Gastric Lap Band Surgery

Hospitals begin gastric banding weight-loss surgery on patients with lower BMI

Some hospitals are starting to promote gastric band surgery for patients with lower BMIs, in a sign that the recent Food & Drug Administration decision to lower the threshold of obesity that a patient must exhibit in order to fit the indication for gastric banding surgery could turn out to be a boon for Allergan Inc. (NYSE: AGN ).

The Davis Clinic in Houston, Texas, announced that it will offer the weight-loss surgery for the newly included range of obese patients, using Allergan's Lap-Band device, which first won FDA clearance in 2001.

Prior to February of this year, gastric banding surgery was approved only for patients with a body mass index of 35 or higher. The FDA expanded the approved group to include patients with a BMI of 30 or higher who also exhibit a co-morbid condition like diabetes or hypertension, enabling about 26 million more people to opt for the surgery, according to a clinic release.

While the influx of candidates is a clear win for Allergan, the lower threshold of patients doesn't qualify for insurance coverage, meaning they'll have to pay cash for the procedure.

"We are hopeful that in the next few years, we will see that change," said Jamie Carr, clinical director at the David Clinic. "For the time being, the procedure must be done on a cash-pay basis, but of all procedures available today, the LAP-BAND is certainly the most affordable when an individual must pay for surgery themselves."

"Allergan is committed to continuing its efforts to ensure widespread coverage for those who qualify for the procedure," Cathy Taylor, Allergan spokeswoman, told MassDevice .

The device was originally indicated for use only in patients categorized as "severely obese," with a BMI of 40 or 100 pounds or more over their estimated ideal weight. A BMI of 30 to 35 translates to about 35 to 65 pounds over estimated ideal weight.

The Centers for Disease Control & Prevention assign a BMI of 30 or above as "obese", while 25 to 29.9 is considered "overweight", and 18.5 to 24.9 is considered "normal".

In December 2010 the Gastroentology and Urology Devices Advisory Panel, which provides recommendations to the watchdog agency on product approvals, voted 8-2 that the FDA allow doctors to prescribe Allergan's device for patients with a BMI of at least 35, or a BMI greater than or equal to 30 along with at least one co-morbid condition, such as diabetes or hypertension.

Lap-Band verse Gastric Bypass Surgery

What are the main differences between Lap-Band and Gastric Bypass ? How do these bariatric surgeries compare? Having weight-loss surgery is a costly decision that affects your waistline and your wallet.

Both surgeries are heavily used in by bariatric surgeons today, and both have their advantages and disadvantages. Below are the quick facts about each surgery and what type of patient may be best for it.

Gastric Bypass Surgery Facts Studies have shown that gastric bypass surgery helps patients lose more weight than Lap-Band surgery. Gastric Bypass Surgery is a more effective treatment towards diabetes than lap-band. (In a recent study, 89% of people with type 2 diabetes who underwent gastric bypass surgery went into remission and 57% were still in remission after five years ) Gastric Bypass is a very powerful weight loss surgery, that alters a person’s digestive track to increase weight-loss.

In the short-term, there are fewer complications and risks with Lap-Band Surgery. One study suggests that Gastric Banding is cheaper in the long run verse Gastric Bypass ( The average number of hospital visits fell 25% over a four-year period in the banding group, while increasing 15% in the bypass group. By year four, the banding patients were spending more than $4,000 on their care, while bypass patients spent more than $9,000.) Lap-Band Surgery is less invasive than Gastric Bypass. Gastric Banding (Lap-Band Surgery) is also less costly. Which Bariatric Surgery is Best for Me?

Typically if you’re morbidly overweight, Gastric Bypass surgery is for you. Patients with less severe BMIs typically choose Lap-Band Surgery . But it isn’t that simple. If patients have co-morbidites, espcially type 2 diabetes, they are often urged to consider gastric bypass surgery more than lap-band surgery. With type 2 diabetes, there is evidence that suggests gastric bypass is more apt to treat the disease than lap-band surgery.

Average Weight-Loss: Lap-Band vs Gastric Bypass

Gastric Bypass: Most weight-loss within six months of the surgery. Typically 1.5 years to 2 years is the height of weight-loss, then it begins to plateau.  Most patients can expect 70% of their excess weight lost.

Lap-Band : Patients who’ve undergone Lap-Band surgery can expect to lose 60% of their excess weight. The weight loss is typically slow and steady for the first 3 to 4 years, then reaches the plateau.

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