Obesity Surgery Benefits
Gastric banding tightens belts and budget
Gastric banding continues to woo its critics as the most comprehensive study yet finds patients keep the weight off over a decade after surgery. But a huge number of eligible Australians are missing out, with most public hospitals refusing to perform the procedure the lead researcher says.
The 15-year follow-up study involving over 3,000 patients found Australians who opted for laparoscopic adjustable gastric banding surgery lost an impressive amount of weight – 26 kilograms on average– and maintained weight loss for more than 10 years.
And the trend is set to continue beyond the 20-25 year mark, lead researcher Professor Paul O’Brien told Gastroenterology Update.
A meta-analysis of all gastric banding research with long-term weight loss data – included in the study published this week in the Annals of Surgery – found on average patients lost 54% of their excess weight ten years after gastric banding surgery. In the current Australian study, there were no deaths associated with the surgery or any revisional procedures that were needed for about half the cohort. About one in 20 patients had the band removedduring the follow-up period.
The authors from the Centre forObesity Research and Education(CORE) touted the benefits of gastric banding for type 2 diabetes patients.But in a position statement released last year, Diabetes Australia maintained gastric banding should only be used as a “last resort” for very obese adults and for whom lifestyle changes and other medical treatments have proven unsuccessful. Professor O’Brien disagrees, citing his 2008 study that found three quarters of gastric banding patients with initial BMIs between 30 and 40 went into diabetes remission.
“While it shouldn’t be the first option, it shouldn’t be the last,” he said.“It’s effective and if it’s managed properly it’s very, very safe and to say “no, we’ll only do it on extreme people as a last resort is the wrong sort of thinking”.
Annals of Surgery, 2012