By Jason Gale Feb. 10 (Bloomberg) — Weight-loss surgery was more effective at slimming severely obese teens and improving their health than two years of diet and exercise, a study found. Adolescents fitted with Allergan Inc. ’s Lap-Band device lost about 11 times more weight compared with a group following so-called lifestyle approaches, researchers in Melbourne said. The results reported today in the Journal of the American Medical Association suggest bariatric surgery is an effective treatment for younger obese patients, the authors said. Weight-loss surgery has soared in popularity among U.S. adults in response to rising rates of obesity. The procedure has been controversial because the quality of evidence to support it is poor, said Edward H. Livingston , professor of surgery at the University of Texas Southwestern Medical Center in Dallas and a contributing editor to the journal. The study’s findings “go a long way toward providing the evidence necessary to evaluate the benefits and risks of bariatric surgery,” Livingston wrote in an accompanying editorial. “Many insurance companies in the United States will not pay for bariatric surgeries, and their decision to not cover this treatment is based on the lack of compelling, universally accepted evidence in its favor.” Obesity Rate Doubled At least one U.S. adolescent in six — more than 5 million people — was obese in 2004, according to the study. The number of obese Americans has more than doubled over 30 years to 72 million, according to the U.S. Centers for Disease Control and Prevention. People who are overweight or obese have a greater risk of diabetes, heart attacks and strokes, the Atlanta-based agency said last month. Allergan had 2009 revenue of $238 million for products designed to treat obesity and most of it was from sales of the Lap-Band, said company spokeswoman Cathy Taylor in an e-mail today. The Irvine, California, company is testing the device in severely obese adolescents ages 14 to 17 and submitted an application to the U.S. Food and Drug Administration last year for approval in that age group, she said. For the study, researchers at Melbourne’s Monash University followed 50 adolescents ages 14 to 18 over two years. All participants were deemed severely obese, having a body mass index , or BMI, greater than 35. Half were randomly selected for gastric banding and the remainder was asked to follow an individualized diet and exercise plan. Reversible Procedure Gastric banding is done when a surgeon places a band around the upper portion of the stomach to create a pouch to hold food, which limits the amount a person can eat. The reversible procedure is one of the two most common for weight loss, with the other being gastric bypass . In today’s study, two years after the start the gastric banding group had lost an average of 34 kilograms (76 pounds), representing an overall average loss of 28 percent of total body weight and 79 percent of excess weight, the researchers said. In comparison, the lifestyle group lost an average of 3 kilograms (6.6 pounds), or an average of 3.1 percent total weight loss and 13 percent excess weight loss. “Despite a comprehensive, behaviorally focused intervention, those in the lifestyle group were not able to achieve substantial weight loss,” wrote the study’s authors led by Paul E. O’Brien , director of Monash’s Centre for Obesity Research and Education. “Indeed, keeping adolescents and their parents involved in the trial for its two-year duration proved challenging.” Allergan supplied the Lap-Band Adjustable Gastric Banding system used in the research, the study said. Lower Risk Although the study wasn’t designed to measure improvements in specific health problems, it did demonstrate a reduction in a group of conditions associated with increased risk for cardiovascular disease and diabetes, the authors said. At enrollment, 9 study participants in the gastric banding arm and 10 in the lifestyle group suffered from so-called metabolic syndrome , as the group is known. After 24 months, none of the gastric banding group had the problem, compared with 4 of the 18 teens in the lifestyle group who completed the study. “Gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health,” the authors said. The gastric banding group experienced no adverse events in the period shortly after surgery, the authors said. Eight operations to adjust the band or repair tubing connected to the band were required in seven patients in the surgery group. “The gastric banding approach to weight loss is not a quick fix,” the researchers wrote. Lifestyle treatments may achieve weight loss and improved health for some individuals and should remain the first option for obese adolescents, they said. The study was funded by the National Health and Medical Research Council. One of the study’s authors, John Dixon of Monash University, reported consulting agreements with Allergan and other companies. To contact the reporter on this story: Jason Gale at j.gale@bloomberg.net
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Weight-Loss Surgery May Help Severely Obese Teens, Study Finds
