms include:

• Severe abdominal pain
• Persistent vomiting
• Reflux or heartburn
• Difficulty swallowing

In many cases, slippage requires urgent surgery. There are also some other device-related failures, like tubing leaks, port disconnections, or band erosion into the stomach wall. All mentioned issues often lead to band removal.

3. Chronic Food Intolerance and Gastrointestinal Distress

Some patients may develop chronic food intolerance, which means that it is very uncomfortable for them to eat certain foods, which in the long term makes them avoid them.

They then have a tendency to rely on “slider foods” like soups, ice cream, or shakes, and while these foods are easier to tolerate, they are often high in calories and low in nutrients. This does not go hand in hand with weight loss and can lead to poor nutrition over time.  Patients can fall into the cycle of discomfort, avoidance of healthy foods, and reliance on calorie-dense alternatives, which is one of the major reasons Lap Band patients struggle long-term.

4. Esophageal Problems: Reflux, Dilation, and Dysmotility

The Lap Band can cause lasting damage to the esophagus in different ways:

• GERD (acid reflux): Up to one-third of patients develop new or worsening reflux.
• Esophagitis: Chronic reflux can inflame and damage the esophagus.
• Esophageal dilation: Over time, the esophagus stretches as it works harder to push food past the band.
• Dysmotility: The esophagus may lose its ability to move food properly, a condition that may be permanent.

Even if the band is removed, some of these problems do not resolve completely. This is a serious concern for long-term health and comfort.

5. High Rate of Reoperation and Nutritional Compromise

One of the clearest signs of Lap Band’s limitations is the high reoperation rate, which means that Lap Band often doesn’t hold up well long-term compared to other weight loss surgeries. Here are some facts:

• Over 50% of bands are removed within 7–10 years.
• About 25% of patients experience major late complications.
• Many eventually undergo conversion to another surgery, such as gastric sleeve or bypass.

In addition, food intolerance often leads to nutritional compromise.. Over time, this can cause vitamin deficiencies, low protein intake, and other health risks—even if calorie intake remains high.

It’s never just black and white

Decades of research have shown that there are some disadvantages of Lap Band Surgery. We divided them into short and long term:

• In the short term, patients face nausea, pain, difficulty swallowing, infections, and the risk of band slippage.
• In the long term, the problems grow: inadequate weight loss, frequent device failures, chronic digestive issues, esophageal damage, and a high chance of reoperation.

While a small group of patients may do well with the Lap Band, the majority experience complications or disappointment with their results. That’s why most bariatric surgeons today recommend using other procedures like the gastric sleeve or the gastric bypass. They deliver more consistent weight loss results and a better quality of life.

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FAQ

Is the Lap Band still performed today?

Yes, but very rarely. Most bariatric surgeons prefer the gastric sleeve or bypass because they offer better weight loss and fewer complications.

How much weight can you expect to lose with the Lap Band?

On average, patients lose about 40–50% of their excess weight. Many regain weight after a few years. By comparison, gastric sleeve and bypass often achieve 60–70% excess weight loss or more.

Can the Lap Band cause permanent damage?

Yes. Esophageal dilation, chronic reflux, and scarring can sometimes persist even after the band is removed.

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