Minimally-invasive weight loss surgery improves health and morbidly obese teens

Teenagers' obesity-related medical complications improve just six months after laparoscopic gastric banding surgery, according to outcomes data presented this week. The preliminary results by physician-scientists from Morgan Stanley Children's Hospital of NewYork-Presbyterian and Columbia University Medical Center were presented on June 17 at The Endocrine Society's 90th Annual Meeting in San Francisco.

The study reports that the small group of extremely obese teenagers who received the minimally invasive surgery, also called the Lap-Band procedure, as part of a clinical trial lost an average of 20 pounds after six months and had significant improvements in abdominal fat, triglyceride measurements (levels of fat in the blood) and blood sugar levels as measured by hemoglobin A1c - all risk factors for diabetes and heart disease. The patients' liver function and a measure of immune response also improved, according to the abstract.

"Extremely obese teenagers have obesity-related health problems, particularly diabetes and increased cardiovascular risk. Laparoscopic gastric banding, which has been shown to be a safe and effective way to lose weight, now offers the possibility of reducing obesity's medical complications," says lead author Dr. Ilene Fennoy, a pediatric endocrinologist at Morgan Stanley Children's Hospital of NewYork-Presbyterian and clinical professor of pediatrics at the Columbia University College of Physicians and Surgeons.

"Until recently, these patients have had to rely primarily on non-surgical methods or higher-risk surgeries to lose weight, and few of these treatments have succeeded in achieving major weight loss or greatly improving their overall health."

The Lap-Band procedure, which is approved by the Food and Drug Administration (FDA) for adults but not yet in teenagers, involves making the stomach smaller without staples. Instead, a band is place around the upper part of the stomach, creating a small pouch that restricts food intake. The surgeon implants a small access port, and after the surgery the doctor periodically adjusts the gastric band by inflating or deflating a saline-filled balloon that lies inside the band. If desired, the procedure is reversible. Morgan Stanley Children's Hospital/Columbia University Medical Center is one of three sites in the nation approved to study this procedure in teens.

The study, which is part of the multidisciplinary FDA-approved Lap-Band Trial for Teens being performed at Morgan Stanley Children's Hospital and Columbia University Medical Center, followed 14 adolescents - six boys and eight girls - between the ages of 14 and 17 who were, on average, 174 pounds overweight. Patients received dietary counseling and encouragement to exercise, both before and after surgery.

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Inamed of Irvine, Calif., the manufacturer of the Lap-Band, supplied the gastric bands for the study.

Columbia University Medical Center