lap band/bmi

Hi all. I was just curious about the lap band procedure. Do you have to be under a certain weight before that can be performed on you? Also, does ohio medicare cover the lap band. I am reallllllly scared to have the open surgery. Thanks.

I don't think that there is a maximum weight for the Lap band, but there might be a point that they may have to do it as an open procedure. the good news is..I'm sure that someone at my doctor's ofice said that Medicare was the best insurance for covering Lap Bands.

Bobbie, There is no real "cutoff" of BMI for the lap band. However, weight loss is much slower with the band than with bypass, so I tend to push for a bypass in people who have a BMI of 60 or above. However, if your worried mainly about having an open procedure, rest assured that a bypass can be done with the "minimally invasive" or laparoscopic technique as well. Good luck, Dr. C The Deaconess Surgical Weight Loss Center Cincinnati, Ohio (513) 559-2545

Dear Bobbi: First off let me say I am a big believer in the Band, so much so that I offer the procedure. Here's some more information. Most studies on the Lap Band were done in Europe on patients whose BMI's ranged from 35 - 46.0. Newer studies (short term < 2 years) show "a significantly less EWL in patients with a BMI > 50. The range Excess Weight Loss (EWL the measurement of success = >50%) is from 40-60% with the Lap Band. It is more effective for lower BMI's according to Dixon and O'Brien the pioneer surgeons from Australia. They also concluded that those with a BMI > 50 did have good results in the form of comorbidity improvement. Having said that the Band is being put in almost all BMI ranges of 35 and greater, unfortunately there isn't long term data on this in the U.S. The largest published is a single study by Dr. Ren from New York of 400 patients with 46% EWL at 1 year which appears to improve over 2-3 years. Initial data is promising that the trends in long term band placement may approach 60% and some have reported higher but the numbers are few and don't offer definitive proof at this point. RNY is in the neighborhood of 60-80% EWL longterm (>35 years of patients) with an average of 5-10% reweight gain 3-5 years out with thousands of patients studied. So I think you can see our dilemma as surgeons. I definitely believe that this is a GREAT and EFFECTIVE tool for weight loss but it does require the patients have a full understanding of the differences. If it is what you are most comfortable with then it is the procedure for you. It is definitely safer with a much smaller mortality rate. If your surgeon feels comfortable offering you a Lap RNY based on a higher BMI, then they should feel comfortable offering you the Lap Band as well. So much is happening so fast it's difficult to keep up with the studies and I always feel behind. I hope that this helps a little and I am definitely not trying to sway you toward a procedure, its just information. Sincerely, Calvin Selwyn, M.D. Assistant Professor UC Center for Surgical Weight Loss

Thanks so much for all the information!!! I'm learning more as I read the boards daily but, I see, I still have lots to learn. Thanks again for your replies. Bobbie