My Bariatric Life: People with a BMI >30 and One Comorbidity Approved for Weight Loss Surgery

Patient Expert

Many obese people have achieved significant improvement in their health through one form or another of bariatric surgery for morbid obesity, which means a Body Mass Index (BMI) of >40, or a BMI of >35 with one comorbidity. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), approximately 15 million people meet the criteria for morbid obesity.

Yet there is a large population that suffers from obesity that does not meet these criteria. More than 37 million Americans have a BMI between 30-35 and at least one obesity-related comorbid condition. And until now, weight loss surgery was not a treatment option for them.

Earlier this year, the FDA approved the Lap-Band adjustable gastric banding for obese adults with a BMI of 30-40 and at least one comorbid condition (such as asthma, diabetes, or hypertension). This is significant, even life-changing for these individuals. Obesity is the second-leading cause of preventable death in the United States, second only to smoking. Medical research has found that, if left untreated, those individuals who are currently obese will likely remain obese.

Typically, in order to qualify for gastric bypass, the patient must have at least 100lbs to lose. Now, with Lap-Band, patients who have 30lbs or more to lose may qualify for the procedure.

Obesity Lessens Life Expectancy Markedly

The years of life lost due to obesity are significant. An article published in The Lancet, a medical journal, reports that patients with a BMI >40 lose about 10 years off their expected lifespan. Similarly, an article in JAMA, another medical journal, states that a 20 year-old man with a BMI of 45 is expected to lose 13 years of life compared to a normal-weight individual. Loss of life of two to five years was estimated to occur even at moderate levels of obesity, which is a BMI >30.

How Lap-Band Works

Lap-Band is an FDA-approved adjustable gastric banding device from Allergan, a pharmaceutical company. Lap-Band is not the generic name for gastric banding devices; it is the only such device, currently, to be approved for patients with at least 30lbs to lose, a BMI of >30 and at least one comorbid condition.

Lap-Band is an adjustable silicone tube, which is placed around the upper part of the stomach (think of a belt placed around your waist that could be made tighter and tighter to cinch your waist smaller). This effectively reduces the stomach's capacity, restricting the amount of food the patient is able to eat at one time and also slowing the rate at which food leaves the stomach. The result is that patients achieve sustained weight loss by limiting food intake, reducing appetite, and slowing digestion.

After the surgeon implants the Lap-Band around the upper part of the patient's stomach, usually laprosopically, a tube is then connected from the gastric band to a small access port that is affixed beneath the skin of the patient's abdomen. Patients usually return to normal activity within a week.

After the first four to six weeks, adjustments to the Lap-Band are made by the surgeon through the access port. This is done as needed - more frequently in the first year - to maintain optimal weight loss, by adding or removing saline solution.

There is no cutting or stapling of the stomach, or rerouting of the digestive system with gastric banding. It is a less invasive procedure as compared to other weight loss surgeries, such as gastric bypass or gastric sleeve, and there's low malnutrition risk.

Clinical Study Reports Significant Results

A clinical study by Allergan showed that those patients undergoing the Lap-Band gastric banging procedure, and having a BMI between 30 and 40, in the first 12-months following the procedure achieved:

  • A mean excess weight loss of 64.5%
  • A mean reduction in BMI of 6.5 points
  • A mean reduction in waist circumference for men 6.1 inches and women 5.9 inches

The study also found that weight loss was maintained at year 2.

Improving Health Outcomes

The Lap-Band has been an effective weight loss procedure with well-established safety profile for years, with more than 650,000 surgeries performed. With the expanded indication to include patients who are obese -- but not morbidly obese -- there is promise to help a greater number of patients in their fight against obesity.

A personal note...

I had  my  weight-loss surgery  in 2003. My wish is to help you on your own journey of lifetime obesity disease management with shareposts along the way to help you navigate that journey successfully.