Weight Loss Surgery: Bar for Lap Band Lowered, but Is Gastric Bypass Better?

Feb. 21, 2011— -- On the heels of a Feb. 16 decision by the Food and Drug Administration to make millions more people eligible for laparoscopic gastric banding (lap band) weight loss surgery, a new study suggests the more invasive gastric bypass may be better.

Researchers from the University of California, San Francisco, compared the effects of lap band and gastric bypass among 200 morbidly obese patients treated at the UCSF Bariatric Surgery Program. Gastric bypass led to greater weight loss, increased resolution of diabetes and improved quality of life one year after surgery, they reported today in Archives of Surgery.

Complication rates were similar between the two procedures, but re-operation rates were lower for gastric bypass, leading the researchers to conclude that the risk-benefit profile for gastric bypass was superior.

But experts urge caution in interpreting the study's results, and stress that the varying benefits and risks of either procedure make the decision a personal one.

"If a patient's primary interest is to lose their diabetes, then gastric bypass is better. If the patient prefers slower weight loss, then banding is better," said Dr. Theodore Khalili, founder and director of the Khalili Center for Bariatric Care in Beverly Hills and former director of the Weight Loss Surgery Program Cedars-Sinai Medical Center. "Unless there is an absolute contraindication to one procedure, then we let the patient decide."

Roughly one-third of Americans are obese with a body-mass index over 30, and five percent are morbidly obese with a BMI over 40, according to the Centers for Disease Control and Prevention. The extra weight boosts the risk of type 2 diabetes, heart disease, stroke, cancer, and even death. While weight loss surgery can help obese people shed the extra pounds and some of the related health risks, the surgical risks and the cost (upwards of $20,000) make the decision not one to be taken lightly.