Gastric Banding Assists Obese Teens

(February 10, 2010) - Gastric banding appears to be a big help for severely obese teens. (Read about "Bariatric Surgery" "Obesity") 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 Journal of the American Medical Association.

Adolescent obesity is a serious health challenge globally. In the US, more than 17.4 percent, or more than 5 million adolescents were obese in 2004. That's an increase from 14.8 percent four years earlier. 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 behavior 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.

Researchers 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 randomized controlled trial included 50 adolescents between 14 and 18 years of age with a body mass index (Read about "Body Mass Index") 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. 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 percent 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., representing an overall average loss of 28.3 percent of total body weight and 78.8 percent excess weight loss. The lifestyle group lost an average of 6.6 lbs., representing an average 3.1 percent total weight loss and 13.2 percent 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 percent) in the lifestyle group had the metabolic syndrome. (Read about "Metabolic Syndrome") At 24 months, none of the gastric banding group had the metabolic syndrome compared with 4 of the 18 completers (22 percent) 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, eight times patients needed operations (33 percent) involving revisional procedures. One patient required two operations.

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