Is a Lap Band the New Way to Lose Weight?


I lost my weight, over 100 pounds, through diet and exercise. I’m not anti-surgery, and considered it for myself, but I suggest first trying what I’ve done.

A battle is currently raging within the F.D.A., detailed in this New York Times opinion piece, about whether or not to allow lap band surgery for those who are only mildly obese, 30-40 pounds overweight.  Right now, it’s approved in dangerously obese adults, those with a body mass index (BMI) of at least 35.  For a 5’4″ woman, that means 204 lbs.

The lap band, which reduces the size of the stomach to make eating a large meal impossible, seems like a great fix: they are less expensive and less risky than gastric bypass and some success stories have people losing upwards of 100 lbs within a year.

Unfortunately, however, our knowledge of the lap bands effects on the moderately obese is woefully inadequate and based largely on a study involving only 149 patients with short-term followup:

“In this study, the operations were done by carefully selected surgeons on relatively healthy patients, all under the age of 55 — which gave the study its best chance of producing favorable results. Even so, there were many adverse reactions. The most common were vomiting, difficulty swallowing, pain and gastroesophageal reflux. Five percent of subjects required additional surgery one to nine months after getting their lap bands, and in most cases this meant permanent removal. One of the devices that was removed had already eroded — raising concern about how long lap bands last. And unlike the initial surgery, often an outpatient procedure, the revisions and removals meant hospitalizations lasting up to a week.”

The bottom line is that we don’t know enough about the lap band.  It works to promote weight loss and reductions in diabetes in the short-term.  Its success and safety are still largely untried in the long-term in lower-risk patients. The lap band may turn out to be an effective method of weight loss for less obese people, but we need more information on both the benefits and risks for the moderately obese before this becomes clear.

Dr John Ellis MD

Board-certified anesthesiologist, with expertise in cardiovascular anesthesia and the implications of obesity and sleep apnea in anesthesia. See vascularanesthesia.com for professional information. Dr. Ellis has used the strategies in here to: (1) lose 120 lbs over 18 months, (2) stop all antihypertensive medicines, and (3) no longer need CPAP treatment for sleep apnea.

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