Tuesday, May 02, 2006

Australian LAP-BAND Study Passes Over Low-Carb Comparison

Paul O'Brien compared LAP-BAND surgery to a calorie-restricted diet

A new study out of Melbourne, Australia released today concluded that the controversial LAP-BAND surgery is allegedly a much better way to lose weight and get healthy than more traditional non-surgery weight loss methods.

Led by Paul O'Brien, Director of the Centre for Obesity Research and Education at Monash University, researchers examined 80 random mild to moderately obese adults with a BMI between 30-35 and split them into two groups: 1) physician-directed, very low-calorie diet in combination with the weight loss pill orlistat, lifestyle change support sessions, and regular exercise, or 2) laparoscopic adjustable gastric band (LAP-BAND) surgery performed by two experienced surgeons within a month of the matriculation of the study. An inflatable band was inserted around the upper part of the patient's stomach to create the feeling of fullness.

At the end of the two-year study, the patients who had LAP-BAND surgery had lost an average of 45 pounds, or 21.6 percent of their initial body weight compared with less than a 12 pound loss average, or 5.5 percent of the intial body weight for those on the low-calorie diet.

As for metabolic syndrome symptoms, the LAP-BAND group saw significantly less occurence of these conditions than the non-surgical group dropping from 38 percent down to 3 percent during the study for the surgical group compared with 24 percent still exhibiting symptoms in the calorie-restricted group.

While the weight loss between the two groups was even six months into the study, the low-calorie group began regaining some of their weight while the LAP-BAND group continued losing weight throughout the duration of the study.

Finally, the average BMI of the LAP-BAND participants fell from 33.7 down to 26.4 compared with 33.5 down to 31.5 at the end of the two-year study.

The findings of this study were published in the May 2, 2006 issue of the Annals of Internal Medicine.

O'Brien said his study is groundbreaking because it proves LAP-BAND weight loss surgery, which has its benefits and risks, is more effective than natural weight loss methods.

"This was one of the first rigorously controlled studies to measure the impact of weight-loss surgery against traditional weight-loss methods," O'Brien explained. "It confirms the results of prior studies that weight-loss surgery is superior over traditional approaches like diet and exercise alone."

But there's only one problem with your conclusion, Professor O'Brien -- you only compared LAP-BAND surgery with an ultra-low-calorie diet combined with diet pills and exercise and did not look at other traditional non-surgical weight loss approaches such as low-fat or low-carb diets. In order for you to declare weight loss surgery as BETTER than natural changes in diet and exercise, you absolutely MUST look at a variety of dietary plans and not limit the study to the difficult-to-stay-on calorie restriction diet.

I would be willing to bet that the weight loss and improvements in metabolic syndrome would be MUCH GREATER in study participants following a low-carbohydrate diet plan compared with the LAP-BAND patients in your study. In fact, researchers have already connected the dots showing improvements in metabolic syndrome for people on low-carb.

Additionally, while the subjects in the study were only moderately obese, I am sure they would see similar statistical weight loss results as I did during my 180-pound low-carb weight loss in just one year on the Atkins diet. My total weight loss in that one year accounted for a whopping 43 percent drop from my initial body weight of 410 pounds, which is more than DOUBLE the percentage of weight loss that the LAP-BAND patients experienced in two years!

If Professor O'Brien and his research team is so confident in their conclusion regarding LAP-BAND surgery being better than all other traditional, non-surgical weight loss methods, then why don't we make them prove it?! I am hereby issuing a public challenge to O'Brien and any other health researcher out there brave enough to conduct a study comparing LAP-BAND weight loss surgery with a low-carb regimen in moderately obese patients. Now THAT would be an interesting study to see.

Interestingly, O'Brien concluded from the results of his study that more people who are moderately obese should be having LAP-BAND surgery instead of making changes in their diet and exercise habits.

"Currently, the generally accepted practice is to perform weight-loss surgery only on the severely and morbidly obese," he said. "But these positive results suggest that physicians should re-examine the guidelines for weight-loss surgery to determine if they should be expanded to include mild to moderately obese patients."

Why are you so gung-ho about turning to surgery over other less-invasive weight loss methods which could potentially be more risky, Professor O'Brien? I don't know about you, but I think responsible physicians would exhaust every single possible solution available to them, including various changes in diet, prior to cutting open a patient to install a device that artificially changes their eating habits. That makes no sense to me as a first option when natural changes can and do make a difference in people's lives every single day.

Teaching people that there are healthier ways to eat and helping them implement those changes into their own life is a much better plan of action for taking on the growing obesity epidemic than resorting to surgery. That's what I was able to do when I was desperate to lose weight and I encourage others to try various kinds of programs to change their dietary habits before ever resorting to weight loss surgery.

You can e-mail Professor Paul O'Brien encouraging him to compare LAP-BAND with livin' la vida low-carb at Is he up for the challenge? We shall see.


Blogger Lowcarb_dave said...

It seems like they are trying to open up new 'markets' for their surgery.

The lap-band though, would be at the top of the list (in my mind) for WLS.

It does the less internal damage, and can be reversed at a later date.

5/03/2006 12:41 AM  
Blogger Science4u1959 said...

Did the prof, before touting the "benefits" of his lap-band, also take into account that reducing caloric intake (because that's what it boils down to) is a dangerous approach? A calorie-restricted diet, no matter how that restriction is achieved, also reduces the intake of healthy fats - and thus the absorption of essential nutrients, as well as vitamins and minerals. Caloric restriction is clearly NOT the way to go - many studies have confirmed this fact.

Some individuals may need to reduce caloric intake, due to medications, metabolic defects or other factors. But generally speaking it is not advisable (nor necessary) to do so, for a multitude of reasons, unless absolutely unavoidable.

The natural (and limited) reduction of caloric intake that a controlled-carb regimen provides is not dangerous, as the intake of wholesome, unprocessed and nutrient-dense foods increases at the same time.

5/03/2006 10:27 PM  
Blogger DJ Ovation said...

If caloric restriction is not the way to go, then why do you pursue a low carb diet that restricts caloric intake? Many people feel that limiting their caloric intake by going on a diet is unnatural because we, as human beings, consume food naturally without counting calories or carbs or fat grams. We eat until we are satisfied, and some people need to eat more food in order to be satisfied.

WLS, specifically gastric banding, helps individuals who have attempted, and failed, to limit their food consumption through what you would consider "natural" means. The gastric band is a tool that creates the sensation of "fullness" earlier in the meal and aids in portion control without interferring in the absorption of essential vitamins and minerals. Eating right and exercising are still positive, valuable ways to acheive and sustain weight-loss as a banded patient.

If you do not need the lap-band and can lose weight in a more traditional manner, then weight-loss surgery should not be an option. The band is for those who have tried, and failed, in mantaining a healthy weight through diets, pills, and other traditional methods.

12/31/2006 8:28 PM  
Blogger Jimmy Moore said...

That's a copout, dj. I don't eat low-carb because it helps me restrict my calories. In fact, I eat a LOT MORE calories now than I ever did when I was on a low-fat diet. The metabolic science behind low-carb has shown that you don't need to count calories and it becomes natural.

Hey, if someone wants to have their insides manipulated to help them lose weight, then who am I to stop them? But there are better, less invasive ways to do it naturally.

12/31/2006 8:36 PM  

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