FDA lap band surgery guidelines loosen eligibility criteria

February 18, 2011

The FDA's lower BMI threshold for lap band surgery makes 26 million more obese Americans eligible for the weight loss procedure. Image: CC Invictus OU812/Flickr

New lap band surgery guidelines have been issued by the Food and Drug Administration. After reviewing studies on the results of lap band surgery, the FDA has lowered the minimum body mass index to be eligible if patients have an obesity-related condition. The new FDA guidelines make about 26 million more obese Americans eligible for lap band surgery.

Lower BMI threshold for lap band surgery

The new FDA lap band surgery guidelines reduce the minimum body mass index to be eligible for the procedure from at least 40 BMI to 30 BMI. Patients with a BMI of 30, or 26 percent body fat, would be approved for lap band surgery if diets and weight loss drugs haven’t worked for them, and they have an obesity-related condition such as diabetes or high blood pressure. Someone who is 5-foot-9 and weighs about 203 pounds would have a 30 BMI.  A lap band, also known as a Lap-Band Adjustable Gastric Banding System, is a ring inflated with a saline solution that is cinched around the upper portion of the stomach. The lap band restricts the amount of food a person can eat during a meal.

Weight loss surgeries

Lap band surgery is sometimes confused with gastric bypass, a different weight loss surgery. Gastric bypass surgery involves reducing the capacity of the stomach and bypassing a section of intestine to reduce the caloric absorption of food. People lose more weight with a gastric bypass, but the operation is riskier. Patients with type 2 diabetes experience a reduction in symptoms a few days after a gastric bypass operation. With lap band surgery, diabetes symptoms are not affected until the patient loses weight, which can take several months. Unlike the gastric bypass procedure, lap band surgery is easily reversible. In 2010 about 220,000 weight-loss surgeries were performed in the U.S. About 60 percent were gastric bypass operations.

Results of lap band surgery

The new FDA ruling regarding lap band surgery is based on a trial conducted by Allergan, a lap band manufacturer, of 149 patients who had a BMI greater than 30 for an average of 17 years. For the trial to succeed, at least 40 percent of the patients had to lose 30 percent of their excess weight after lap band surgery. About 84 percent hit that target within a year and 65 percent were no longer considered obese and kept the weight off the second year. Allergan will monitor the lap band patients’ weight for five years.

Sources

CBS News: http://www.cbsnews.com/stories/2011/02/18/earlyshow/main20033327.shtml

Los Angeles Times: http://www.latimes.com/health/la-na-lap-band-20110217,0,6472853.story

Web MD: http://www.webmd.com/diet/weight-loss-surgery/news/20110217/fda-oks-lap-band-surgery-for-more-patients

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