Gastric bypass surgery is more effective at helping severely obese patients lose weight and control diabetes than Lap-Band surgery, according to a new study.
"If you have severe obesity and diabetes the better procedure is gastric bypass," says the study's leader author, Dr. Guilherme Campos, a surgeon at the University of Wisconsin School of Medicine and Public Health. "The results are not as good with the band."
Campos and his colleagues examined the two weight-loss surgeries in a group of 200 obese patients. Half underwent Lap-Band surgery and half had riskier, more complicated gastric bypass surgery. The gastric bypass patients lost 64% of their excess weight on average in one year, as compared with the Lap-Band patients, who lost 36% of their excess weight on average in the same period.
Here's another way to look at it: Let's say a patient weighs 360 pounds and his ideal body weight is 160 pounds. That means he has 200 pounds of excess weight. With gastric bypass surgery, Campos says, the patient could expect to lose 128 pounds in one year. With Lap-Band surgery, he could expect to lose only 72 pounds in a year.
Additionally, the researchers found the weight loss associated with gastric bypass surgery allowed more patients to safely discontinue the use of insulin to manage diabetes after one year. Campos’ study is published in Monday's issue of the medical journal Archives of Surgery.
Weight loss surgeries restrict the amount of food a person can eat. During Lap-Band surgery an adjustable band is implanted around the upper portion of the stomach, then tightened to limit the intake of food. Gastric bypass surgery is more complicated. The stomach is "stapled" shut, closing off a portion while food is redirected or "bypassed" to the intestines.
"Any time you're making holes in the bowl and connecting two pieces of bowel together you run the risks of leaks and bleeding," says Dr. Harry Sax, a surgeon at Warren Alpert School of Medicine at Brown University. "The risks are much lower than they were 10 or 15 years ago, but they are still higher than the bands."
Since Lap-Bands were approved by the Food and Drug Administration in 2001 there has been a steep increase in their use. A gastric band can be removed if necessary, whereas reversing gastric bypass is more difficult. The bands, however, are not problem-free. They can slip or erode into the stomach over time.
The complications associated with gastric bypass surgery tend to occur early after surgery, and Sax says the procedure may be a more durable operation in the long term.
If you're thinking about weight loss surgery you can find a map of accredited surgery centers in your area by visiting the American College of Surgeons.
