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| |  Obese Adolescents Who Receive Gastric Banding Achieve Significant Weight Loss CHICAGO -- February 9, 2010 -- A higher percentage of severely obese adolescents who received laparoscopic adjustable gastric banding lost more than 50% of excess weight and experienced greater benefits to health and quality of life compared with those in an intensive lifestyle management program, according to a study published in the February 10 issue of JAMA. “Bariatric surgery is now extensively used for adults and is being evaluated for adolescents,” the authors wrote. “Laparoscopic adjustable gastric banding has the potential to provide a safe and effective treatment.” Paul E. O’Brien, MD, Monash University and the Centre for Adolescent Health, Royal Children’s Hospital, Melbourne, Australia, and colleagues conducted a study to examine whether gastric banding would induce more weight loss and would provide greater health benefits and better improvement in the quality of life of severely obese adolescents than the application of currently available lifestyle approaches. The randomised controlled trial included 50 adolescents aged 14 to 18 years with a body mass index (BMI) higher than 35 who were assigned either to participate in a supervised lifestyle intervention or to undergo gastric banding, and followed up for 2 years. The lifestyle intervention program included reduced calorie intake, increased activity, and behavioural modification. The study was performed between May 2005 and September 2008. Twenty-four of 25 patients in the gastric banding group and 18 of 25 in the lifestyle group completed the study. The researchers found that the primary outcome of greater than 50% of excess weight loss was achieved by 21 of 25 participants (84%) in the gastric banding group and 3 of 25 (12%) in the lifestyle group. At 2 years the gastric banding group had lost an average of about 34.5 kg (76 lbs), representing an overall average loss of 28.3% of total body weight and 78.8% excess weight loss. The lifestyle group lost an average of 3.0 kg (6.6 lbs), representing an average 3.1% total weight loss and 13.2% excess weight loss. The differences between groups was significant for all weight measures at 24 months. “At entry, 9 participants (36%) in the gastric banding group and 10 (40%) in the lifestyle group had the metabolic syndrome. At 24 months, none of the gastric banding group had the metabolic syndrome compared with 4 of the 18 completers (22%) in the lifestyle group,” the authors wrote. The gastric banding group experienced improved quality of life with no adverse events in the period shortly after surgery. However, 8 operations (33%) involving revisional procedures were required in 7 patients in the surgery group. “In this study, gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health,” the authors wrote. “The adolescent and parents must understand the importance of careful adherence to recommended eating behaviours and of seeking early consultation if symptoms of reflux, heartburn or vomiting occur. As importantly, they should be in a setting in which they can maintain contact with health professionals who understand the process of care. This study indicates that, in such a setting, the laparoscopic adjustable gastric banding process can achieve important improvements in weight, health, and quality of life in severely obese adolescents.” the researchers conclude.
SOURCE: JAMA
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