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Gastric Banding Surgery Works for Teens

Teens Who Got Surgery Lost More Weight Than Those Who Got Nonsurgical Treatment, Researchers Find
By
WebMD Health News
Reviewed by Louise Chang, MD

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 surgeons.

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 Association.

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 self-esteem.

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.

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