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Industry Giants Push Obesity Surgery

March 31, 2008 |

Medical-device makers, venture capitalists and surgeons are racing to turn a once-controversial weight-loss procedure into the next big thing in elective surgery.

Once dismissed by some surgeons as a gimmick, gastric banding — in which a silicone band is wrapped around the upper stomach to restrict food intake — is now the focus of a fierce competition pitting consumer-products giant Johnson & Johnson against Botox maker Allergan Inc. Venture-capital-backed outpatient centers are popping up to implant the bands. Growing ranks of surgeons are touting the procedure at free public seminars. All see a vast market in a country where diet and exercise programs have failed to slow an obesity epidemic.


Like any major surgery, gastric banding carries risks of infection and even death. The silicone device can shift after surgery, causing it to lose effectiveness. No one knows how long it will last inside the body, so patients may eventually need another surgery to replace or remove it. And some surgeons say the weight loss achieved through banding isn’t as much as other weight-loss procedures. “There’s no question that advertising and the commercialization of the band is what’s driving it,” says J.K. Champion, a bariatric surgeon in Atlanta. Bariatric is a medical term derived from the Greek word “baros” meaning “weight.”

Weight-loss surgery remains rare, despite the fact that about a third of adult Americans are obese — and despite evidence that the procedures improve overall health. Only an estimated 1% of the nation’s 15 million morbidly obese people, typically those who are 100 pounds or more overweight, have undergone surgery. That may be partly due to the fact that the most popular weight-loss surgery to date has been gastric bypass, a more invasive procedure.

A number of recent studies suggest that gastric banding is safer than gastric bypass, and some data suggest comparable, if slower, weight-loss results. Improvements in surgical techniques and follow-up care have helped gastric banding become the dominant weight-loss operation in Europe and Australia. Credit Suisse analyst Marc Goodman predicts that gastric banding will account for half of all weight-loss surgeries by 2010, up from about 30% today.

Treatment for Diabetes

And banding is emerging as a treatment for diabetes: It effectively cured the disease in 73% of treated adults who were lighter than people who typically undergo weight-loss surgery, according to an Australian study published in the Journal of the American Medical Association in January. Diabetes remission closely tracks weight loss.

Some parts of the country are already bombarded with gastric-banding ads. In one television spot airing in Texas for True Results, a Dallas-based chain of six outpatient centers, a young woman says, “I’m going to be around much longer for my family,” after losing 178 pounds. Unlike the band makers, physicians and clinics can make advertising claims that aren’t subject to the strict rules imposed by the Food and Drug Administration.


We see patients come into our office at the Cleveland Clinic who have heard about the band,” says Philip Schauer, director of the Ohio-based Cleveland Clinic’s bariatric and metabolic institute. He adds that the ads exert a powerful influence. “You don’t see commercials for gastric bypass,” he says.

In gastric bypass, the surgeon reroutes the gastrointestinal system. But gastric bands don’t alter the body’s basic plumbing. Tiny incisions are made in the abdomen, and a camera is passed through one of them so the surgeon can view the operation site on a video monitor. A band made of silicone is fastened around the upper stomach to create a small pouch that limits food intake. read more




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