Will New Guidelines Turn Lap-Bands Into Cosmetic Surgery?

Last month an FDA advisory panel recommended lowering the B.M.I. requirements for gastric lap bands from 35 to 30. Now some doctors say this could turn the serious procedure into another quick-fix weight-loss method. Saw that one coming, didn’t you?

According to current guidelines, the surgery is appropriate for people who haven’t had success losing weight through diet and exercise if their BMI is 40 or above, or 35 and above if they have health problems like diabetes or hypertension. The New York Times reports that Allergan, which makes the Lap-Band, wants to lower those numbers to 35 for those with no health problems, and 30 for those with health complications, which wouldn’t have to be as severe. A company executive estimated that 27 million American have a BMI of 30 to 35 with at least one associated health condition.

One obvious problem with these new guidelines: Doctors have recently admitted B.M.I. is bullshit. One member of the panel, Dr. John G. Kral, argued that this is precisely why the requirements should be lowered. “The B.M.I. criterion is so seriously flawed,” he said. “Removing this barrier of this idiotic number in itself would be an important step.”

However, other doctors are expressing concerns about allowing more people to undergo lap band surgery because there’s no research proving that the operation’s long-term health benefits for slightly obese patients outweigh the risks. In a Times op-ed, Diana Zuckerman, President of the National Research Center for Women and Families, offered a disturbing account of how the F.D.A. originally approved Inamed’s Lap-Band for the extremely obese based on a study of only 200 people. The company was required to perform a more extensive follow-up study, but after the company was bought by Allergan — surprise! — it was never competed. You’ll also be shocked to learn that the study Allergan is using to back up its latest request involved only 149 patients who had lap bands for one to two years.