Entries in Lap Band (7)


For Some, Weight-Loss Surgery Can Trigger Eating Disorders

Brand X Pictures/Thinkstock(NEW YORK) -- When multiple traditional diet methods fail, weight-loss procedures such as lap band surgery are seen as a last hope for getting obese patients to eat more healthfully and lose weight.

But for an under-recognized minority of patients, the surgery only triggers a different kind of disordered eating.  For some, it's bulimia, while for others, it's anorexia.

Sixty percent of individuals seeking treatment for obesity have some kind of eating disorder, usually binge eating, according to a 2007 Harvard study.  It is these individuals, who already have an unhealthy relationship with food and their bodies, who are at most risk of developing further eating disorders post-surgery, says Lisa Lilenfeld, a psychologist and president of the Eating Disorders Coalition at Argosy University in Washington, D.C.

Lap band or gastric bypass surgery is not likely to create an eating disorder where there wasn't one, she explains, but "the most likely thing is that people had untreated or unsuccessfully treated binge eating disorders before surgery will continue to have problems after surgery.  The problem is, it becomes physically challenging and potentially dangerous to binge like this because of the structural changes in the stomach," she says.

On the other end of the spectrum, patients who used to overeat now overshoot with their weight loss, severely limiting their caloric intake to the point of malnutrition and anorexia.

"I've had a number of patients go from very obese to very underweight, so much so that they need to be rehabilitated with intravenous nutrition," says Dr. Donald Kirby, a gastroenterologist at the Cleveland Clinic who treats patients undergoing bariatric weight-loss surgery.

Because there are still no statistics on how many of these patients experience eating disorders post-op, it's difficult to gauge the scope of this issue and there is much debate over its prevalence between the surgeons who perform the procedures and the therapists who treat eating disorders down the line.

Dr. Mitch Roslin, a bariatric surgeon at Lenox Hill Hospital in New York, has performed thousands of bariatric surgeries and he says he only sees one or two cases a year of eating disorders, but psychologist Lilenfeld believes it's much more common than that.

Copyright 2011 ABC News Radio


Should Lap Band Be Approved for Teens?

Creatas/Thinkstock(WASHINGTON) -- More teenagers may now have the opportunity to turn their weight around through Lap-Band procedures -- possibly even with FDA approval. Currently, minors must have parent permission, but the Lap-Band creator, Allergan, has requested that the FDA approve Lap-Band procedures for anyone more than 14 years old. The procedure uses a temporary elastic band to consrict the patient's stomach so that it can only hold a small amount of food.

Cathy Taylor, a spokesperson for Allergan, said the company made the request because of the increase in obese teenagers, and the disease's correlation to life-threatening conditions such as heart disease and type 2 diabetes.

"In addition, the prevalence of obesity continues to rise, making it a significant health epidemic," said Taylor. "Due to all of the above, Allergan continues to be committed to the research and development of the Lap-Band System to help those affected by obesity, to improve their health and lives."

Because the Lap-Band System is not currently FDA-approved for use in patients younger than 18, Taylor said, "Allergan does not promote the use of the product with adolescents. Therefore, we cannot elaborate on the potential benefit of Lap-Band in this patient population."

But that does not mean the company is not trying to prove that it is beneficial to adolescents. Amanda Sena, a spokesperson for the FDA, confirmed that Allergan is currently conducting clinical trials in the United States to determine the effectiveness of the Lap-Band in the morbidly obese teen population.

Sena said she could not comment on when the FDA would come to a decision for Lap-Band use in teens.

The Lap-Band procedure in teens remains a controversial issue. While some obesity experts agree that the surgery should be available for teens, others believe the procedure should be a last resort, if not forbidden altogether, in this age group.

Copyright 2011 ABC News Radio


Study: Teens Lose Bone Mass After Gastric Bypass Surgery

Jupiterimages/Thinkstock(CINCINNATTI) -- Many adults who have gastric bypass surgery suffer bone loss in the years after their operation, and a new study shows the same thing happens to adolescents.

Researchers led by Dr. Anne-Marie Kaulfers, then a clinical fellow in endocrinology at Cincinnati Children's Hospital Medical Center, looked at 61 adolescents who had Roux-en-Y gastric bypasses.  A Roux-en-Y bypass involves making a small pouch from stomach tissue and attaching it directly to the small intestine, bypassing most of the stomach and the first part of the small intestine, called the duodenum.

They found teens suffered 5.2 percent bone loss a year after surgery, which increased to 7.4 percent after two years.  However, obese teens already have an above-average amount of mineral mass in their bones, so even though they lost more than seven percent of that mass, it decreased to the same amount that normal-weight teenagers have.

The study stopped two years post-surgery, so the researchers don't know whether the decline continues beyond that point.  "However, if bone loss continues, even at a slow rate, these patients may have an increased risk of fractures later in life," the authors wrote.

While some specialists say the findings aren't new because other studies showed similar results in adults, others say the study draws attention to one of the big risks of gastric bypass surgery.

"This study is very important because we all know that there are consequences to rapid weight loss, and bone loss has been a concern in adults and now we know that it happens in adolescents," said Dr. James Geiger, surgical director of the C.S. Mott Children's Hospital Comprehensive Weight Management Program in Ann Arbor, Michigan.

Experts say it's important to learn more about bone loss in younger people who have a gastric bypass in order to determine why it happens, what the long-term consequences are and how possibly to reverse bone loss.

Copyright 2011 ABC News Radio


Lap Band Surgery Might Not Be the Solution for Super Obesity

Jupiterimages/Thinkstock(BRUSSELS, Belgium) -- Almost half of the patients who have elected to have lap band surgery for obesity eventually need to have the devices removed due to erosion or other malfunctions, researchers say.

Morbid obesity is a serious health condition that can interfere with basic physical functions such as breathing or walking.  It can also lead to reduced life expectancy.

A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable device that is placed around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. 

A new study has assessed the long-term effectiveness and safety of such banding for for morbid obesity.  Dr. Jacques Himpens, of Saint Pierre University Hospital in Brussels and colleagues, evaluated 82 patients with an average age of 50 within 12 years after having the surgery. 

The researchers reported in the Archives of Surgery that although the average excess weight loss after 12 years was about 42.8 percent, a third of the patients experienced band erosion while half of them had to have the bands removed. 

Based on these findings, the authors concluded that gastric banding may have poor long-term outcomes.

Gastric banding has come under scrutiny and a number of previously published studies have reported similarly poor long-term effects.

Copyright 2011 ABC News Radio 


Gastric Bypass More Effective than Lap Band in First Year

Photo Courtesy - Getty Images(SAN FRANCISCO) -- A new study published in the Archives of Surgery suggests that gastric bypass surgery is more effective than the lap band in helping morbidly obese people lose weight.

Researchers at the University of California in San Francisco studied 200 patients, 100 of whom chose to undergo gastric bypass and 100 who opted for a lap band. The study found that after a year, those who had a gastric bypass lost an average of 64 percent of their excess weight, compared to 36 percent for those with a lap band.

Gastric bypass was also more effective in the resolution of diabetes, at 76 percent, compared to the lap band, at 50 percent.

However, experts have cautioned about the validity of the results, given that it can take up to three years to see the full effect of lap band surgery.

Copyright 2011 ABC News Radio


FDA Panel Recommends Lap Band Expansion

 Photo Courtesy - Getty Images(WASHINGTON) -- A U.S. Food and Drug Administration advisory committee voted 8-2 Friday in favor of expanding use of the popular Lap Band weight-loss device for use on those who are less obese, potentially expanding the eligibility for surgery from 13 million Americans to nearly 32 million.

The decision comes in response to a request by Lap Band manufacturer Allergan to lower the recommended body mass index needed to qualify for the procedure.

And, like a majority of the FDA panel members, many experts also believe that the time has come to expand eligibility for the weight-loss procedure.

In Lap Band surgery, an inflatable ring is placed over part of the stomach to reduce the amount of food consumed. The procedure had already approved for people categorized as morbidly obese, or adults with a body mass index, or BMI, of at least 40, and those with BMI of 35 who have at least one obesity-related health problem.

The panel now recommends the BMI lower limit drop to 35 for those with no related health problems and 30 for those with weight-related medical problems. Patients categorized as obese but who weigh 34 pounds less than the original indication would qualify.

Copyright 2010 ABC News Radio


FDA Panel to Consider Lap Band Expansion

Photo Courtesy - Getty Images(WASHINGTON) -- A U.S. Food and Drug Administration advisory committee convening Friday will consider a request by manufacturers of the Lap Band to allow the popular weight-loss device to be used on those who are less obese.

The request by Allergan, the same company that manufactures Botox, will likely prove to be a controversial one, as some say such an approval could push the band further into the realm of cosmetic elective surgery. And the fact that the chairwoman of the FDA committee considering the request owns stock in Allergan will likely do little to quell this controversy.

While the heads of FDA advisory panels do not vote, in this case, Dr. Karen Woods, the chairwoman of the FDA advisory committee making the determination, could stand to gain financially from an affirmative decision, according to ABC News chief health and medical editor Dr. Richard Besser.

"It is disturbing that the person who's heading the review committee has stock in that company," Besser told ABC News, "Allergan has a lot to benefit if this is approved."

Today, nearly 13 million Americans may qualify for Lap Band surgery, but if the FDA approves Allergan's request, the number eligible for the procedure could spike to nearly 32 million.

Copyright 2010 ABC News Radio

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