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Wednesday, 6 June, 2001, 09:19 GMT 10:19 UK
Stomach band treatment for obesity
Lap band
The lap band can be fitted with keyhole surgery
A new method of surgery to treat people with severe obesity has been approved in the US.

The technique involves implanting an inflatable band around the upper part of the stomach.

Using a saline solution, the band can be inflated so that a smaller gastric pouch is formed.

This limits food consumption and creates an earlier feeling of fullness.


Surgery has a place in the treatment of obesity, but it is not a quick fix

Dr Andrew Hill
The device, called the Lap-Band Adjustable Gastric Banding System, has been approved by the US Food and Drug Administration (FDA).

It has been developed by a company called BioEnterics Corporation.

Stapling

Other surgical techniques currently available to treat obesity, such as stomach stapling and gastric bypasses involve major operations.

But the lap band can be fitted using minimally invasive keyhole surgery.

It is intended to stay in place permanently, but can be tightened or loosened at any time by surgeons through a portal under the skin.

Stomach
Obesity is on the increase
The FDA said the device was only intended for use on severely obese people who had failed to lose weight by other means.

People with the lap band will need to diet and exercise in order to maintain their weight loss.

In a study of 299 people, patients lost an average of 36% of their excess weight over three years. Two percent gained some weight, and 5% stayed the same.

During the study, patients were put on a strict diet and required to exercise for 30 minutes a day.

However, nearly 90% of patients experienced at least one side effect such as nausea, vomiting, heartburn, abdominal pain, and band slippage or pouch enlargement.

A quarter of patients had their band removed, mostly because of side effects.

Initially, the band will only be available at a limited number of centres in the US where surgeons have the skills and training required to fit it.

Alternatives

Dr Andrew Hill, chairman of theUK based Association for the Study of Obesity, said a similar technique, which involved inserting a balloon into the stomach, had failed to produce hoped-for results.

He told BBC News Online: "This technique works by reducing the amount of the stomach volume that is available thereby decreasing the amount of food that a person can eat without feeling sick or uncomfortable.

"Surgery has a place in the treatment of obesity, but it is not a quick fix and is not for the mildly obese.

"It really is the end point of treatment options."

Dr Hill said there were many different treatment options available.

But he warned that none would enable people to lose weight very rapidly.

"People should be aiming for slow and maintained weight loss, for instance 5% to 10% of their bodyweight over a year."

Severely obese people are defined in the US as those who are at least 100 pounds overweight, or twice their ideal body weight.

Severe obesity has been linked to health problems such as high blood pressure and diabetes.

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See also:

30 May 01 | Health
Obesity epidemic warning
24 May 01 | Health
New drug to beat obesity
30 Mar 01 | Health
Obesity 'starts in the womb'
01 Jun 01 | Health
Anti-obesity drug 'works well'
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