How do teenagers respond to lap-band surgery?

The Lap-Band procedure, which is approved by the Food and Drug Administration (FDA) for adults but not yet in teenagers, involves making the stomach smaller without staples. Instead, a band is place around the upper part of the stomach, creating a small pouch that restricts food intake. The surgeon implants a small access port, and after the surgery the doctor periodically adjusts the gastric band by inflating or deflating a saline-filled balloon that lies inside the band. If desired, the procedure is reversible.

NewYork-Presbyterian Morgan Stanley Children's Hospital is one of three sites in the nation approved to study this procedure in teens.The study, which is part of the multidisciplinary FDA-approved Lap-Band Trial, followed 14 adolescents–six boys and eight girls–between the ages of 14 and 17 who were, on average, 174 pounds overweight. Patients received dietary counseling and encouragement to exercise, both before and after surgery.

"Children who are obese are at risk for developing lifelong physical and emotional problems," said Jeffrey L. Zitsman, MD, Director of the Division of Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children's Hospital. "These include Type 2 diabetes, heart disease, high blood pressure, trouble breathing, difficulty sleeping, and degenerative joint disorders. Teenagers who have weight problems tend to have lower self-esteem and can develop depression, anxiety and other psychological issues. Studies also show that the majority of children and adolescents who are obese remain obese as adults. Our staff is dedicated to helping adolescents who are obese lose weight when conventional methods have been unsuccessful. Our surgical team has extensive experience in laparoscopic bariatric surgery and long-term management of patients in a supportive and caring environment."

Teenagers participating in the study who received the minimally invasive surgery lost an average of 20 pounds after six months. They also had significant improvements in abdominal fat, triglyceride measurements (levels of fat in the blood) and blood sugar levels as measured by hemoglobin A1c – all risk factors for diabetes and heart disease. The patients' liver function and a measure of immune response also improved.

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