Gastric banding surgery offers fewer complications, but more research needed

Laparoscopic adjustable gastric banding surgery can effectively treat obesity in adolescents and seems to offer a better alternative than gastric bypass surgery, but further study is needed to determine whether it's better than nonsurgical options, a UT Southwestern Medical Center surgeon writes in an editorial in the Feb. 10 issue of the Journal of the American Medical Association.

"The latest research helps us define which surgical procedure may be preferable, but we are still a long way from settling the question of whether surgery should be used to treat obesity in teens," said Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern. The editorial accompanies a research study by Australian physicians examining weight-loss surgery among adolescents.

Treatment of obesity in adolescents should be a priority because obesity portends other diseases, such as cardiac problems, hypertension and diabetes, later in life, said Dr. Livingston, director of UT Southwestern's Clinical Center for the Surgical Management of Obesity.

Many physicians are reluctant to recommend weight-loss surgery as an obesity treatment for adolescents due to lack of research and data showing its effectiveness, Dr. Livingston said, so the latest contribution to the medical literature is a welcome addition.

While gastric bypass surgery permanently alters the stomach, laparoscopic adjustable gastric banding surgery can be reversed and has fewer complications, making it a better fit for the still-growing adolescent population, noted Dr. Livingston.

Australian researchers compared gastric banding surgery to medically supervised diets among 50 randomly assigned obese adolescents. The Australian data showed greater weight loss among patients receiving the bands, but complication rates raised questions about whether it was worth the benefit, Dr. Livingston said. In addition, the researchers found that while medical interventions successfully controlled many of the problematic disease complications without surgery, improvements were greater with surgery, he said.