Should Lap-Band be approved to tighten the belt of teenage obesity?

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Allergan Inc., maker of the weight loss device Lap-Band, is seeking FDA approval to extend the use of the device to obese teenagers. The Lap-Band is a silicon ring fitted around the stomach to reduce food intake. Clinical trials on teens have already been initiated, and the company believes that because an estimated one-in-three U.S. adolescents is obese or overweight, the procedure should be available to them. Qualifying patients would be those over the age of 14 who meet a certain weight requirement, have failed to lose weight through other weight loss methods and have one or more obesity-related health conditions, such as diabetes. The weight requirements, however, would stipulate that teenage patients meet more stringent BMI criteria in order to undergo the procedure. For instance, a girl who is five feet and six inches would need to weigh 216 pounds in order to undergo the procedure, versus 186 pounds for an adult of that height. Implanting the Lap-Band requires general anesthesia surgery and currently costs as much as $20,000. Allergan is requesting FDA approval, which might increase the likelihood that insurance will cover the costs.

Some experts, however, argue that FDA approval of the Lap-Band for teenagers sends the wrong message. Diana Zuckerman, president of the National Research Center for Women and Families, told the Los Angeles Times that FDA approval would give the impression that “this is a safe way to lose weight.” But there are risks involved, and others believe that bariatric surgery (such as gastric bypass) is a better alternative.

ACSH's Dr. Gilbert Ross believes that this opposition “seems to be based mainly on a moralistic ‘blame the victim’ philosophy. Those opposed say that teens should simply be watching their diets and exercising more, not getting potentially dangerous procedures to fight obesity. Objectively, however, there is no reason why obese teens should not get the benefit of this technique, as older obese patients do, if they fulfill the appropriate criteria. Of course, because the anaesthesia needed for such surgeries has its risks, this procedure should not be used frivolously.”