Adjustable gastric banding: a patient’s perspective, one year later

A year after getting an adjustable gastric band, this patient has lost over 100 pounds and says his life has changed dramatically.

Issue: June 2006

Wayne McCourt weighed 320 pounds when last year began. Now, in the summer of 2006, the man looks transformed. He weighs 209 pounds — over 100 pounds lighter than the 48-year-old morbidly obese man with a laundry list of comorbidities who made the decision to undergo adjustable gastric banding more than a year ago.

“My life has changed dramatically,” said McCourt, now 50, senior vice president and director of operations at Vindico Medical Education, a continuing medical education company founded by SLACK Incorporated, publisher of Endocrine Today. “I personally thanked my surgeon for saving my life. I felt that I was going down a path that would have given me maybe another ten years of life, if I was lucky. I probably added another 20 years to that, if I can keep up with the process,” he said.

Endocrine Today interviewed McCourt two months after his surgery last year. Now, in a follow-up interview more than a year after the surgery, his difference in size is remarkable.

His HbA1c levels, regularly above 11% before the surgery, now test between 5.3% and 5.7%. The day before this interview, his total cholesterol measured 125 mg/dL. His physician told him his liver enzyme and kidney results looked “perfect.”

Patient background

“When I was 14 years old, I was 100 pounds overweight. I lost the weight taking speed through a doctor, kept it off for a couple of years, but slowly gained it back,” McCourt explained.

“I went to Weight Watchers, Jenny Craig, health clubs, I did Atkins, I was on FenPhen [fenfluramine/phentermine] before it was taken off the market,” he said. Regardless, McCourt, at 6 feet tall, eventually grew to 320 pounds. Morbidly obese and suffering from gastroesophageal reflux, he developed type 2 diabetes in 1999.


McCourt was morbidly obese and had type 2 diabetes, hypertension, arthritis and obstructive sleep apnea. At seven weeks after laparoscopic adjustable gastric banding and an omentectomy, he had lost 45 pounds. One year later, he has lost over 100 pounds.

“The diabetes progressively got worse as I became insulin dependent,” he said. By 2005, he had hypertension (blood pressure 148/90 mm Hg), arthritis, obstructive sleep apnea and had developed a hiatal hernia. He was taking losartan (Cozaar, Merck), simvastatin (Zocor, Merck), pioglitazone (Actos, Takeda Pharms), metformin (Glucophage, Bristol-Myers Squibb) and insulin glargine (Lantus, Aventis).

“What first prompted me to consider bariatric surgery was that major centers such in New York, Chicago, Philadelphia and more have all developed bariatric centers,” he said.

McCourt started researching various surgical treatments and discovered a strong online community of those who had gotten the adjustable gastric band, members of Yahoo-based groups such as Bandsters and SmartBandsters. “There were some very experienced people [online] who are involved in the procedure, professionals who can talk about the safety and the benefits,” he said.

He found a number of books for research as well, including Weight Loss Surgery, a Lighter Look at a Heavy Subject, by Terry Simpson, MD; Lap-Band for Life, by Ariel Ortiz Lagardère, MD; Laparoscopic Adjustable Gastric Banding, by Jessie Ahroni, PhD, and How to Live With a Lap-Band, by George Fielding, MD.

Research on earlier studies, as he saw it, seemed to say that lap banding resulted in a lesser amount of weight loss than gastric bypass, but that after two years, patients lose weight more slowly and more safely.

“There was a discovery phase where I asked myself if I wanted to have the surgery,” he said. After watching an episode of the Today Show on which Fielding was a guest, the decision was made. McCourt decided to seek out his surgery at the NYU Program for Surgical Weight Loss, where Fielding is a bariatric surgeon.

After the lengthy and frustrating process of securing insurance coverage, the procedure was set and performed by Fielding in February 2005. Along with the banding, he elected to undergo an omentectomy as well. “My endocrinologist told me that the relationship between visceral fat and type 2 diabetes was nothing new and had been discussed in the literature for years,” he said. “I wanted a fast cure for diabetes. I wanted to lose the weight, but I wanted the diabetes out of the way as well.”

There were no complications to the surgery itself; the only complication McCourt reported was severe pain as a result of the omentectomy. The pain lasted three or four days, which McCourt said was not a bad trade.

Vast improvement

Two weeks after the surgery, he stopped taking insulin glargine but was still taking 15 mg of pioglitazone. He had lost a significant amount of weight and his sleep apnea had disappeared.

He has come much further in the year since. He has dropped all the diabetes medications. He’s taken up moderate exercise, walking four to five miles per day, sometimes seven to eight miles. He plans to lose 10 to 15 more pounds to achieve his target weight.

“Like most people, I do miss the passion of eating a big meal. You can still eat a lot of the foods that you used to eat, but you have to be careful with a lot of the dry foods,” McCourt said. He confirmed that side affects for him included productive burping, occurring on average about once per week. “If something gets caught, it usually just comes right back up again. It’s not as if it’s vomit or bile, it’s just the food you ate.” McCourt said he simply uses a napkin to remove the food. “You really have to eat slow.”

McCourt says that overdoing it by eating too much does lead to severe abdominal pain. To help with this, as well as to fit in with an on-the-go career and lifestyle, soups have become more of a mainstay in his diet. “If there is liquid with it, it seems to go down better,” he said, joking that he’s become a soup connoisseur.

Other physical improvements he’s noticed include a marked improvement in his energy level, how much less he sweats, and how he doesn’t get out of breath doing simple tasks around the house — even ordinary tasks such as bending over to open a box, which used to leave him breathless.

He has also stopped shopping at clothing stores for bigger sizes. “I’m not waking up every day wondering if my pants are going to fit.”

Mentally, not having to inject insulin or take pills is a huge change, as is not thinking that he was going to die in just a few years. “I’d almost given up. I’d accepted a short-term life,” he said.

Now, McCourt’s endocrinologist doesn’t want to see him every three months any more, but only once a year. “He doesn’t think I need to get my HbA1c checked every three months now. He can’t see any reason to treat me, or for me to keep coming back. He says I’ve graduated,” McCourt said.

“From a patient’s perspective, you have a chance to save your life. If you are 350 lbs and you’re a diabetic, you’ve been heavy all your life and you’ve gone through the ups and downs ... what the band gives you is the tool to be able to stay consistent.” – by Evan Young