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Weight Loss: Is Bypass Better Than Banding?

Very Obese Bypass Patients in Study Lost More Weight, Kept It Off Longer

Obesity and Weight Regain continued...

Among the major findings:

  • Three years after surgery, 22% of the banding patients were still severely obese (BMI of 35 or greater), compared to 7% of bypass patients.
  • Six years after surgery, nearly three times as many banding patients had a BMI of 35 or greater (33% vs. 12%).
  • Fourteen percent of the banding patients remained morbidly obese (BMI of 40 or greater) after six years, compared to 2.4% of bypass patients.
  • The complication rate immediately following surgery was 17% in the bypass patients and 5% in the banding patients. Six years later, 19% of the bypass patients and 41% of the banding patients reported long-term complications.

Forty-seven of the 221 patients who had the banding procedure (21%) ended up having the bands removed.

“At the present time, Roux-en-Y gastric bypass seems clearly superior to gastric banding when treating morbidly obese patients," researcher Sebastien Romy, MD, and colleagues write.

Ronald H. Clements, MD, who directs the bariatric surgery program at Vanderbilt University Medical Center in Nashville, Tenn., says the findings come as no surprise.

“Our experience and that of many others is that close to 25% of these bands end up being removed for some reason such as slippage, erosion, or failure to lose weight,” Clements says.

Role of Consumer Marketing

Clements adds that aggressive marketing by the gastric banding industry has been largely responsible for the dramatic increase in gastric banding procedures.

“It’s common for patients to tell me they want gastric banding because they have seen a commercial for it,” he says. “When I explain the pros and cons of banding, bypass, and sleeve procedures, they often change their minds.”

American Society for Metabolic and Bariatric Surgery (ASMBS) President Robin Blackstone acknowledges that aggressive marketing of gastric banding is an issue.

“The society does not favor the direct-to-consumer type of advertising that we are seeing with gastric banding,” she says. “We recommend that patients seek out a center which offers a variety of procedures and also offers counseling to address the risks and benefits of each one.”

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