Gastric banding an effective long-term solution to obesity

Laparoscopic adjustable gastric banding – lap banding – is a safe and effective long-term strategy for managing obesity, according to the findings of a landmark 15-year follow-up study of patients treated in Australia.

The follow-up study, the longest and most comprehensive yet reported, was published in the Annals of Surgery, and found a significant number of lap band patients maintained an average weight loss of 26 kilograms for more than a decade after their procedure.

Professor Paul O’Brien and colleagues from the Centre for Obesity Research and Education (CORE) at Monash University in Melbourne analysed the results in 3,227 patients who had gastric banding between 1994, when the procedure was first introduced, and 2011. The patients in the study were averaged at 47 years of age and 78 per cent were women.

Of those patients, 714 had surgery at least 10 years ago and, on average, had maintained a weight loss of 26 kilograms, or almost half of their excess weight.

The weight loss results were similar for the 54 patients in the study who had undergone treatment at least 15 years ago.

“These results show that when you have a significant problem with obesity, a long-term solution is available,” Professor O’Brien said.

Laparoscopic gastric banding
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Laparoscopic gastric banding is surgery to help with weight loss. The surgeon places a band around the upper part of your stomach to create a small pouch to hold food. The band limits the amount of food you can eat by making you feel full after eating small amounts of food.

After surgery, your doctor can adjust the band to make food pass more slowly or quickly through your digestive system.

“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.”

Professor O’Brien said there were also important ramifications for the control of type 2 diabetes, which was strongly associated with being overweight.

Risks for gastric banding are:

  Gastric band erodes through the stomach (if this happens, it must be removed)
  Gastric band may slip partly out of place
  Gastritis (inflamed stomach lining), heartburn, or stomach ulcers
  Infection in the port, which may need antibiotics or surgery
  Injury to your stomach, intestines, or other organs during surgery
  Poor nutrition
  Scarring inside your belly, which could lead to a blockage in your bowel
  Your surgeon may not be able to reach the access port to tighten or loosen the band (you would need minor surgery to fix this problem)
  Vomiting from eating more than your stomach pouch can hold

“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 said.

The patients included in the study had followed the rules of their treating team regarding eating, exercise and activity and committed to returning permanently to the aftercare program.

Laparoscopic gastric banding Alternative Names

Lap-Band; LAGB; Laparoscopic adjustable gastric banding; Bariatric surgery - laparoscopic gastric banding

All the surgery was 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).

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