Frequently Asked Questions
What are the options for weight loss treatment?
Many obese patients initially seek to lose weight through diet and exercise or pharmacotherapy; however this generally results in only mild or moderate weight loss. See Non-Surgical Treatment Options for more information.
Three commonly used surgical weight loss options are: gastric bypass, sleeve gastrectomy, and gastric banding. Compared to other bariatric procedures, laparoscopic adjustable gastric banding (LAGB) is less invasive, has fewer and less severe complications, less postoperative pain, a shorter hospital stay, more rapid post-operative recovery, and comparable weight loss efficacy. A 2009 Obesity Surgery publication examining the relationship between bariatric surgical approach and in-hospital postoperative complications found significant differences between surgical options. A multivariate analysis of database data from 8,413 adults who underwent bariatric surgery in New York State indicated that open bypass patients were 5.4 times and laparoscopic bypass patients were 3.2 times more likely to experience a complication compared to laparoscopic banding patients.101 See Surgical Treatment Options for more information.
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Should I recommend surgery?
Due of the increased risk of comorbidity and mortality associated with morbid obesity, many patients do not achieve a significant weight reduction with diet and exercise or pharmacotherapy.
According to the American Society for Metabolic and Bariatric Surgery (ASMBS), you should recommend surgery if your patient has failed non-surgical weight loss, has a body mass index (BMI) greater than 40 kg/m2, or has a BMI greater than 35 kg/m2 with associated severe comorbid conditions. See Obesity and its Risks for more information.
Evidence-Based Algorithm for the Treatment of Obesity
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How do I know if my patient is eligible for surgery?
- Have failed non-surgical weight loss
- Have a body mass index (BMI) greater than 40 kg/m2
- Have a BMI greater than 35 kg/m2 with one or more severe comorbid conditions
- Be at least 100 pounds heavier than their estimated ideal weight
- Be willing to adhere to post-operative care and follow-up
If your patient fulfills these criteria, they may benefit from bariatric surgery. See Determining Patient Eligibility for more information.
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How do I locate and contact the right surgeon for my patient?
You can locate a bariatric surgeon by name or ZIP Code through our website, and learn about the pre- and post-operative surgical care their practice provides. Using our online surgeon locator tool gives you enhanced access to LAP-BAND® System Certified Surgeons.
You can also use our Lap-BandLink™ Patient Care Network to track and manage your surgeon relationships and patient referrals.
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What kind of weight loss results will my patients achieve with the LAP-BAND AP® System?
Weight loss results can vary depending on individual factors such as baseline weight, comorbidities, diet, exercise, patient motivation, and support. It is essential that the right expectations are set with patients before they proceed with surgery and LAP-BAND® System surgeons address this extensively as part of the pre-operative education that is provided to patients.
Published literature may serve as a useful source to inform patients' weight loss expectations. The multicenter observational LAP-BAND AP® Experience (APEX) Study* reported the following interim results at 24- and 48-weeks post-surgery for severely obese patients:108
| 24-weeks post-surgery N = 303 |
48-weeks post-surgery N = 139 |
|
|---|---|---|
| Mean baseline weight (SD ; range) |
277.1 (54.1; 183-488) |
|
| Mean BMI | 38.2 | 35.7 |
| Mean % excess weight loss (%EWL) | 34% | 47.5 |
*The LAP-BAND® System was approved in the United States on the basis of a nonrandomized, single-arm study (N=299). Significant improvement in percent of excess weight loss vs. baseline was achieved at 12 months (34.5%), and 36 months (36.2%).Back to top
What are the risks and complications associated with LAP-BAND® System surgery?
The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required at some time.
Placement of the LAP-BAND® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure, and the patient's ability to tolerate a foreign object implanted in the body.
Band slippage, erosion and deflation, reflux, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required. LAP-BAND is not for those who are pregnant, or have symptoms of autoimmune, severe heart, lung, or gastrointestinal disease, cirrhosis or pancreatitis. More detailed risk information is available on our Risk Information page or call
1-800-LAP-BAND.
How will laparoscopic adjustable gastric banding (LAGB) surgery affect my patient's obesity-related health conditions?
The purpose of bariatric surgery is to help patients achieve significant and sustained weight loss. Significant, sustained weight loss as a result of bariatric surgery is associated with the following post-operative health improvements:
- Asthma
- Cardiovascular Disease
- Depression
- Dyslipidemia
- Gastroesophageal Reflux Disease
- Hypertension
- Infertility
- Lower Back Pain
- Metabolic Syndrome
- Migraines
- Obstructive Sleep Apnea
- Osteoarthritis
- Pseudotumor Cerebri
- Type 2 Diabetes
- Urinary Stress Incontinence
How long does recovery usually take?
Patients are usually able to return home within 24 hours after surgery, and resume their normal activities within a week. On average, patients visit their surgeon six weeks after surgery to have the LAP-BAND® System adjusted for the first time. Subsequent visits can continue every six weeks for at least one year; however this may vary with each patient as ongoing adjustments may be necessary to reach the patient's weight loss goals. See Patient Recovery Time for more information.
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What is my post-operative role as the referring physician?
You will need to remain actively involved in your patient's ongoing medical care, especially if the patient's referral was necessitated by one or more comorbidities. Successful treatment of your patient involves ongoing management to reduce excess body weight, which is the primary responsibility of the bariatric surgeon, and control of obesity-related comorbidities and the associated medications.
Many bariatric practices offer support groups for their post-operative patients. If you are referring your patients to a surgeon who is part of a designated Bariatric Surgery Centers of Excellence program, patient support elements may already be in place. You may want to encourage your patients to participate, because research has shown that regular follow-up contributes to better outcomes. See Your Role in the Patient Journey for more information.
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Where can I find resource materials for my patient?
You can order patient education materials from our website.
Additionally, patients can find information about managing and treating obesity at The Obesity Action Coalition and the International Bariatric Support Center
The National Institutes of Health (NIH) also provides information on weight control, obesity, physical activity, and related nutritional issues.
To ensure your patient is well-informed, you can also recommend that your patient attend a LAP-BAND® System seminar which is hosted by LAP-BAND® System practices. During the seminar, patients will learn about various surgical options, including the LAP-BAND® System. Find a LAP-BAND® System Seminar near you.
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What is the cost of the surgery?
The cost of the LAP-BAND® System procedure varies widely based on:
- The type of health plan
- Whether the surgeons and hospital are in-network providers
- Whether the procedure is performed on an in- or out-patient basis
Many health plans, including Medicare and, in some states, Medicaid, cover the cost of LAP-BAND® System surgery. Thus some, if not all costs, may be covered for your patient.
Your LAP-BAND® System surgeon's office is trained and experienced in dealing with all reimbursement and coverage requirements, and will work with patients to obtain coverage. In some cases when coverage is not available, office personnel will provide patients with information on other available financing options.
The procedure, including faculty, surgeon and anesthesiologist, generally costs from $12,000 to $30,000. Follow-up care and adjustment fees usually range from $35 to $200 per visit, depending on the type and length of care provided.
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Can the LAP-BAND® System be removed?
Although it is intended as a long-term implant, the LAP-BAND® System can be removed. The stomach may return to its original shape once the LAP-BAND® System is removed, which may result in subsequent weight gain.
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Please contact us if you have a question, require more information, or have feedback about our products or website.
