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LAP-BAND(R) System Weight-Loss Surgery Associated With More Than 70 Percent Reduced Risk of Death in People With Severe Obesity
Date:11/21/2007

Observational study published in the Annals of Surgery

MELBOURNE, Australia, Nov. 21 /PRNewswire/ -- Severely obese people who received the LAP-BAND(R) Adjustable Gastric Banding System to lose weight had a 72 percent reduction in their risk of dying compared to obese people who were not offered any specific weight-loss treatment, according to findings published in the December issue of the Annals of Surgery (1). The LAP-BAND(R) System was approved in June 2001 by the U.S. Food & Drug Administration for weight reduction in severely obese adults.

"This research is critical because it shows that people with severe obesity, who are known to be at a much higher risk than the general population for dying prematurely, may be able to significantly decrease their risk with laparoscopic adjustable gastric banding," explains Dr. Paul O'Brien, FRACS a study author from the Monash University Centre for Obesity Research and Education (CORE) in Melbourne, Australia, head of the Centre for Bariatric Surgery in Melbourne and the National Medical Director for the American Institute of Gastric Banding in Dallas, Texas. "What is also particularly compelling is that this study shows it is possible to gain a significant survival benefit without the risks associated with more invasive bariatric surgical procedures, such as gastric bypass."

The study involved two groups of people who were between 37 and 70 years of age with a Body Mass Index (BMI) of 35 kg/m2 or greater: A LAP-BAND(R) System group, which included 966 patients (average age 47, average BMI 45 kg/m2) and a previously established population-based cohort of 2119 people who were not offered any specific weight-loss treatment (average age 55, average BMI 38 kg/m2). There were four deaths (heart disease, cancer(2) and suicide) in the LAP-BAND(R) System group after a median follow-up of four years, vs. 225 deaths after a median follow-up of 12 years in the non-treated group. After statistically controlling for the differences in follow up time, sex, age and BMI, the hazard for death was 72 percent lower for LAP-BAND(R) System patients compared to the non-treated group (hazard ratio for death: 0.28, 95% confidence interval: 0.10-0.85). LAP-BAND(R) System patients lost an average of approximately 63 pounds 2 years after installation.

The very low death rate seen in the LAP-BAND(R) System group, while good news, limited the study, making it difficult to precisely determine the magnitude of the effect of the procedure on improved survival. Also, there may have been unknown differences between the two groups that may have affected results. The new findings are consistent with those from other studies showing a reduced risk of death (~30% to 89%) associated with the weight loss following other forms of bariatric surgery (2,3,4,5,6).

About Obesity

In the United States, obesity is considered the second leading cause of preventable death (7). Further, research has shown that individuals with a BMI of 35 or more have a reduced life expectancy of nine to 13 years (8). A BMI of 35 or more translates to a weight of 200 pounds or more for a woman of average height (5' 4") when ideal weight at this height is considered to be 140 pounds, and to a weight of 250 pounds or more for man who is six feet tall when ideal weight for this height is considered to be 177 pounds.

About the LAP-BAND(R) System

The LAP-BAND(R) System was approved by the FDA in June 2001 for severely obese adults with a Body Mass Index (BMI) of 40 or more or for adults with a BMI of at least 35 plus at least one severe obesity-related health condition, such as Type 2 diabetes, hypertension and asthma. Used in more than 300,000 procedures worldwide, this simple reversible surgically implanted device has safely helped severely obese adults successfully achieve and maintain long- term weight loss.

The LAP-BAND(R) System was developed to facilitate long-term weight loss and reduce the health risks associated with severe and morbid obesity. Unlike gastric bypass, it does not involve stomach cutting, stapling or intestinal re-routing (9,10). Using laparoscopic surgical techniques, the device is placed around the top portion of the patient's stomach, creating a small pouch. By reducing stomach capacity, the LAP-BAND(R) System can help achieve long-term weight loss by creating an earlier feeling of satiety. The LAP-BAND(R) System is adjustable, which means that the inflatable band can be tightened or loosened to help the patient achieve a level of satiety while maintaining a healthy diet. It is also reversible and can be removed at any time.

About CORE at Monash University

CORE is a Monash University centre that operates within the Faculty of Medicine, Nursing and Health Sciences. The mission of CORE is to understand the disease of obesity, to identify optimal methods for its long-term management that are safe and cost effective, and to determine preventive strategies that can be implemented.

Dr. Paul O'Brien is one of the world's leading experts in laparoscopic adjustable gastric banding, using the LAP-BAND(R) System. He is Head of the Centre for Bariatric Surgery in Melbourne, National Medical Director for the American Institute of Gastric Banding in Dallas, Texas, and is Emeritus Professor of Surgery and Head of the Centre for Obesity Research and Education (CORE) at Monash University in Melbourne.

Dr. O'Brien also recently published a book called The LAP-BAND Solution: A Partnership for Weight Loss (http://www.thelapbandbook.com)

References

(1) Peeters A, O'Brien PE, Laurie C, Anderson M, Wolfe R, Flum D,

MacInnis RJ, English DR, Dixon J. Substantial intentional weight

loss and mortality in the severely obese. Ann Surg, December 2007;

246(6): Epublication before print.

(2) Flum DR, Dellinger EP, Impact of gastric bypass operation on

survival: a population-based analysis. J Am Coll Surg 2004; 199:543-

51.

(3) Christou NV, MacLean LD. Effect of bariatric surgery on long-term

mortality. Adv Surg 2005;39:165-79.

(4) Christou NV, Sampalis JS, Liberman M et al. Surgery decreases long-

term mortality, morbidity, and health care use in morbidly obese

patients. Ann Surg 2004;240:416-23; discussion 423-4.

(5) Sjostrom L and others. Effects of bariatric surgery on mortality in

Swedish obese subjects. NEJM. 2007;357:741-752.

(6) Adams, TD and others. Long-term mortality after gastric bypass.

NEJM. 2007;357:753-761.

(7) American Obesity Association. AOA Fact Sheets. Available at

http://www.obesity.org/subs/fastfacts/obesity_US.shtml. Accessed

1/18/07.

(8) Fonataine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of

Life Lost Due to Obesity. JAMA. 2003; 289:187-193.

(9) Chapman A, Kiroff G, Game P, Foster B, O'Brien P, Ham J, Maddern G.

Laparoscopic adjustable gastric banding in the treatment of

obsesity: A systematic review. Surgery 2004;135:326-351.

(10) Parikh MS, Shen R, Weiner M, Siegel N, Ren CJ. Laparoscopic

bariatric surgery in super-obese patients (BMI>50) is safe and

effective: a review of 332 patients. Obes Surg. 2005 Jun-Jul;

15(6):858-63.


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SOURCE Monash University Centre for Obesity Research andEducation
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