Obese teens who receive gastric banding achieve significant weight loss

A higher percentage of severely obese adolescents who received laparoscopic adjustable gastric banding lost more than 50 percent of excess weight and experienced greater benefits to health and quality of life compared to those in an intensive lifestyle management program, according to a study in the 10 February issue of JAMA.

Adolescent obesity is a serious health challenge globally. In the US, more than 17.4%, or more than 5 million adolescents were obese in 2004, an increase from 14.8% in 2000. Obesity is associated with both immediate and late health effects and reduced life expectancy, according to background information in the article. Lifestyle programs that have included changes in diet, exercise, and behaviour to promote weight loss often have poor results. "Bariatric surgery is now extensively used for adults and is being evaluated for adolescents," the authors write. "Laparoscopic adjustable gastric banding (gastric banding) has the potential to provide a safe and effective treatment."

Paul E. O'Brien, MD, FRACS, and colleagues of Monash University and the Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia, conducted a study to examine whether gastric banding would induce more weight loss and would provide greater health benefits and better improvement in the quality of life of severely obese adolescents than the application of currently available lifestyle approaches. The randomised controlled trial included 50 adolescents between 14 and 18 years of age with a body mass index (BMI) higher than 35 who were assigned either to participate in a supervised lifestyle intervention or to undergo gastric banding, and followed up for 2 years. The lifestyle intervention program included reduced calorie intake, increased activity and behavioral modification. The study was performed between May 2005 and September 2008. Twenty-four of 25 patients in the gastric banding group and 18 of 25 in the lifestyle group completed the study.

The researchers found that the primary outcome of greater than 50% of excess weight loss was achieved by 21 of 25 participants (84 percent) in the gastric banding group and 3 of 25 (12 percent) in the lifestyle group. At 2 years the gastric banding group had lost an average of about 76 lbs. (34 kg), representing an overall average loss of 28.3% of total body weight and 78.8% excess weight loss. The lifestyle group lost an average of 6.6 lbs. (3 kg), representing an average 3.1% total weight loss and 13.2% excess weight loss. The differences between groups was significant for all weight measures at 24 months.

"At entry, 9 participants (36 percent) in the gastric banding group and 10 (40%) in the lifestyle group had the metabolic syndrome. At 24 months, none of the gastric banding group had the metabolic syndrome compared with 4 of the 18 completers (22%) in the lifestyle group," the authors write. The gastric banding group experienced improved quality of life with no adverse events in the period shortly after surgery. However, 8 operations (33%) involving revisional procedures were required in 7 patients in the surgery group.

"In this study, gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health. The adolescent and parents must understand the importance of careful adherence to recommended eating behaviours and of seeking early consultation if symptoms of reflux, heartburn, or vomiting occur. As importantly, they should be in a setting in which they can maintain contact with health professionals who understand the process of care. This study indicates that, in such a setting, the laparoscopic adjustable gastric banding process can achieve important improvements in weight, health, and quality of life in severely obese adolescents," the researchers conclude.

(Source: JAMA/Archives: JAMA: February 2010)

Article Date: 15/2/2010

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Comment from: jenny ranson | 2/15/2010 12:52:50 PM
yes, a gastric band will obviously cause significant weight loss but at what price about 4 years ago my mother underwent the procedure as she was borderline diabetic from obesity. Within 2 years she had lost a lot of weight, but her teeth have rotted from vomiting caused by blockages in the band. She will get physically sick at least 5 times a week, due to things getting stuck in the bank, she has even vomited from drinking water too quickly. By trying to remove excess pressure on the band she burps and it is so revolting and embarrassing in public and then runs off five minutes later to be sick. The quality of her life may have improved in the weight loss aspect but, her whole body is showing symptoms of bulimia. Do not think that this is a quick fix it is very hard on family and your body, you are left with scars, and loads of spare skin, which will also prevent you from waring the clothes you dream of, and to remove that you are looking at over $10,000 and even more scars. Excessive burping, dissolving/chipping teeth, constant uncontrollable vomiting, and awful sagging skin. Children can lose weight much easier than adults, me and my brother have lost a total of over 50KG the old fashion way, with much less side effects and almost no extra skin. If kids decide to start undergoing this procedure they will be left with a lifetime of side effects and torture of loved ones. I know its hard to lose weight, but anything is better than this gastric band surgery.