I have a serious concern that bariatric surgery, particularly the use of the Lap-Band, is becoming the preferred alternative to gradual weight loss programs for the obese. Many patients prefer this quick-fix surgical approach as do hospital execs because of its revenue-generating potential. Allergan, the manufacturer of the device, recently proposed to the FDA that the use of the device be allowed for the less obese. Here is an excerpt from the first article about this topic (see: Obesity Surgery May Become Option for Many More):
An advisory committee to the Food and Drug Administration will consider...a request by Allergan, the pharmaceutical company, to significantly lower how obese someone must be to qualify for surgery using the company’s Lap-Band device, which restricts intake to the stomach....If the agency approves the change, the number of Americans eligible for the Lap-Band operation could easily double, ensuring more sales for Allergan and probably more insurance coverage for such operations. But the proposed change, sought at a time when the obesity epidemic in the United States seems intractable, still leaves some people uneasy, in part because of side effects and failure rates. In addition, long-term weight reduction is hard to maintain....A new generation of diet pills has failed to gain federal approval, limiting options for overweight Americans, and Allergan and other companies are betting that surgery will become more of a frontline option rather than a last resort....Doctors have already started to operate on extremely heavy teenagers, not just adults. And some experts are recasting weight-loss procedures, known as bariatric surgery, as metabolic surgery, saying that it might be justified to treat diabetes, even in people who are barely obese or not obese. Gastric banding involves placing an inflatable silicone ring around the upper part of the stomach, which limits food consumption and makes one feel full faster. Current guidelines say weight loss surgery is appropriate for people who have failed to lose weight through diet and exercise and have a body mass index, or B.M.I., of 40 and above, or 35 and above if a person has at least one serious health problem, like diabetes or high blood pressure, that is tied to obesity. Allergan wants to lower the threshold for the Lap-Band to a B.M.I. of 35 with no associated health problems and to 30 with such problems.
Subsequent to the article cited above, the NYT published the findings of the FDA panel, which approved the expanded use of the device (see: Panel Votes to Expand Surgery for Less Obese). Here is an excerpt from this latter article:
A federal advisory panel...endorsed an expansion of the use of Allergan’s Lap-Band stomach-restricting device to patients who are less than severely obese. The vote could pave the way to double the number of Americans who qualify for weight-loss surgery. And it could eventually lead to making other types of weight-loss surgery available to those who are not quite as heavy.....The advisory committee to the Food and Drug Administration voted 8 to 2 that the benefits of Lap-Band surgery exceeded the risks for patients in the lower range of obesity. It voted 8 to 2 that the device was safe, and 8 to 1, with one abstention, that the device was effective.
The direction in which bariatric surgery is moving is disturbing to me (see: Bariatric Surgery Moves into the Mainstream for Obesity Control). The spin being applied here is obvious. Individuals with a vested interest in the procedure are trying to change the name of the procedure to metabolic surgery. They have also begun the process of gradually loosening the clinical criteria for patient selection. I question how serious an effort is being made by some physicians to advocate diet and exercise for many of these patients. I understand that the use of the Lap-Band device can be reversed but the procedure does introduce a significant alteration in gastric physiology plus exposing the patient to the risk of surgery. A situation is unfolding that will lead to broad and inappropriate use of this device given the prevalence of obesity in this country.
A federal advisory panel Friday endorsed an expansion of the use of Allergan’s Lap-Band stomach-restricting device to patients who are less than severely obese.
The vote could pave the way to double the number of Americans who qualify for weight-loss surgery. And it could eventually lead to making other types of weight-loss surgery available to those who are not quite as heavy.
“I see this as the first step in the march toward changing the standard of care,” E. Francine Stokes McElveen, the consumer representative on the committee, said during the meeting in Gaithersburg, Md.
The advisory committee to the Food and Drug Administration voted 8 to 2 that the benefits of Lap-Band surgery exceeded the risks for patients in the lower range of obesity. It voted 8 to 2 that the device was safe, and 8 to 1, with one abstention, that the device was effective.
I have been thinking about this topic for a while too. You've done a wonderful job telling about your thoughts
Posted by: hunger suppressant | May 22, 2012 at 09:14 AM
Before they start putting the Lap-Band on patients who are 50 pounds overweight, the public has to be made aware of how dangerous it is; about one in 1,000 patients die within 30 days of surgery ??
Posted by: Nutrition | April 26, 2012 at 07:41 AM
There is no alternative to just regular exercise. that is the most healthy way to loose weight. Also nutrition facts and activities to keep your mind off food or w.e hinders you to eat.
Posted by: nyautoaccidentlaw | April 09, 2011 at 01:51 PM
Before they start putting the Lap-Band on patients who are 50 pounds overweight, the public has to be made aware of how dangerous it is; about one in 1,000 patients die within 30 days of surgery.
Posted by: ajlounyinjurylaw | March 14, 2011 at 11:58 PM
When your meals include dairy products, you should use low-fat yogurt or skim milk instead of full-fat alternatives. However, try to limit your dairy consumption to 2 cups of skim milk, 2 cups of low-fat yogurt or 1 ounce of low-fat cheese each day.
Posted by: Liquid Deit | January 10, 2011 at 03:31 AM