Why bother dieting when you can go under the knife to lose those unwanted pounds? Last week, an FDA advisory panel approved an expansion of the use of Allergan Inc’s Lap-Band, a gastric banding device used to achieve weight loss in morbidly obese adults. The FDA committee voted 8-2 that the benefits of the Lap-Band surgery outweighed the risks for those with lower BMIs, such as those considered overweight or obese.
Because the device, an inflatable silicone ring that constricts the upper part of your stomach, can be inserted laparoscopically and is removable, the Lap-Band is a popular choice among weight loss surgeries. Up until now, the Lap-Band was only approved for those who have reportedly been unable to lose weight through diet and exercise and have either a BMI of 40 or above or approximately 100 lbs. overweight, or a combination of a BMI of 35 or above and at least one serious weight-related health problem, such as hypertension or diabetes. Allergan submitted a request to the FDA asking to market the Lap-Band device to people with a BMI of 35, or to those with a BMI of 30 with concurrent health problems.
According to the New York Times, this approval could double the number of Americans who qualify for Lap-Band surgery; Allergan certainly has the staggering obesity statistics to back up its request. Currently, it is estimated that one-third of adults are obese, or have a BMI of 30 or greater. Further, a recent study in the New England Journal of Medicine showed that women with a BMI of 30 to 35 had a 44 percent higher risk of death than women who had a BMI less than 25.
There are limitations and larger issues to consider with the accepted expansion of this surgery. To start, BMI is a rudimentary and unsophisticated measurement. It does not take into account sex or body composition, such as ratio of muscle to fat. Further, obesity is, more often than not, more complicated than simply overeating. Many people that undergo bariatric surgery are required to see a psychologist to work through the psychological difficulties of cutting down on the amount of food consumed. Following the surgery, recipients of the Lap-Band can only eat about a half cup of food at one time.
Medical device companies and pharmaceuticals make a tremendous amount of money off of those in poor health. Obesity is, after all, a remarkably expensive condition. It is estimated that we spend $147 billion a year treating weight-related illnesses. This FDA approval will mean that insurance companies will be able to cover the cost of the surgery.
With the incredible amount of people who now qualify, it’s time to be proactive, not reactive. Although most patients experience a 40 to 50 percent loss of excess weight, it should be noted that the Lap-Band, or any other weight loss surgery, does not guarantee weight loss. It is simply a tool to help with weight loss, but it must be used appropriately. Ultimately, lifelong diet and lifestyle changes must be made to lose weight and keep it off. As with any surgery, there are risks associated with the procedure, in addition to those specific to the gastric bypass such as band erosion or slippage.
While the FDA committee ruled that the benefits of the Lap-Band outweigh the risks, it’s still important to focus on prevention. The bottom line: this isn’t a miracle cure, it’s part of a whole lifestyle shift that takes work.