Lap-Band Shown Effective for Long-Term Weight Loss

Jan. 18, 2013 -- More than 200,000 weight loss surgeries are performed each year in the U.S.

Several recent studies have questioned the effectiveness and safety of one type, gastric banding, which has led to a decline in its use as patients choose other surgical options.

But the largest and longest study yet of the procedure found that patients followed for up to 15 years maintained significant weight loss -- an average of about 60 pounds.

About half the patients in the study needed additional surgeries to adjust the bands or deal with other complications, but only about 1 in 20 patients opted to have the bands removed.

Researcher Paul O’Brien, MD, of Melbourne, Australia’s Monash University, was a pioneer of the Lap-Band procedure, and his latest study was supported by Allergan Inc., which markets the gastric band system.

He says gastric banding offers an effective, reversible, long-term solution for weight loss as long as patients get good follow-up care and are willing to carefully control the way they eat.

The study is published in the January issue of the Annals of Surgery.

“Placing the band is just the first step in the process,” he says. “Compliance and follow-up are critically important. There are plenty of people out there doing this surgery without a follow-up program for their patients, and they are setting them up for failure.”

The Lap-Band procedure is one of several weight loss surgeries performed in the U.S. and the only one that is easily reversible.

The band is an inflatable silicone ring that is wrapped around the upper part of the stomach to create a pouch the size of a golf ball, which limits the amount of food that can be eaten. The band can be tightened or loosened to increase or decrease the size of the opening to the lower stomach.

The most commonly performed type of gastric bypass surgery also reduces the size of the stomach to that of a golf ball. The surgery also bypasses a section of the small intestine, which limits calorie absorption.

The gastric sleeve procedure involves the surgical removal of a portion of the stomach to create a "sleeve" that connects to the small intestine.

Just a few years ago, gastric banding was widely seen as less risky, less costly, and less invasive than either of the other surgical options, and about half of weight loss procedures in the U.S. involved banding.

But that has changed as the long-term data comparing weight loss surgeries has come in, says Ronald H. Clements, MD, who directs the bariatric surgery program at Vanderbilt University Medical Center in Nashville.

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