Gastric Banding Most Effective for Obese Teens
TUESDAY Feb. 9, 2010 -- Severely obese teens who received gastric banding surgery lost significantly more weight than those who made lifestyle changes such as dieting and exercise, Australian researchers report.
Their study included 50 teens, aged 14 to 18, with a body-mass index (BMI) higher than 35 (statistical obesity begins at a BMI of 30). Half underwent laparoscopic adjustable gastric banding while the other half took part in a supervised lifestyle intervention.
Gastric banding involves the placement of a band to divide and reduce the size of the stomach. It has proven effective in helping patients feel satiated earlier, spurring weight loss.
The study participants were followed for up to two years; 24 patients in the gastric banding group and 18 of those in the lifestyle group completed the study.
The target of losing more than 50 percent of excess weight was achieved by 84 percent of teens in the gastric banding group but by just 12 percent of those in the lifestyle group. After two years, those in the gastric banding group had lost an average of 76 pounds, representing an overall average loss of 28.3 percent of total body weight and 78.8 percent excess weight loss. The teens in the lifestyle group lost an average of 6.6 pounds, representing an average 3.1 percent total weight loss and 13.2 percent excess weight loss.
At the start of the study, 36 percent of teens in the gastric banding group and 40 percent of those in the lifestyle group had the metabolic syndrome, a cluster of symptoms that predispose people to heart disease. After two years, none of the patients in the gastric banding group had metabolic syndrome, compared with 22 percent of those in the lifestyle group.
The teens who had gastric banding typically experienced improved quality of life, but seven of them required follow-up surgery.
"In this study, gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health," wrote Dr. Paul E. O'Brien and colleagues at Monash University and the Centre for Adolescent Health, Royal Children's Hospital, Melbourne.
They said that teens and parents "must understand the importance of careful adherence to recommended eating behaviors 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 concluded.
The study appears in the February 10 issue of the Journal of the American Medical Association.
The Nemours Foundation has more about weight loss surgery and teens.
Posted: February 2010