MONASH U. (AUS) — Gastric banding is safe and effective for managing obesity long-term, according to a study of patients 10 to 15 years after their surgeries.
The study, the longest and most comprehensive yet reported, appears in the Annals of Surgery, and finds a significant number of laparoscopic adjustable gastric banding (lap banding) patients maintained an average weight loss of 26 kilograms for more than a decade after their procedure.
Researchers analyzed the results in 3,227 patients who had gastric banding surgery in Australia between 1994, when the procedure was first introduced, and 2011. The patients in the study were averaged at 47 years-of-age and 78 percent were women.
Of those patients, 714 had surgery at least 10 years ago and, on average, had maintained a weight loss of 26 kilograms, or almost half of their excess weight.
The weight loss results were similar for the 54 patients in the study who had undergone treatment at least 15 years ago.
“These results show that when you have a significant problem with obesity, a long-term solution is available,” says Professor Paul O’Brien of the Centre for Obesity Research and Education at Monash University in Melbourne.
“This surgery is safe and effective, and it has lasting benefits. Substantial weight loss can change the lives of people who are obese—they can be healthier and live longer.”
O’Brien says there are also important ramifications for the control of type 2 diabetes, which was strongly associated with being overweight.
“In obese patients with type 2 diabetes, weight loss after gastric banding can lead to effective control of blood sugar levels without the need for medication in about three-quarters of cases,” O’Brien says.
The patients included in the study had followed the rules of their treating team regarding eating, exercise, and activity and committed to returning permanently to the aftercare program.
All the surgery was performed by O’Brien, an international pioneer of the technique, and Associate Professor Wendy Brown, President of the Obesity Surgery Society of Australia and New Zealand.
There were no deaths associated with the surgery or with any later operations that were needed in about half of the patients. About one in 20 patients had the band removed during the study period.
“In treating a chronic disease such as obesity over a lifetime, it is likely that something will need to be corrected at some time in some patients,” says O’Brien.
“The study shows a marked reduction of revisional procedures with the introduction of the new version of the Lap-Band 6 years ago. Importantly, those who had revisional surgery lost as much weight in the long term as those who did not need it.”
The report also included a comparison of gastric banding—which can be done as a day-surgery procedure—and more invasive types of weight-loss surgery such as gastric bypass that are high risk and require longer hospital stay. The weight loss with gastric banding, and the need for future revisional surgery, was similar to that with gastric bypass.
“Access to weight-loss surgery in Australia remains severely limited for many obese patients as relatively few cases are treated within the public health system. We are working hard to improve access,” says O’Brien.
“We have ample evidence that weight-loss surgery is effective, and it is unfair that half of eligible patients cannot be treated, particularly as it has been shown that gastric banding is a highly cost-effective health care measure. The stigma of obesity, and the assumption that it is the person’s fault, entrenches discrimination against people who could benefit.”
Source: Monash University