Should Overweight Teens Be Allowed To Get Gastric Bands?

Gastric bands are becoming an increasingly common fix for many overweight patients. While safe in the short term, some fear that we simply don't know enough about the long-term effects to keep pushing the procedure — especially on teens.

Many doctors are looking forward to the day when the U.S. regulators grant permission to use gastric bands on teens. As it stands now, doctors can perform the procedure on teens at their discretion, but because it is still considered "experimental," many decide to approach weight loss in less invasive, more traditional ways like diet and exercise.

This might be a good thing, especially as some doctors have raised concerns about the effectiveness of the band, like Neelu Pal. Dr. Pal was working at the New York University Medical Center when she began noticing patients coming in with serious complications following the lap-band surgery. After one patient died, Pal decided to raise the alarm by quietly calling those about to undergo the procedure, and warning them about the possible risks involved. Hospital authorities learned about the phone calls and fired her. Because of her concerns, Pal says she has been blackballed from medicine.

Reuters paints a rather grim picture of the industry, in which Allergan Inc, the lead makers of the lap-bands, and doctors at NYU have teamed up in a corrupt plan to push as many patients into the procedure as possible. Though this is disturbing enough on its own, regulators are considering okaying lap-bands for children as young as 14, and this worries many other practicing doctors, including Dr. Mary Brandt. Brandt worked on a recent study of the lap-band's effectiveness among teens. Her findings have lead her to believe that there is a "fundamental problem with putting a rigid plastic object around a moving organ." She continues: "I'll be happy to reverse my position as soon as I see 10 or 20 year data."

Even leaving aside the health concerns, gastric bands seem like a bad idea for teens. For some adult patients, the last resort surgery has been something of a god-send, but Reuters makes it sound like a company-endorsed quick fix for a complicated problem, made all the more difficult by the teenage brain. Dr. Roberta Maller Hartman points out that although the band restricts the ability to eat, it does not stop teens from wanting to eat. "The band doesn't reduce the desire to eat emotionally. That has to be addressed," said Dr. Maller. "Teens tend to need more hands-on, one-to-one support." For many people - and especially for teens - food is such a fraught topic, as is weight. Though the band may be able to offer a (potentially temporary) physical solution, in itself, it can't solve the entire problem. Add to this Dr Pal's concerns about the safety of the procedure, and it's hard not to wonder why we would recommend this for kids at all.

Special Report: Targeting Teens For Gastric Bands [Reuters]