For an obese patient, the lap-band (laparoscopic adjustable gastric banding) procedure seems to be a dream come true. New guidelines suggest that patients with a body mass index as low as 30 may be eligible for this surgery.
A study published in Archives of Surgery shows that the long-term outcomes of the lap-band appear to be relatively poor. A thirteen-year Belgian follow-up study shows that only 43% of patients maintained a loss of excess weight, nearly 60% required reoperation and obesity-related problems such as diabetes, hypertension and sleep apnea persisted. More than half the patients developed complications following the surgery. In the study group, the average weight loss was fifty pounds. Despite these relatively poor outcomes with lap-band, many patients said they were “pleased” or “very pleased” with the procedure.
Journalist Mike Mitka questioned the lead author of the study, Dr. Jacques Himpens, about the disappointing results. Himpens explains that some people have a misconception about the role of surgery in treating morbid obesity:
“Surgery is not the answer to reducing morbid obesity. Surgery can play a part, but we should be more focused on changing patient behavior—reducing the amount of food eaten at a meal and eliminating snacking.
“The increased proportion of those with the comorbid conditions—that includes people who had diabetes or hypertension when they underwent the procedure and those who developed it during the follow-up due to weight gain—reminds us that the positive effects of banding wear off and these conditions evolve and emerge over time.
“As for why most people feel satisfied after undergoing the procedure, even if they have [the gastric band] removed, I think it is because they do not feel guilty any more. They did something, and if it failed, at least they tried.”
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