Weight Loss Surgery



Her secret: weight loss surgery that leaves her with a smaller stomach while leaving her with smaller scars than the traditional surgery. What makes Secrist's story truly amazing is that in less than two years she has lost 107 pounds, thanks to adjustable gastric banding, a surgical procedure that is commonly performed in Europe, but has only been recently approved for use the U.S.

The surgery can be performed laparoscopically, which means small tools are guided by a small camera through small incisions in the abdomen. The traditional weight loss procedure in the U.S., gastric bypass, involves a large incision to surgically alter the stomach and make it smaller. The Midland, Mich. woman traveled to Sweden to get the surgery, and her mom and dad later made the trip for the same reason.

Adjustable Gastric Banding

Adjustable gastric banding is far less popular here than gastric bypass surgery. Banding has been done in the U.S., yet previously required open surgery, with all its potential complications.

But two new studies find the laparoscopic approach for banding to be a safe and effective weight loss option for people who are 100 pounds or more overweight. The studies, reported in the latest issue of the journal Annals of Surgery, found that patients who underwent gastric banding surgery lost roughly 50% of their excess body weight within two years.

The procedure involves the implantation of a hollow silicone band placed around the top of the stomach, which is adjusted to determine how much food the stomach can hold. The adjustment is made by inflating or deflating the band using salt water piped in trough a tube attached to a port placed under the skin near the breastbone. Several types of bands are available in Europe, but the FDA has approved only one - the Lap-Band system made by the California firm BioEnterics System.

One of the newly published studies evaluated the Lap-Band device in 500 morbidly obese French patients. Researcher Franck Zinzindohoue, MD, and colleagues reported a 53% excess weight loss at two years, with 10% of patients having to have second operations due to complications. No deaths were reported among the patients. The outcomes were much better than those reported in a recent study finding that more than half of patients abandoned the band in favor of gastric bypass surgery.

The authors attribute their good outcome to a procedure they developed to reduce the incidence of band slippage, one of the most common complications of gastric banding.

Some Patients Are Unhappy Because They Did Not Loose As Much Weight As They Wanted

Still, in an accompanying editorial, weight loss surgeon John M. Kellum, MD, says surgeons in America may want to think twice before recommending gastric band surgery over gastric bypass. He no longer performs gastric banding, and says most of his patients who had the banding procedure were unhappy with it because they did not lose as much weight as they had hoped to.

"Some of my patients actually gained weight, which never happens with gastric bypass," he tells WebMD. "We were also troubled by the fairly high number of patients who had complications with the band." Kellum says a newer type of band from Sweden may be safer for patients than the Lap-Band, but it has not been studied in the U.S.

In the second new study, authors claimed a lower rate of band erosion and slippage. But the procedure is not recommended for all patients, especially the heaviest, which Kellum says could restrict its usefulness among American patients.

"American patients tend to be heavier than those in Europe, and the heavier the patient the higher the likelihood that complications will occur," he says.

Jennifer Secrist, who now weighs 140 pounds and is a size 6, says she knows of a few gastric band patients, or "bandsters," who have had trouble losing weight with the procedure. But she would not hesitate to recommend it to anyone whose health is jeopardized by morbid obesity. She publishes a web journal of her process to inspire others.

"I want people to know there are alternatives to being heavy," she says. "This has done so much for me. I can't begin to describe it."