As we enter the Christmas of 2009, many of us are looking for the future in 2010, and hoping that that future includes safe, long lasting weight loss. With the new health care bill looming, expect options which are currently available to the morbidly obese to undergo scrutiny as to return on investment, and effects on long term health care expenditutes.
In Nature this month, a review article on they types of bariatric surgery and thier outcomes was published. Three methods were compared, open and laparoscopic Roux-en-Y gastric bypass, and laparoscopic adjustable gastric banding.
The results of the first longitudinal clinical trial were recently pulished in the New England Journal of Medicine. The Longitudinal Assessment of Bariatric Surgery (LABS) consortium have published the results of their first study, LABS-1, which indicate that the overall risk of adverse outcomes of bariatric surgical procedures is low and contingent on patient characteristics.
The article reports the following: "Roux-en-Y gastric bypass involves the creation of a small upper stomach pouch and its attachment to the jejunum, which results in bypass of the rest of the stomach and the duodenum. This bypass leads to weight loss by restriction of food intake, as well as through a variety of poorly understood neurohormonal changes that enhance satiety. During the procedure of laparoscopic gastric banding, a small stomach pouch is generated by placement of an adjustable band around the upper stomach. Weight loss predominantly occurs as a result of restricted food intake, although neurohormonal changes that enhance satiety can also occur with this procedure. The LABS-1 investigators found that the 30-day composite end point of death, major thrombotic complication, reintervention and prolonged hospitalization was 1.0% for laparoscopic adjustable gastric banding, 4.8% for laparoscopic Roux-en-Y gastric bypass surgery, and 7.8% for open Roux-en-Y gastric bypass surgery".
The study did not measure the effectiveness of the surgeries, nor long-term sucess in terms of durable weight loss.
There are many places in Alabama to have this surgery. Alabama Weight Loss Surgery is one of the few that has been designated a "Center of Excellence" (COE) by the American Society for Metabolic and Bariatric Surgery and the Surgical Review Cooperation. This highly prized designation is based on their program components, excellent outcomes, and safety, as well as a site visit to validate the program's data.