Weight-loss surgery safe for less obese patients

The surgery has been available to severely obese patients for a decade, but the new study evaluated the benefits and risks of the procedure in those who were mildly obese.

The research was led by bariatric surgeon Esteban Varela, MD, now at Washington University School of Medicine in St. Louis.

Results of the new study, available online in the journal Obesity Surgery, coincide with a recent decision by the U.S. Food and Drug Administration to expand the use of gastric banding surgery in those who are mildly obese.

“This is a significant step in obesity treatment,” says Varela, associate professor of surgery. “The health risks even in mildly obese people can be life-threatening over time. It is vital that these patients have other options for losing weight when more traditional approaches are not successful.”

Gastric banding surgery is now available to adults with a BMI of 30 or more if they have one obesity-related health condition, such as high blood pressure or diabetes. Previously, patients could only have they surgery if they had a BMI of 35 or more.

A person who is 5 feet 5 inches tall with diabetes would have to weigh 210 pounds to qualify for the procedure under the old guidelines. Now, that person would only need to weigh 180 pounds.

About 27 million Americans have a BMI between 30 and 35 and at least one obesity-related health condition.

In the study, Varela compared outcomes in 30 consecutive obese patients who underwent laparoscopic adjustable gastric banding surgery. Twenty patients were severely obese, and 10 were mildly obese. All the patients had attempted to lose weight through medical weight loss programs but had not succeeded.

The researchers followed the patients for 30 days after the surgery. They found the procedure was just as safe in less obese patients as in those who were severely obese.

None of the patients in the study died, and minor complications, while few, only occurred among those who were severely obese. In addition, the procedure could be performed faster and resulted in less blood loss among those who were mildly obese.

“The procedure is safe and has the potential to help many more mildly obese patients lose weight and improve related health conditions, particularly diabetes,” Varela says. “These patients often have struggled for years to lose weight through diet and exercise programs and have not been successful. This surgery requires a lifestyle change – but it can help patients lose a significant amount of weight and keep it off long-term.”

This minimally invasive surgical procedure involves insertion of a silicone gastric band that fits around the top portion of the stomach, restricting the amount of food a person can eat and decreasing appetite. The band can be tightened or loosened to adjust the size of the stomach.

Laparoscopic adjustable gastric banding is just one type of weight-loss surgery that is performed by Washington University surgeons at Barnes-Jewish Hospital, which is designated as a Bariatric Surgery Center of Excellence by the American Society of Bariatric Surgery.

More information: Varela JE, et al. Perioperative outcomes of laparoscopic adjustable gastric banding in mildly obese (BMI<35) compared to severely obese. Obesity Surgery. Published online Feb. 10, 2011

Provided by Washington University School of Medicine in St. Louis