Gastric bands—the long-term costs

Gastric bands are sometimes seen as a "quick fix" for people who need to lose a lot of weight. There's no doubt they can work well, but the long-term consequences might make you think twice.

A new study of 80 gastric band patients found that half no longer had the band after 12 years, having had it removed. This could have been because of complications, because it didn't work well enough, or for another reason, such as simply not wanting it any more.

Four in 10 people had experienced serious complications, including damage to the stomach from the band. And 6 in 10 had needed one or more follow-up operations. Follow-ups included needing the band repositioned or removed, switching to a gastric bypass operation, or correcting the position of the port to the band, which can slip out of place. (The port is the point where the band can be injected with fluid to tighten it).

Despite these problems, the majority of people in the study (6 in 10) were satisfied or very satisfied with the results. And people had lost significant amounts of weight.

However, one-quarter were dissatisfied with the results of their operation. That seems quite a high proportion of people, given that they'd undergone an expensive, serious procedure. You wonder whether these particular people should have had gastric bands at all. Would they have been better off with a gastric bypass operation, or maybe taking a weight-loss drug, or following a weight-loss diet and exercise program? Did they get a realistic picture of the potential risks and benefits before they chose surgery?

What you need to know. If you are contemplating any type of surgery, be sure to ask your surgeon to explain what you can expect afterward, both in terms of potential benefits and harms. Gastric band surgery carries quite a high risk of harm, with more than half of people needing a follow-up operation afterwards.

Long-term Outcomes of Laparoscopic Adjustable Gastric Banding [Archives of Surgery]

--Anna Sayburn, BMJ Group

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