FDA Weighs Broader Use Of Weight-Loss Surgery
ROBERT SIEGEL, host:
Advisers to the Food and Drug Administration have cleared the way for a major expansion of one type of obesity surgery. The makers of a device used to band the stomach, which restricts the amount of food a person can eat, may soon be able to offer the surgery to millions more people.
NPR's Allison Aubrey reports.
ALISON AUBREY: The decision could be a game changer for the nearly 25 million Americans who are very heavy but until now were not considered obese enough to be candidates for weight loss surgery.
If the FDA agrees with its advisers' recommendations, then a procedure known as lap-band surgery could be offered to those on the on ramp of obesity, say, a woman who is 5-foot-4 and weighs 175 pounds or more, who has at least one of the health problems brought on by weight, such as sleep apnea, type 2 diabetes or high blood pressure.
Dr. MICHAEL SNYDER (Rose Medical Center, Bariatric Surgery): People that say, look, I've been a good dieter intermittently, but I really don't have control, and I want to be full with a lot less, then those people are going to need a band.
AUBREY: Michael Snyder is a surgeon at the Rose Medical Center in Denver. He's done over 1,600 band procedures in the last decade. This surgery is less invasive and less expensive than a full gastric bypass, in which a patient's stomach and intestines are rearranged. In the case of the banding, which takes about 20 minutes to perform, Snyder implants a silicon band or ring a few inches from the top of a patient's stomach.
Dr. SNYDER: Fullness is located in the top of your stomach, okay? When you fill your stomach up, the stretch in the top of your stomach is what makes you feel full. So what happens is you fill up your stomach above the band, and the tightness of the band determines how quickly you get full and how long you stay full.
AUBREY: After the procedure, patients are put on a diet of five or so small meals per day, usually four to six ounces of food per meal. That's about the size of an average chicken breast. On this type of diet, about 80 percent of banding procedure patients lose significant amounts of weight. And for many of them, this comes after years of struggling with diets and sicknesses that often accompany obesity.
Dr. LOUIS ARONNE (Director, Comprehensive Weight Control Program, Weill Cornell Medical Center, New York): Obesity is a lot harder to treat than it looks.
AUBREY: Louis Aronne directs the Comprehensive Weight Control Program at Weill Cornell Medical Center in New York. He's not a surgeon, so he sees patients long before they consider an operation for obesity. And he says, of course, he'd like them to all succeed with diet and exercise programs alone, but he says when this doesn't work, banding is a good option.
Dr. ARONNE: I look at the band as part of an overall treatment program. It clearly is not a cure. It's something that can help somebody to do better.
AUBREY: And he says if you look at the economics of it, obesity surgery for the extremely obese has turned out to be a cost saver. He points to one analysis that shows the $10,000 banding procedure pays for itself within three to four years.
Dr. ARONNE: That's a bargain when it comes to health care. So instead of treating someone's diabetes, hypertension, cholesterol and needing a bypass and dialysis, if you treat their obesity early on, you don't get to that point.
AUBREY: Surgical banding can lead to complications. Allergan, the company that makes the band device, studied the outcome of about 140 moderately overweight patients who had the procedure. They found 50 percent experienced vomiting after surgery, 7 percent got infections, and about a quarter of the bands slipped and needed readjusting. But in looking at the evidence, advisers to the FDA say the benefits of significant weight loss brought on by banding far exceed the risks of surgery.
Allison Aubrey, NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.