Adjustable gastric banding is much more effective long-term than a very low-calorie diet for people who are about 50 pounds overweight, a study shows.

Medical guidelines support this surgical procedure — which puts a band around the top of stomach to create a feeling of fullness — in patients who are extremely obese, about 100 or more pounds over a healthy weight, or those who are almost as overweight and have serious medical conditions, such as type 2 diabetes.

Researchers at Monash University Medical School in Melbourne, Australia, recruited 80 patients who were on average 52 pounds over a healthy weight. Half had the laparoscopic adjustable gastric band surgery.

The other half followed a medical program that included a variety of strategies such as a very-low-calorie diet (500 calories a day) with liquid meal replacements, prescription weight-loss medication and behavioral therapies.

Findings in today's Annals of Internal Medicine:

• After six months, both the surgery patients and the low-calorie dieters lost an average of 14% of their starting weight.

• After two years, the gastric band patients lost 22% of their starting weight. That was about 87% of their excess weight, or roughly 45 pounds. They also showed marked improvement in their health and quality of life.

• At the end of two years, the dieters had regained much of their lost weight but were still 5.5% below their starting weight. They had lost 22% of their excess weight, or about 12 pounds.

Researchers are still analyzing the weight-loss data. "I'm very happy that the gastric band patients are continuing to maintain their weight loss," says lead author Paul O'Brien, director of the university's Centre for Obesity Research and Education. Since the study, he received grants from INAMED Health, maker of the LAP-BAND System.

In this study, the surgery was as safe as the diet program, but O'Brien notes the procedure does carry risks, and some may need follow-up procedures, such as readjusting the band position. The surgery costs $14,000 to $18,000 in the USA, he says.

Insurance companies vary widely in coverage of gastric banding or gastric bypass, a more complex surgery that creates a much smaller stomach and rearranges the small intestine. Average cost: $26,000. Under certain conditions, Medicare covers both surgeries.

This is really good news for insurance patients and lower bmi patients. This type of study is the exact type that insurance companies expect to change their coverage..... It could totally change the way the lap band is used. And it is in a prestigious jounal. Finally, it is a "foreign study"-way less likely to be published here-again attesting to its importance!!!!:clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2: :clap2:

Which is precisely why its not such a struggle to get banded over here. They will generally consider anyone who is obese, with a BMI of 30 or above.

What I'm finding, having had a BMI of 35 when I was banded is that there truly is a preventative element in there. I had the potential to get much much fatter but it was nipped in the bud and I feel that I've had so much of an easier time adjusting to life with the band (and have well exceeded those averages stated above) because my eating habits had not become really out of whack yet.

I was also more fit and abled bodied than many more obese patients and have been able to get back to a pretty rigorous trainign schedule very early in the peace.