The United States Food and Drug Administration recently lowered the prerequisite body mass index from 35 to 30 (in patients with a comorbity) for use of Allergan’s Lap-Band ® Adjustable Gastric Banding System. An article in Bariatric Times, authored by Boston surgeon and researchers, urges the investigation of factors other than BMI when developing models for risk stratification in bariatric procedures.
The broader criteria established in February nearly double the number of Lap-Band candidates. Presently approved patients are those with a BMI over 40 and patients with a BMI of 30 to 40 in the presence of weight-related comorbidities such as hypertension, dyslipidemia, or obstructive sleep apnea.
The authors suggest a number of factors other than BMI may predict response to surgery. Among them:
- number of comorbidities
- severity of comorbidities
- rate of onset of comorbidities
- type of procedure performed (restrictive vs malabsorptive)
- changes in insulin sensitivity
Read the full article in Bariatric Times by Richard J. Joseph, BS; George L. Blackburn, MD, PhD; and Daniel B. Jones, MD, MS, FACS