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Comparing Gastric Banding to Lifestyle Intervention continued...

TV and other screen time was limited to two hours a day, and a personal trainer was provided to each teen for a six-week period. Parents were involved in the lifestyle intervention and education.

The gastric banding group had the procedure done within a month of being assigned to the group. They got detailed instructions on correct eating -- for instance, having three or fewer small meals a day, eating slowly, and chewing well. They were urged to get 30 minutes or more of formal exercise every day and to keep active during the day.

Comparing Gastric Banding to Lifestyle Intervention

Twenty-four of the 25 teens in the surgery group and 18 of the 25 in the lifestyle group finished the study. Other results:

  • The gastric banding group lost an average of nearly 13 BMI units; the lifestyle intervention group lost 1.3 BMI units on average.
  • At the end of the study, none of the gastric banding group had metabolic syndrome -- a cluster of risk factors for heart disease and other ailments -- although nine had it at the start. Ten in the lifestyle group had metabolic syndrome at the start, and four of the 18 finishers did at the end.

For several reasons, the banding type of bariatric surgery is preferred over other procedures, such as gastric bypass surgery, O'Brien says. "It is gentle, safe, effective, and fully reversible," he says. "A 15-year-old will be 35 in 20 years' time. Surely we will have better ways to control weight by then. If he has a [gastric band] he can have it out, all goes back to normal, and, if needed, he can go on the new therapy. That cannot happen with procedures that create major and essentially irreversible change [such as bypass surgery]."

As good as the results were, the researchers note in their report that the surgery "is not a quick fix." In fact, 28% of teens in the surgery group needed revisions because of enlargement of the stomach or other factors. To avoid the enlargement problem, eating small meals is crucial, the researchers say.

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