Gastric band works better than 500-calorie diet
by Nanci Hellmich / USA Today
May 2, 2006 Adjustable gastric banding is much more effective long-term than a very low-calorie diet for people who are about 50 pounds overweight, a study shows.
Medical
guidelines support this surgical procedure -- which puts a band around
the top of stomach to create a feeling of fullness -- in patients who
are extremely obese, about 100 or more pounds over a healthy weight, or those who are almost as overweight and have serious medical conditions, such as type 2 diabetes.
Researchers
at Monash University Medical School in Melbourne, Australia, recruited
80 patients who were on average 52 pounds over a healthy weight. Half
had the laparoscopic adjustable gastric band surgery.
The other
half followed a medical program that included a variety of strategies
such as a very-low-calorie diet (500 calories a day) with liquid meal
replacements, prescription weight-loss medication and behavioral
therapies.
Findings in today's Annals of Internal Medicine:
- After six months, both the surgery patients and the low-calorie dieters lost an average of 14% of their starting weight.
- After
two years, the gastric band patients lost 22% of their starting weight.
That was about 87% of their excess weight, or roughly 45 pounds. They
also showed marked improvement in their health and quality of life.
- At
the end of two years, the dieters had regained much of their lost
weight but were still 5.5% below their starting weight. They had lost
22% of their excess weight, or about 12 pounds.
Researchers
are still analyzing the weight-loss data. "I'm very happy that the
gastric band patients are continuing to maintain their weight loss,"
says lead author Paul O'Brien, director of the university's Centre for
Obesity Research and Education. Since the study, he received grants
from INAMED Health, maker of the LAP-BAND® System.
In this
study, the surgery was as safe as the diet program, but O'Brien notes
the procedure does carry risks, and some may need follow-up procedures,
such as readjusting the band position. The surgery costs $14,000 to
$18,000 in the USA, he says.
Insurance companies vary widely in
coverage of gastric banding or gastric bypass, a more complex surgery
that creates a much smaller stomach and rearranges the small intestine.
Average cost: $26,000. Under certain conditions, Medicare covers both
surgeries.
Many surgeons in the USA use gastric bypass because
bypass patients lose more weight overall and lose it faster, says Neil
Hutcher, president of the American Society for Bariatric Surgery and a
surgeon in Richmond, Va.
Thomas Wadden, an obesity expert at the
University of Pennsylvania School of Medicine in Philadelphia, says
gastric banding "is a very effective procedure, but it's not a
rational, cost-effective solution to the epidemic of obesity."
"Because
we have limited health-care dollars, we have to decide how best to
invest them. Are we going to provide bariatric surgery for a relatively
small number of people or instead invest in the prevention of obesity
so our children hopefully won't need this surgery?"
Copyright © 2006 USA Today. All rights reserved. Republished with permission.
