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Who Needs a Lap-Band?
According to an NBC report by Chief Science Correspondent Robert Bazell, there are 220,000 weight loss surgeries conducted each year in America. Of that, half are attributed to Lap-Band surgery (the other half are gastric bypasses.) A recent report by Reuters says, “Allergan, Inc., the maker of Lap-Bands, Botox, breast implants, and other cosmetic products, wants approval to promote the surgically implanted Lap-Band device to people with lower body mass indexes who are still considered obese.”
Presently, the Lap-Band is indicated for people who have a Body Mass Index (BMI) of 40 and above or 35 with a serious health problem. Allergan “… is seeking FDA approval to insert the Lap-Band in adults with a BMI of 35 or higher or a BMI of 30 plus one weight-related health problem such as diabetes or high blood pressure.” The issue is whether or not the benefits or Lap-Band surgery outweigh the risks.
What is Lap-Band Surgery?
Lap-Band surgery is performed to reduce the amount of food a person can eat. It is safer than the gastric bypass because it does not remove any part of the digestive tract and it is reversible. Through several small cuts in the belly, the doctor inserts small surgical tools and a camera to place a silicone band around the upper part of the stomach to create a small pouch. Attached to the band is a thin tube leading to an access port that is left under the skin. The access port is the place where the doctor puts in a needle to add or take away saline. Adding saline tightens the band and makes the stomach smaller. The doctor can take away saline if the ring is too tight.” Watch this video about the Lap-Band procedure at About.com.
Should more people be eligible?
But is an increase in the eligibility of weight loss surgery the right step toward improving America’s health? According to research published in the journal Surgery, the Lap-Band procedure resulted in variable weight loss and a substantial number of complications. In a three year follow-up of 186 patients who had the Lap-Band procedure, 30 percent did not lose more than 25 percent of their excess weight, and 54 percent did not achieve a BMI less than 35. Complications developed in 47 percent of patients, (although they decreased to 32 percent as the device improved over the years.)
In a study by Allergan reported on their website Lap-Band.com, 88% of 299 patients reported side effects ranging from mild to severe. Nausea and vomiting (51%), gastroesophageal reflux (regurgitation) (34%), band slippage/pouch dilatation (24%) and stoma obstruction (stomach-band outlet blockage) (14%) were the most common post-operative complications.
But, as Dr. Lee Kaplan from Massachusetts General Hospital told The New York Times, the “dramatic effects…go well beyond the weight loss effects.” Lap-Band advocates point to its effectiveness in resolving diabetes, high blood pressure, and other medical conditions.
On December 3, 2010, The New York Times reported that an advisory committee to the FDA did endorse the expansion of Lap-Band to less than severely obese patients - and the F.D.A. usually agrees with its advisory committees. Still, the decision to go through major surgery to lose weight is a personal one. Allergan’s Lap-Band was the first adjustable medical device for individualized weight loss, but remember, it’s not the only option.
What are your thoughts or experiences about Lap-Band surgery and other gastric banding devices on the market?