A New Option for Weight Loss Surgery

These days, Jennifer Secrist has little interest in idle
activities. The 23-year-old loves to rock climb, hike, ride
her mountain bike, and do almost anything that gets her
outside and moving.

"I can't stand to sit around," she tells WebMD. "I have so
much energy now it's amazing."

Weight Loss Surgery

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Her secret: weight loss surgery that leaves her with a
smaller stomach while leaving her with smaller scars than
the traditional surgery. What makes Secrist's story truly
amazing is that in less than two years she has lost 107
pounds, thanks to adjustable gastric banding, a surgical
procedure that is commonly performed in Europe, but has only
been recently approved for use the U.S.

diet programs that work, weight loss plan, simply weight loss,

The surgery can be performed laparoscopically, which means
small tools are guided by a small camera through small
incisions in the abdomen. The traditional weight loss
procedure in the U.S., gastric bypass, involves a large
incision to surgically alter the stomach and make it
smaller. The Midland, Mich. woman traveled to Sweden to get
the surgery, and her mom and dad later made the trip for the
same reason.

Adjustable Gastric Banding

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Adjustable gastric banding is far less popular here than
gastric bypass surgery. Banding has been done in the U.S.,
yet previously required open surgery, with all its potential
complications.

But two new studies find the laparoscopic approach for
banding to be a safe and effective weight loss option for
people who are 100 pounds or more overweight. The studies,
reported in the latest issue of the journal Annals of
Surgery, found that patients who underwent gastric banding
surgery lost roughly 50% of their excess body weight within
two years.

The procedure involves the implantation of a hollow silicone
band placed around the top of the stomach, which is adjusted
to determine how much food the stomach can hold. The
adjustment is made by inflating or deflating the band using
salt water piped in trough a tube attached to a port placed
under the skin near the breastbone. Several types of bands
are available in Europe, but the FDA has approved only one -
the Lap-Band system made by the California firm BioEnterics
System.

One of the newly published studies evaluated the Lap-Band
device in 500 morbidly obese French patients. Researcher
Franck Zinzindohoue, MD, and colleagues reported a 53%
excess weight loss at two years, with 10% of patients having
to have second operations due to complications. No deaths
were reported among the patients. The outcomes were much
better than those reported in a recent study finding that
more than half of patients abandoned the band in favor of
gastric bypass surgery.

The authors attribute their good outcome to a procedure they
developed to reduce the incidence of band slippage, one of
the most common complications of gastric banding.

Some Patients Are Unhappy Because They Did Not Loose As Much
Weight As They Wanted

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Still, in an accompanying editorial, weight loss surgeon
John M. Kellum, MD, says surgeons in America may want to
think twice before recommending gastric band surgery over
gastric bypass. He no longer performs gastric banding, and
says most of his patients who had the banding procedure were
unhappy with it because they did not lose as much weight as
they had hoped to.

"Some of my patients actually gained weight, which never
happens with gastric bypass," he tells WebMD. "We were also
troubled by the fairly high number of patients who had
complications with the band." Kellum says a newer type of
band from Sweden may be safer for patients than the
Lap-Band, but it has not been studied in the U.S.

In the second new study, authors claimed a lower rate of
band erosion and slippage. But the procedure is not
recommended for all patients, especially the heaviest, which
Kellum says could restrict its usefulness among American
patients.

"American patients tend to be heavier than those in Europe,
and the heavier the patient the higher the likelihood that
complications will occur," he says.

Jennifer Secrist, who now weighs 140 pounds and is a size 6,
says she knows of a few gastric band patients, or
"bandsters," who have had trouble losing weight with the
procedure. But she would not hesitate to recommend it to
anyone whose health is jeopardized by morbid obesity. She
publishes a web journal of her process to inspire others.

"I want people to know there are alternatives to being
heavy," she says. "This has done so much for me. I can't
begin to describe it."

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