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Are Weight Loss Plateaus Real?

Ninh Nguyen, chief of the division of gastrointestinal and bariatric surgery at the University of California, Irvine School of Medicine. “Compared to the adjustable gastric banding, the laparoscopic sleeve gastrectomy is associated with improved weight loss and lower incidence of late complications,” Nguyen said by email. “The late complication rate requiring revision (procedures) after sleeve gastrectomy is one-fourth that of gastric banding.” More than half of weight-loss procedures done today use the sleeve gastrectomy, which reduces the stomach to the size of a banana, according to the American Society for Metabolic and Bariatric Surgery. Procedures to remove or adjust gastric bands were associated with longer hospital stays, a greater number of serious complications and more admissions to intensive care units compared with operations to implant the devices, the study found. Researchers didn’t find any difference in death rates or costs between implantation procedures and operations to remove or fix the bands, with both types of surgery costing an average of $11,600 to $12,000. One limitation of the study is that researchers only examined procedures done at academic medical centers, although the authors suggest that trends might be similar at community hospitals. Another drawback is the lack of data explaining why bands were removed. That makes it impossible to say if the removal happened after complications or because patients elected to switch to a different, newer alternative such as the sleeve gastrectomy to see if they could achieve more weight loss. Most often, when the gastric bands are removed it’s either because patients couldn’t tolerate the devices being tightened or because they didn’t lose enough weight, said Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center. Because the sleeve is still relatively new, however, it’s too soon to say whether it will achieve better weight loss or fewer complications over the long term, Courcoulas, who wasn’t involved in the study, said by email.

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