The three most pervasive stories discussed in today’s news media are America’s overdependence on trade with China, steadily inflating fuel prices across the globe, and the growing obesity epidemic in the United States. How these issues are ultimately resolved, or not resolved, will play a large role in defining how America evolves in the ensuing decades.

Unfortunately, the first two issues are still in the discovery phase. We know that there is a problem, and we recognize the urgency to find solutions, but there remains no clearly defined path to resolution. Conversely, with respect to the obesity crisis in America, we are approaching a scientific consensus on a set of procedures and solutions that have the ability to affect substantial change. (See chart below.)

Weight loss surgery, long viewed as only a last resort possibility for those considered morbidly or terminally obese, is increasingly becoming an accepted practice for reversing the harmful effects of excess weight. In addition, new evidence suggests that procedures like Lap-Band surgery can also be effective in treating individual problems with excess weight before they become personal health crises.

Mind you, this is not a consensus that was reached easily or without significant trial and error. Surgical techniques have gone through multitudes of refinements to become safe and effective. Different “fad” diets have come and gone with seemingly the same frequency as days on a calendar and produced varying levels of success and failure. Additionally, expectations have evolved from just seeing results to achieving sustained results despite the fact that the empirical evidence on diets is not even ambiguous: diets do not produce sustainable weight loss for the vast majority of people.

To put it into perspective, consider hybrid cars in relation to the current energy issues facing our nation as analogous to the Atkins diet with respect to weight loss. Both have produced some success for a niche portion of the population, but in and of themselves are still just a part of an overall synergy of solutions that will be necessary to create positive, widespread change in the factors underlying the problems.

As a nation, we are still waiting for the other solutions that will ultimately chart our intended course towards energy independence. However, for the millions of Americans battling every day to fight excess weight, and for all Americans who have seen their health care costs rise as a result of this national obesity epidemic, the path to a solution has become much more clearly defined.

One of the most important recent innovations is the development of a procedure called Laparoscopic Adjustable Gastric Banding (LAGB), and commonly referred to as Lap-Band surgery. This technique has been available in Australia and Europe for over 20 years, and was approved by the FDA for use in the United States in 2001. The initial success of Lap-Band surgeries this decade has offered a new ray of hope to Americans who are committed to improving their lives by attaining more peace of mind and better overall health and wellness through weight loss.

People are turning to weight loss surgery for a variety of reasons. The most important reason is the desire of so many people to reduce the harrowing health risks associated with being overweight. From Type 2 diabetes to heart disease to chronic pain to infertility in women, among so many others, there is a direct relationship between weight loss and improved overall health.

The problem that many people face is an inability to find sustained success with traditional weight loss methods like dieting or medical treatment. Weight loss surgery is proving to be a successful alternative. In fact, according to a study led by Dr. Paul O’Brien at Monash University in Melbourne Australia:

“Surgical treatment using laparoscopic adjustable gastric banding was statistically significantly more effective than nonsurgical therapy in reducing weight, resolving the metabolic syndrome, and improving quality of life during a 24-month treatment program. “

Many people are also choosing weight loss surgery for reasons other than just improving health, including: relieving the mental anguish of low self-esteem associated with poor body image; improving their perception in the workplace and their upward career mobility; increasing their ability to live an active lifestyle; and, reducing their health care costs. Fortunately, weight loss surgery techniques are becoming more refined and producing more consistently successful and safer results.

It can be reasonably inferred that as the clinical data for the Lap-Band technique catches up with other more established weight loss surgeries like the gastric bypass, Lap-Band surgery will become the generally accepted best practice for long-term weight loss success.

The innovation of the LAGB surgery is providing people who are fighting excess weight with a more realistic chance of achieving long-term weight loss success and is giving people hope where it might not have existed before.

Unfortunately, many weight loss surgery treatments are being held back from realizing their full potential as solutions to the obesity issue in America. Inexplicably, many insurance companies are now pulling back coverage that they once offered, as reported in the LA Times (see link below). For those insurance companies who will cover weight loss surgery, restrictive eligibility and coverage gaps exist with respect to coverage for weight loss surgery.

Current eligibility standards allow only people at certain obesity thresholds to qualify for insurance coverage for weight loss surgery, and even those who are “covered” often have to overcome hurdles to get approved or significant delays in the approval process. Plus, many insurance companies will pay for the surgical procedure but not for the necessary aftercare.

Analyzing an individual’s likelihood of being eligible for coverage depends on their placement in the Body Mass Index (BMI) spectrum. “Morbidly obese” is defined as having a BMI of 40 or above. Some insurance providers will cover the cost of weight loss surgery for patients in this category. “Obese” is defined as having a BMI of 30 or above. In this group, only those who have a BMI over 35 and who are experiencing significant, potentially terminal health problems as a result of their excess weight are eligible for coverage.

The tide does though appear to be turning. New scientific evidence has concluded that the current BMI-based criteria for determining coverage eligibility for weight loss surgery is inadequate. According to Medical News Today, a recent study conducted by the University of Texas Southwestern Medical Center and published in the December issue of the journal Surgery for Obesity and Related Diseases shows that people with a BMI as low as 30 can in many cases benefit more from the reduction in cardiovascular risk factors associated with weight loss surgery than those with BMIs in the 40s and above.

In addition, according to an interview published at ObesityHelp.com (see "Relevant Resources" capsule below), research conducted by Brad Snyder, M.D. at the University of Texas-Houston Medical Center, also serves to disprove the fallacy that weight loss surgery is only for the morbidly obese. Dr. Snyder’s goal was to assess the relationship between starting BMI and weight loss success for gastric banding surgery patients. He studied nearly 600 gastric band patients a year out from their surgery.

Based on his research, Dr. Snyder explained, “It was very clear that people with a BMI of 30 lost considerably more weight over that year than people with BMIs in the 50s.”

These recent findings provide significant contradictions to the currently accepted notion that only the morbidly obese should reasonably qualify for weight loss surgery procedures. This emerging trend in scientifically proven knowledge is providing hope to many potential weight loss surgery patients, as well as to providers. Weight loss surgery is trending toward becoming an accepted procedure to prevent or reverse the negative effects of excess weight before they reach a terminal level, as opposed to the current status of weight loss surgery as a reactive procedure for those who are already in the throes of obesity.

On an intuitive level this shift in thinking makes perfect sense. Furthermore, it is helping to correct a bias in general perception regarding the validity of weight loss surgery as a reasonable option for more than just the morbidly obese.

Cosmetic surgeries such as breast augmentations and rhinoplasties are invasive procedures that carry legitimate surgical risks, yet they have become readily acceptable for those focused on improving appearance and self-esteem. While rhinoplasties can enhance wellness by improving an individual’s ability to breathe, breast augmentations have become common practice without providing any significant health benefits at all.

Additionally, Lasik surgery is associated with risk factors such as blepharitis but is becoming more readily utilized, as the technique is refined, to improve quality of life through better vision. The Lap-Band’s probable curve of acceptance in the U.S. may be illustrated by comparing it to Lasik eye surgery.

Upon first being introduced into the marketplace, many people were intimidated by the prospect of having a laser operation on a part of their body as important as the eyes. Now, as the technique has proven its safety and effectiveness over time, Lasik is becoming a no-brainer for many people. Lap-Band surgery is following a similar arc on its journey to widespread acceptance and use.

Acceptance of Lap-Band weight loss surgery is growing because the procedure unquestionably improves health by reducing a myriad of risk factors associated with excess weight. Plus, it improves quality of life through both its related health benefits and the ability for patients to lead more active post-surgery lives. Furthermore, weight loss surgery is not defined as a cosmetic procedure, yet provides a significant cosmetic benefit to many people who have low self-esteem associated with a poor body image. Certain types of weight loss surgeries, such as Lap-Band surgery, are also completely reversible save for the small incision necessary to place the removable and adjustable band.

It has taken time to prove the safety and effectiveness of techniques like the Lap-Band procedure. Now that weight loss surgery techniques have advanced, and more trusted options like the Lap-Band are available, our society is in possession of an invaluable and accepted weapon to more effectively fight obesity. As a result, many people who had previously been beaten down by persistent hopelessness now can have legitimate hope once again.

Lap-Band surgery was approved for use in the Unites States in June of 2001 and is one of the latest innovations in the field of bariatric surgery. It is designed to provide many of the same weight loss benefits of a gastric bypass while being more effective for sustained weight loss long-term, less invasive as a surgical procedure, and more flexible for the patient after the procedure.

Gastric Bypass

The stomach is stapled to create a smaller pouch; most of the stomach and a portion of the intestines are then bypassed by attaching, most often by stapling, a part of the intestine to the smaller stomach pouch. Weight loss occurs because less food can be consumed, reducing caloric intake.

Advantages include: more rapid initial weight loss than any other weight loss surgery technique; new surgical innovations that allow for a less invasive procedure than before; a longer history and breadth of clinical data in the U.S.

Disadvantages include: cutting and stapling of the stomach and intestines that cannot be reversed; greater likelihood of surgical complications; reduction in the absorption of nutrients as a result of bypassing the digestive tract; higher reported mortality rate (.5-2%) than Lap-Band surgery.

Lap-Band Surgery

A smaller, restricted stomach pouch is created by the placement of an inflatable band around the upper portion of the stomach. Less food can then be consumed at one time, and the stomach takes longer to empty. The result is weight loss through reduction in caloric intake and slower digestion, which reduces appetite.

Advantages include: the lowest mortality rate (.05%), least invasive procedure, and lowest risk for operative complications of all weight loss surgeries; the adjustable and reversible nature of the band, which requires no composition changes to the stomach or intestines; lower risk of malnutrition as this surgery is restrictive, but not malabsorptive.

Disadvantages include: slower initial weight loss, despite overall long-term effectiveness; necessity for complete patient commitment and follow-ups with aftercare provider; implantation of a medical device, which can make some people uneasy.

The most important conclusion to be drawn is that while both techniques are viable and have proven to be successful, the Lap-Band technique is rapidly gaining stature in the bariatric surgery field because of its long-term effectiveness and the adjustability and flexibility inherent in the Lap-Band itself.

The primary advantage of Lap-Band surgery is that in addition to the given facts that it is proven to be safer, more effective, and less invasive, it affords patients the benefit of flexibility for what may occur three, four, five years down the road. Whether it be a pregnancy or a career change, for example, events can occur that compel individuals into different eating habits or altered goals. People like having a solution that provides sustained weight loss results but can also adjust to their needs. LAGB surgery seemingly gives them that success and flexibility.

It is important to note that the implantation of the Lap-Band is only the first step, not the total solution. Rather, it is a patient’s ability to stay committed to his or her aftercare program that will ultimately determine the success of the Lap-Band surgery procedure.

The laparoscopic surgery associated with the implantation of the Lap-Band has been refined to the point where it is a 30-45 minute outpatient procedure. An important aspect of the Lap-Band procedure is the aftercare, a plan designed for long-term weight loss. Wherever a patient chooses to go for a weight loss surgery, be it for a bypass or a Lap-Band, many medical experts agree that it is absolutely imperative that a proven aftercare system be in place to ensure that they can experience the long-term positive effects intended from the surgery.

It is no accident that this article on weight loss surgery is concluding with a discussion of aftercare. One of the most important components of a weight loss surgery solution is the patient’s access to and commitment to aftercare. In fact, Lap-Band surgeries and the Lap-Band itself have advanced to the point that other than very rare occurrences of band slippage or leakage (both of which are correctable through minor revisional surgery), the primary complication is simply a patient’s inability to follow the aftercare guidelines.

Research supports the importance of an aftercare program in conjunction with weight loss surgery. According to a survey released at the most recent meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS), individuals who committed to the post-surgery aftercare recommendations of their doctors lost 35% more weight in the first year after the surgery than those who did not. The patients who were more committed to aftercare also were more likely to keep the weight off after five years. Furthermore, as reported in the Annals of Internal Medicine, with integrated patient care, 98% of Lap-Band patients studied lost 87% of their excess weight and kept it off.

A comprehensive aftercare plan should include consultations with nutritionists, physiologists, and psychologists, based on the individual needs of the patient. The ultimate goal is to assist patients in following their personalized nutrition plans as well as the lifestyle changes necessitated by the choice to use the Lap-Band weight loss solution. Regular exercise and adjustments to the band are also regular components of a typical Lap-Band aftercare program.

There is no question that the commitment level a person must have to experience the long-term success of their Lap-Band can be initially daunting for some patients. What most patients come to realize, however, is that they are simply developing healthy and positive lifestyle habits that would be beneficial whether they had taken advantage of Lap-Band surgery or not. Nothing is guaranteed and patients have to be committed, but with the right support structure in place, and a plan designed by experts who have a vested interest in seeing a patient be successful, a Lap-Band procedure provides the safest option with the highest probability for long-term success of any other weight loss surgery available today.

Lap-Band surgery can and will become a major part of the synergy of solution that will help our nation manage its growing weight and health issues. When combined with comprehensive and focused aftercare, Lap-Band surgery is a significant step forward in battling obesity and excess weight one patient at a time.

As general confidence in Lap-Band surgery grows, founded upon scientifically proven evidence of its safety and effectiveness, the surgery will become far more accessible to millions of Americans who can use it to improve their lives. This will create a group of people who have escaped a future dealing with the physical and emotional poverty of obesity, and who now are able to live a longer, happier and healthier life.