Gastric banding a successful long-term solution to obesity


Gastric banding a successful long-term solution to obesity


Laparoscopic adjustable gastric banding (lap banding) has been identified as a successful long-term solution to obesity.

The finding came from a 15-year follow-up study of obese patients in Australia and was published in the journal Annals of Surgery.

Currently, about 1 in 4 Australian adults are affected by obesity. The prevalence of obesity has increased three-fold, from 8% of the total adult population in 1980, to 23% in 2008. The rise in the people affected is resulting in great concern, considering its substantial medical costs and negative impact on health.

A different study in the same journal showed that 1 year after patients had gastric banding, they lost an average of 21.6% of their initial body weight.

The current research, the longest and most inclusive to date, showed that after receiving a lap band (adjustable and reversible technique) a significant number of patients were able to lose 26 kilograms on average and keep the weight off for over a decade.

A team of experts from the Centre for Obesity Research and Education (CORE) at Monash University in Melbourne, Australia, led by Professor Paul O'Brien, gathered and examined data on 3,227 patients who had gastric banding between 1994 (when the technique was first established) and 2011.

The subjects were 47 years old on average, 78% of them were female. A total of 714 of those patients had surgery at least ten years ago, and lost an average of 26 kilograms, or nearly half of their excess weight, and kept it off.

The patients who underwent treatment at least 15 years ago all had similar weight loss outcomes. "These results show that when you have a significant problem with obesity, a long-term solution is available," Professor O'Brien commented.

"This surgery is safe and effective, and it has lasting benefits. Substantial weight loss can change the lives of people who are obese - they can be healthier and live longer," he added.

There was also significant consequences for the management of type 2 diabetes, which is strongly linked to being overweight.

"In obese patients with type 2 diabetes, weight loss after gastric banding can lead to effective control of blood sugar levels without the need for medication in about three-quarters of cases," Professor O'Brien explained.

All of the subjects observed in the report had adhered to their doctors' instructions concerning exercise, activity, and eating. They also said they would continually return to the aftercare program.

All of the procedures were performed by Professor O'Brien, an international pioneer of the technique, and Associate Professor Wendy Brown, President of the Obesity Surgery Society of Australia and New Zealand (OSSANZ).

There were no deaths linked to the surgery or to any later procedures that were required in about 50% of the subjects. During the time of the research, about 1 in 20 participants needed to have the band removed.

Professor O'Brien said:

"In treating a chronic disease such as obesity over a lifetime, it is likely that something will need to be corrected at some time in some patients.

The study shows a marked reduction of revisional procedures with the introduction of the new version of the Lap-Band 6 years ago. Importantly, those who had revisional surgery lost as much weight in the long term as those who did not need it."

The research also compared gastric banding (which can be done as a day-surgery procedure) with more invasive kinds of surgery to lose weight, such as gastric bypass, that can be very risky and require a much longer stay in hospital.

Results showed that the weight loss as well as the need for future revisional surgery with gastric banding was comparable to that with gastric bypass surgery.

Professor O'Brien concluded:

"Access to weight-loss surgery in Australia remains severely limited for many obese patients as relatively few cases are treated within the public health system. We are working hard to improve access.

We have ample evidence that weight-loss surgery is effective, and it is unfair that half of eligible patients cannot be treated, particularly as it has been shown that gastric banding is a highly cost-effective health care measure. The stigma of obesity, and the assumption that it is the person's fault, entrenches discrimination against people who could benefit."


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