The Latest on Lap Band

Dr. George Fielding weighs in on the latest research on Lap-Band surgery.

Posted on | By George Fielding MBBS, FRACS, FRCS, FRCS (Glas)

We all know what we’re supposed to do if we’re very overweight, especially if those extra pounds are starting to cause health problems. We are supposed to follow the mantra of “eat less and exercise more.” It usually works for a while, and we can lose a few pounds, sometimes hundreds of pounds, if we can stick to it long enough. But what most people can’t do is keep the weight off.

Why is that? Well, for one thing, it can be an all-consuming process, where it’s all you think about, and eventually it can exhaust us. And then there’s the hunger. Skinny people usually get hungry, eat, are satisfied, and stop. Many of us who are fat are always hungry and are never satisfied. The normal triggers in our brain that say we can stop don’t work right. We are hungry all day, all night, and it just doesn’t go away. It’s fighting that hunger that’s so hard, so all-consuming. And finally, you have to stay very dedicated to exercise to burn off even one pound of fat.

We try, it works for a while, and then it doesn’t.

It’s at this point, often after several failed attempts, that overweight people may consider the possibility of weight loss surgery. I know it’s when I did 15 years ago. I had lost 60 to 80 pounds five times and regained it every time. Then, in one year, I ended up on 11 new medications as my body collapsed under the constant strain of being 330 pounds. I was a typical fat man faced with a choice. Lose weight or die young. Ask yourself why you don’t see a lot of old fat people. It’s because most are dead, years before their time. A man with a BMI of 45 dies about 13 years before his normal weight brother or sister.

The Lap-Band has been around since 1993, and available in the US since 2001, when it was approved by the FDA. There is plenty of long-term data showing it’s an effective tool. In Australia, O’Brien recently reviewed 3,227 patients treated with Lap-Band between September 1994 and December 2011. A total of 714 patients had completed at least 10 years of follow-up. No patient died from surgery. On average, those 714 patients lost 47% of their excess weight. The band was removed in only 6%. At NYU we studied 2,909 patients and found exactly the same thing - 47% excess weight loss at six years post-surgery. Two of our patients died after surgery. If you combine the two studies, that’s two deaths in over 6000 obese patients, many of whom are ill, and very effective weight loss long-term. Most people kept their bands, and most did well.

Article written by George Fielding MBBS, FRACS, FRCS, FRCS (Glas)