But at six years there were more problems with gastric banding, including about 48 percent who had weight gain or the procedure reversed, compared with about 12 percent who had bypass surgery, the study found.
Gastric banding was associated with more long-term complications (more than 42 percent versus 19 percent) and more new procedures than bypass surgery (about 27 percent vs. 13 percent).
Cholesterol levels among those who had gastric bypass surgery were consistently lower than among those who had gastric banding, who saw no change over time, the researchers add.
This finding implies that blood sugar levels were also lower among those who underwent gastric bypass surgery, the study authors said.
Suter is concerned that many patients are only offered banding and not told of its drawbacks.
"There is, in the United States, an extensive campaign promoting gastric banding as 'the solution' for obesity, which is far from being true," he said.
It can result in significant weight loss, but it remains a surgical procedure, and is certainly associated with significant risks, both in the short and long term, Suter said.
"Patients must be informed that surgery alone is not sufficient to achieve significant weight loss, and they must be instructed about other things they have to do such as changing their eating and lifestyle habits," he said.
In addition, Suter said, "Patients calling or referred for gastric banding must be informed about the other available procedures for morbid obesity, and not offered band only, as is the case in several places."
Depending on the actual operation, either procedure costs between $10,000 and $20,000 plus follow-up costs, and insurance coverage is very inconsistent, according to Dr. Edward Livingston, who serves as the Dr. Lee Hudson-Robert R. Penn Chair in Surgery at the University of Texas Southwestern Medica
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