LAP-BAND trims weight but isn't for everyone

What makes one a good candidate for the LAP-BAND weight-loss procedure was a question asked repeatedly Saturday during the Deseret Morning News/Intermountain Health Care Hotline.

The simple answer has well-defined basics: An individual needs to be at least 18, have a history of unsuccessful weight-loss attempts and be chronically and severely overweight, weighing 100 pounds above the ideal weight or double their ideal weight.

But the answer's more complicated than that, shaded by individual traits and variables. For instance, someone who cannot or is unwilling to swear off soda pop for life can't have the procedure. Soda pop is a definite no-no. And for some patients, the long-term commitment to follow-up care and having the band adjusted periodically is simply too much, according to Dr. Darrin Hansen and Dr. O. Layton Alldredge.

The duo, both general surgeons at Alta View Hospital, answered questions and explained the procedure to callers during the two-hour hotline.

LAP-BAND received Food and Drug Administration approval in 2001 and has been gaining popularity in the United States, although the most common weight loss surgery performed nationally is the gastric bypass. In the gastric bypass, the digestive tract is altered to reduce the amount of food a person who is severely overweight eats.

The newer procedure involves installing the band, which cinches the top part of the stomach to make a smaller pouch and a narrowing opening into the rest of the digestive tract. After a six-week healing period, the band is adjusted using an external port, then periodic adjustments are made as needed. The band can also be removed completely later if needed.

With LAP-BAND, a typical meal is about three-fourths of a cup in size and needs to be nutritious. The food goes into the small pouch, creating a sensation of being full, then slowly drops into the rest of the stomach and on through the digestive tract.

Most of the patients go home the same day. They have a liquid diet for a week, then eat soft foods until they are fully healed and the band is adjusted about five weeks after that.

Alldredge, who has long performed many different types of surgery, said the success he's seen and the changes that have been made in individual patients' lives has moved him more and more to specializing in the bariatric surgery. Many people who are severely overweight isolate themselves, working in jobs where they don't interact with the public. It's rewarding, he said, to see them blossom as their self-image and their health improves.

While he prefers the LAP-BAND, he said, "gastric bypass is a good procedure, too. I would never say someone shouldn't have one."

A common question centered around cost. Typically, LAP-BAND costs about $15,000. Some insurance companies will pay for it and some will not, Hansen said.

The hotline takes place the second Saturday of each month and each one addresses a different health topic. All calls are confidential.

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E-mail: lois@desnews.com