Lap-Band Surgery Effective for Morbidly Obese Children

A new study has found that laparoscopic adjustable gastric banding (LAGB) surgery helps improve the health of morbidly obese adolescents.

Researchers at the New York University School of Medicine (NY, USA) followed nearly 50 patients aged 14-17 enrolled in the study who met criteria for bariatric surgery. Demographic data, body mass index (BMI), body composition and bone density, laboratory evaluations, and comorbid conditions were assessed pre- and postoperatively. Of the patients who completed surgery, 45 were available for complete one-year follow-up, and 41 patients had complete two-year follow-up. Mean preoperative weight was 135 kilograms and mean BMI was 48. The researchers found that at the one-year follow-up, the patients after LAGB had a significant decrease in their total and android fat mass; in addition, 47 of 85 identified comorbidities (55%) were completely resolved and 25 (29%) were improved in comparison with baseline. Improvements in alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, hemoglobin A1c, fasting insulin, triglycerides, and high-density lipoprotein were also seen. The study was published in the November 2009 issue of the Journal of the American College of Surgeons.

"This study is the first to demonstrate the improvements in overall health and distribution of weight loss after Lap band surgery in adolescents,” said lead author Evan Nadler, M.D. "While weight-loss surgery should always be a last resort for adults and adolescents, these findings show us that surgery in adolescents reduces the risk of significant health complications.”

Android fat mass is the distribution of adipose tissue predominantly around the abdomen and trunk, and within the abdominal cavity. Fat distribution of this type is far more common in males than females, and can result in "apple-shaped” obesity, which carries an increased risk of diabetes and heart disease. Although it is not entirely clear why android fat distribution increases the risk of coronary heart diseases, one suggestion is that abdominal fat may be more readily broken down under stress, raising the fatty acid concentration of the blood. This would increase the risk of fat deposition and clogging of the arteries, which in turn may lead to high blood pressure and cardiovascular diseases. Android fat has been linked to the development of obesity-related illnesses, such as diabetes, heart disease, and insulin resistance.

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New York University School of Medicine