Six of 10 gastric-banding patients need repeat operation

Yes, you read that right. Almost two-thirds of patients who undergo a common weight-loss surgery that makes the stomach smaller by putting a band around it have to be readmitted to the hospital, either to get the band repaired or removed, according to a study published this week in the Archives of Surgery. Our recent survey found that about 5 percent of Americans have considered some form of weight loss surgery.

The study looked at a series of 82 patients who had the laparoscopic adjustable gastric banding and were followed for at least 12 years. Of those, 23 (28 percent) suffered "band erosion," a serious complication that requires repeat surgery, in which the band starts to erode into the stomach. And 41 (50 percent) had to have the band removed.

Our survey found that about 5 percent of Americans overall have considered weight loss surgery, and the percentage is higher among those who say they've had trouble losing weight through lifestyle changes, maintaining weight loss, are obese, or have diabetes. And the more of those problems people have, the more likely they are to consider a surgical solution.

The new Archives study suggests that when the band doesn't have to be replaced it can indeed help such people. Those patients lost an average of 48 percent of their excess weight, and had lower rates of diabetes, hypertension, sleep apnea, and other weight-related health problems.

Still, the high rate of re-operation is worrisome. John Santa, M.D., director of Consumer Reports Health Rating Center, says:

It is hard to imagine any manufacturer reporting these kind of results to its customers, let alone shareholders. There'd be outrage and a complete turnover of top management of this product line.

Indeed, the authors of the study—who also performed the surgeries they reported on—concluded that the high failure rate of the band "could be detrimental to its future continued widespread use as a restrictive weight loss operation." They suggest that other weight-loss surgeries—notably gastric bypass surgery, which involves surgically creating a passage for food to bypass a portion of your small intestine—might be preferable.

But that procedure, while it may have better long-term results, is an even more complicated procedure.

Bottom line: So before you consider it, or any other form of weight-loss surgery, make sure you've exhausted other weight loss options. And make sure you and your doctor have a thorough discussion about the potential risks of the surgery.

Sources
Long-term Outcomes of Laparoscopic Adjustable Gastric Banding [Archives of Surgery]
To band or to Bypass, That is the Question [Archives of Surgery]

—Joel Keehn