Gastric bands get in the news from time to time and they do seem like a wonderful solution to overweight. When they work well, they allow previously obese people to regain a more normal weight.

In order for them to work well, patients prepare themselves by changing their eating regime. They deal with any emotional problems that have caused inappropriate eating. And having resolved those issues, they are ready for the gastric band.

They are available on the National Health in certain circumstances, and they can be done in private clinics. If you are thinking about it, then a key issue is long-term after-care. These gastric bands can be the source of future problems, and so you need to have check-ups to be sure they are still working well. They are not guaranteed for a lifetime, they do fail. And the check-up will include checking you are continuing to follow your eating regime.

Many people who become obese and therefore interested in gastric bands are eating for comfort; using food as a way of coping with stress, dealing with boredom, or have got into bad habits of using food recreationally. Essentially using food as a drug to numb bad feelings or for fun. These uses of food need to have stopped before the gastric band is fitted. The point of the band is to make your stomach so small, the size of a golf ball, that you don't have room for unnecessary food. Patients who continue with their old eating habits suffer problems such as explosive diarrhoea. And indeed, the determined gastric band saboteur will swap the recommended small healthy meal with comforting chocolate, sweets and crisps, and so manage to cram in the calories without overfilling the new tiny stomach. So the desired weight loss doesn't happen, and the patient feels even more miserable than before.

So, even with a gastric band, the difficult emotions that triggered the overeating need to be resolved.  Just how intense such unresolved emotions can be is illustrated by the case of a patient, who, having undergone adjustable gastric banding had begun self-adjusting her band by deflating it on an almost daily basis to allow a binge and subsequently over-tightening it to prevent further eating during the rest of the day.

Thus, emotional or binge eating post-surgery can result in protracted vomiting, pouch dilatation, band dislocation, dumping syndrome and other problems that are, strictly speaking, not really a consequence of the surgery itself but rather that these patients have not resolved underlying psychological issues and have not developed alternate and constructive coping strategies.

If you are thinking about a gastric band, then most clinics recommend  cognitive behavioural therapy for emotional eating or binge-eating disorder prior to surgery, and continuing after surgery too, to ensure that you get the most benefit and the fewest problems with your band.

So, if you are thinking that a gastric band might help, come and see me to help with any underlying emotional issues and a move to an eating regime which will prepare you for a successful gastric band.