Gastric Band Improves Obese Teen's Metabolic Status

In morbidly obese teenagers, undergoing a surgical procedure called laparoscopic adjustable gastric banding (LAGB) can significantly improve or and even reverse the metabolic syndrome, according to a study reported this week at The Endocrine Society's 91st annual meeting in New Orleans.

The metabolic syndrome refers to a cluster of risk factors for diabetes and heart disease -- including abdominal obesity, high blood pressure, high blood sugar, low levels of the "good" HDL cholesterol and high triglycerides. The syndrome is typically diagnosed when a person has three or more of these conditions.

Long-term studies are still needed, but LAGB may be a useful intervention for morbid obesity that does not respond to other treatment to prevent the early onset of additional conditions and to avoid cardiovascular events in these young patients, the study team concluded in their meeting abstract.

Dr. Ilene Fennoy and colleagues from Columbia University Medical Center in New York analyzed the patients' size, weight and proportions, along with metabolic factors before and up to 1 year after the gastric banding. The patients included 9 male and 15 female morbidly obese 14- to 17-year-olds. At the beginning of the study, 13 of the 24 study subjects met criteria for metabolic syndrome.

"Rapid improvement in metabolic syndrome parameters occurred during the first 6 months with continued but less dramatic changes to 12 months," the researchers reported.

Six months after LAGB, a statistically significant decrease in body mass index (from 51.3 to 46.2) and waist circumference (from 141 to 131.2 cm) was noted, as expected.

Other parameters of the metabolic syndrome -- triglycerides, blood pressure, and blood levels of C-reactive protein -- were also significantly reduced 6 months following gastric banding.

These improvements continued to 1 year in the 12 patients who were tracked for this long.

Overall, the prevalence of metabolic syndrome dropped from 54.2 percent to 29.2 percent, the authors report. Among the 5 patients with 12-month follow-up who met the criteria for metabolic syndrome when the study began, only 2 still had the metabolic syndrome after 1 year.

Laparoscopic adjustable gastric banding is a procedure currently approved only for morbidly obese adults. Further studies, the researchers conclude, are needed to confirm that the procedure effectively improves the metabolic syndrome in adolescents.