The Lap-Band has been used for years as off-label for patients with low-BMI – in this case a population with a BMI of 30 or more. An FDA study was performed with five year follow up to see the effectiveness of the band for these patients.
From the study report:
The objective of this post-approval study was to evaluate the safety and effectiveness of the LAP-BAND®
System in an obese population (body mass index [BMI] ≥ 30 kg/m2 and < 40 kg/m2) after 5 years of implantation. The primary objective was to demonstrate that the rate of device explants over the first 5 years of implantation, among subjects treated with the LAP-BAND® System under Protocol LBMI-001 was less than 32.5% (ie, 6.5% per year). Secondary objectives included assessment of changes in obesity-related comorbid conditions and psychosocial functioning.
• Greater than 76.9% of subjects achieved at least 30% EWL by month 4 and at every subsequent timepoint in the 60-month study
• Implantation with the LAP-BAND® System resulted in statistically significant decreases in all measures of weight and body mass
• The proportion of subjects who were obese (≥ 30 kg/m2) decreased from 99.3% at baseline to 34.3% at month 12 and to 36.2% at month 60. Those no longer overweight (BMI < 25 kg/m2) increased from 13.3% at month 12 to 22.9% at month 60
• Hypertension, dyslipidemia, and type 2 diabetes improved significantly from baseline to month 60
• Measures in weight-related quality of life improved significantly after implantation with the LAP-BAND® System and throughout the 60-month study
• Five years after LAP-BAND® implantation, the rate of explants with and without band replacement was 14.8%
• Most device-related adverse events were mild (53.2%) or moderate (37.2%) in severity and resolved without sequelae. The most common (> 5%) device-related adverse events were vomiting (16.4%), gastroesophageal reflux disease (12.1%), and dysphagia (11.5%).
• No deaths or unanticipated adverse device effects were reported, and all device-related serious adverse events resolved, and all but one resolved without sequelae
The LAP-BAND® System is safe and effective for people with BMI 30 to < 40 kg/m2 with demonstrated improvements in weight loss, comorbidities, and quality of life, and with a low explant rate through 5 years following treatment.
Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.