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Gastric Banding: Solution to Childhood Obesity?

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Gastric banding, a weight-loss procedure less-invasive than gastric bypass surgery, is in high demand for obese Americans.  Currently the procedure is legally approved for use in weight reduction for severely obese adults 18 years of age or older.

With a proven success rate in adult patients, why not approve gastric banding for teens?  The Food and Drug Administration (FDA) is currently considering that very issue,  broadening its standards on gastric banding to include adolescents 14 to 17.

The National Institutes of Health (NIH) initiated an observational study in 2007 to evaluate the benefits and risks of bariatric surgery in adolescents. The purpose of the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) is to determine if it is an appropriate treatment option for extremely overweight teens.

A gastric band is just what it sounds like: an inflatable silicone band placed around the top portion of the stomach to create a pouch that restricts food intake. It has become increasingly popular in the United States in recent years, and results in reasonable weight loss. The procedure is considered less invasive and risky than gastric bypass.

Use of the gastric band is especially attractive for use in teens, say supporters, because it is reversible, whereas bypass is not.  The laparoscopic procedure takes an hour or less and can be done on an outpatient basis; there is occasional need for a one night hospital stay.
“We know that bariatric surgery is not an easy way out for teens to control weight. They will still need to eat less food and exercise more,” says Mary Horlick, M.D., project scientist for Teen-LABS and director of the Pediatric Clinical Obesity Program of the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the sponsor of Teen-LABS at NIH. “We hope to learn whether or not bariatric surgery is suitable for teens and if it will help them remain at a healthy weight over the long-term.”

The Teen-LABS study is being conducted by researchers at the following medical centers:

    *Cincinnati Children’s Hospital Medical Center (Data Coordinating Center and Clinical Center)
    *Texas Children’s Hospital, Houston
    *Children’s Hospital of Alabama in Birmingham
    *University of Pittsburgh, Pennsylvania

The Teen-LABS study researchers are collecting information on the pre-operative and two year post-operative status of the 200 adolescents (aged 14-17), including measures of body composition, body fat, cardiovascular risks, sleep apnea episodes, diabetes indicators, depressive symptoms, quality of life, eating habits, and nutritional status.  The study is expected to continue through 2012.

A clinical trial, Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents,  published earlier this year in the Journal of the American Medical Association, found that obese adolescent participants having undergone gastric banding resulted in a greater percentage achieving a loss of 50% of excess weight, when compared with lifestyle intervention, diet and exercise, alone.  The randomized controlled trial was performed between May 2005 and September 2008 enrolling 50 adolescents between 14 and 18 years with a body mass index (BMI) higher than 35. Participants were recruited from the Melbourne, Australia, and followed for 2 years.

Dr. Roberta Maller Hartman, a psychologist and Lap-Band patient herself, counsels teens and adults after receiving the gastric band. "I've worked with a lot of high school students and they just want to be like everyone else and go out and eat pizza with their friends," she said. "They can, but they have to take little bites and chew a lot."

Gastric banding demands that teens do something they often aren't very good at — sticking to a rigorous follow-up routine.

Success depends most on a patient's ability to modify their behavior. "The band doesn't reduce the desire to eat emotionally. That has to be addressed," said Dr. Maller. "Teens tend to need more hands-on, one-to-one support."

Dr. Santiago Horgan, Chief of Minimally Invasive Surgery at the University of California San Diego Medical Center, believes that eating right with your gastric band is your key to success, and states, “It's important to review and follow a bariatric surgery diet, as it is critical to your recovery and weight loss success.”

*First Few Days after Surgery: 
    only sips of water of water, or suck on an ice cube.

*1-2 Weeks Post-Op - Liquid Diet only:
    water, clear broth, skim milk, fruit juice, sugar-free popsickes.

*3-4 Weeks Post-Op – Pureed Foods Only (baby food consistency):
    pureed skinless fish or chicken, mashed potatoes, peas, low-fat yogurt or pudding
*5 weeks post-op - Soft Foods:
    Include tender cooked foods like fish and ground turkey; chew foods well. If you don’t, you may experience vomiting, stomach irritation and     swelling. You could also have a stoma obstruction.
    If solid foods cause nausea and vomiting, go back to the liquid diet. Then, slowly add soft foods and eventually transition to solid foods.

*Nutrition Plan - Solid Foods:
    Pay close attention to your diet after lap band surgery.  No liquids during or immediately after meals A lot of patients have difficulty with         solid foods in the morning.   Chew food thoroughly and eat small bits at a time. Eat only three small meals a day and make sure these         meals contain adequate nutrients.

*Forbidden Foods (include, but are not limited to):
    dried fruits, asparagus, pineapple, rhubarb, corn (especially popcorn), grapes, nuts and seeds, carbonated beverages, high calorie     foods/drinks

*10 Important Rules:
    1. Only 3 small meals/day
    2. Eat Slowly and chew food thoroughly
    3. Stop eating as soon as feel full
    4. Do not drink while eating
    5. Do not eat between meals
    6. No Junk Food
    7. Drink enough fluids during the day
    8. Drink only low-calorie liquids
    9. Minimum 30 minutes of exercise/day

Laura Lamp King

(Send your news to foodconsumer.org@gmail.com, Foodconsumer.org is part of the Infoplus.com ™ news and information network)

Subscribe to comments feed Comments (5 posted):

Jess on 07/28/2010 08:31:34
Sheila Granger is pioneering a weight loss programme, in the UK which incorporates the VIRTUAL gastric band. Conducted under clinical hypnotherapy her methods offer a highly effective alternative to gastric/lap band surgery. With ZERO risk, it doesn't require a person to follow a liquidized diet and involves no invasive surgery.
A group trial proved the effectiveness of the VIRTUAL Gastric Band, achieving a 95% success rate amongst people of varying age and size.
Through clinical hypnotherapy, the subconscious believes the body has undergone gastric surgery to reduce the stomach to the size of a golf ball. Therefore a person needs to eat less food before feeling satisfied, ensuring weight loss at a steady rate. The only thing a person has to lose with the VIRTUAL GASTRIC BAND is excess fat.
Deeply passionate about helping people, Sheila is working with medical practitioners in the UK to demonstrate how hypnotherapy will save the NHS £Millions if recognized as a viable treatment for weight loss and other ailments. Sheila Granger, Clinical Hypnotherapist. Tel. +44 1482 863659.
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smilinggreenmom on 08/06/2010 19:14:49
It's so scary that there are teens wanting to have this procedure done. I know it can be frustrating to lose weight but I have been working so hard at eating whole foods, drinking more water and I take my Vidazorb chewable probiotic everyday! These things with exercise can be so much healthier and the band seems more like a quick fix maybe? I dunno - just sounds invasive.
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diane on 08/20/2010 12:00:43
I can say from experience hypnotherapy for weight loss does work, i know because i have had it done.

I must admit before I heard a radio broadcast on the BBC with Claire Hegarty who was invited on the show for being an expert in Weight loss hypnotherapy, i would have said to anyone who suggested that i was hypnotized for weight loss, not to be so stupid. But after struggling with my weight for many years and where my weight went upto 22 stone, i listened to the show after becoming despearate and found it very interesting.

I had tried everything to lose weight, i went on loads of diets, i went to my doctor time and time again and he was not interested, i even asked if i could be given a pill that doctors give out for weight loss but he refused so i was now desperate and would have tried anything.

After listening to claire hegarty on the show and listening to what she had to say about hypnotherapy, i decided to contact her, now you have to understand at this time i was still not believing hypnotherapy could help you lose weight but i did want to know more.

She explained all about hypnotherapy and weight loss and how it works to help you lose weight and i was very interested and started to feel maybe their is light at the end of the tunnel, maybe i can get back my ideal weight. I agreed to meet her and after getting on well with her i became her client. And i have to say, that i am so happy that i am now four stone lighter and still losing weight.

So what i have to say to you is, do research by all means into weight loss hypnosis, but it does work and do go to an expert and see the diference it will make to your life as it has made a huge difference to my life but make sure that they are an expert. Just because they do hypnotherapy, it does not mean they are an expert in hypnotherapy weight loss, when making an appointment ask them are they experienced in this and do they have good results.
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d&g suits on 10/26/2010 05:48:15
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tag heuer watches on 10/28/2010 06:24:37
She explained all about hypnotherapy and weight loss and how it works to help you
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