Feb. 9, 2010 -- Gastric banding surgery produces substantially more weight
loss in obese teens than medical treatment stressing lifestyle changes only,
according to a new study.
The surgery group lost 76.2 pounds on average, while the lifestyle
intervention group lost 6.6 pounds over the two-year study. Put another way,
84% of the gastric banding group lost more than 50% of their excess weight, but
just 12% of those in the lifestyle intervention group did, says senior study
author Paul E. O'Brien, MD, director of the Centre for Obesity Research and
Education (CORE) at Monash University in Melbourne, Australia.
''It is highly successful," O'Brien tells WebMD of the results for surgery,
explaining that a loss greater than 50% is viewed as good by weight loss
Other weight loss experts say the study is one of the first to compare
obesity surgery with lifestyle treatment in teens. More than 17.4%, or 5
million, U.S. teens are obese.
The study is published in the Journal of the American Medical
Comparing Gastric Banding to Lifestyle Intervention
O'Brien and his colleagues randomly assigned 50 Australian teens, aged 14 to
18, with a body mass index (BMI) greater than 35 either to the lifestyle
intervention or gastric banding and followed them for two years.
A BMI of 30 and above is considered obese. Participants also had
obesity-related medical complications such as high blood pressure, asthma, back
pain, physical disability, or psychosocial problems such as low
O'Brien's team used the gastric band known as Lap-Band. In the procedure, a
hollow silicone band is placed around the upper part of the stomach, creating a
small pouch capable of holding just a small amount of food.
Monash's Centre for Obesity Research and Education receives an unrestricted
research grant from Allergan, Lap-Band's manufacturer. In the U.S., Lap-Band is
approved for use in severely obese adults; its use in teens is under study.
Lifestyle intervention is always tried first for obesity treatment, and if
that fails, surgery may be considered. In the study's lifestyle intervention
group, the teens were instructed to reduce calorie intake (to about 800 to
2,000 calories a day, depending on their weight and age) and increase activity,
with a target of more than 10,000 steps a day on the pedometer and at least 30
minutes a day of physical activity.
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.