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Weight-loss surgery unavailable to many who need it

Posted February 10, 2011

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— Standards for a weight-loss surgery that doctors say leave out many people who desperately need help might be revised by the Federal Drug Administration.

To have Lap-Band surgery, the FDA requires that people have a body-mass index of 40. People with a BMI of 35 can qualify if they have co-morbidities, or life-threatening conditions made worse by obesity. Those include diabetes, hypertension, high cholesterol and severe joint problems.

Tana Foote, 49, is cut out by those standards.

After surviving a wreck more than 30 years ago, Foote is still plagued by many chronic health problems – "which has caused weight gain from all the medications that my body has been on," she said.

Complications also left her lungs at 65 percent capacity, which limits her ability to exercise.

Foote said she was excited by the possibility of the Lap-Band weight-loss surgery. It's a reversible procedure in which an adjustable band is placed around the top part of the stomach, making a person feel fuller quicker. It's the least drastic of four weight-loss surgeries.

Foote had her BMI tested. It came in at 34.9 – one tenth of a percent too low to meet FDA requirements.

"I had tears in my eyes. (It was) very heartbreaking," she said.

Doctors said that weight-loss surgery can be necessary for people like Foote, for whom diet and exercise don't work.

"We've been trying diet and exercise for a long time and have not had any long-term success that has been proven. I think it makes sense to do something that has a proven track record," said Dr. Aurora Pryor, a bariatric surgeon at Durham Regional Hospital.

The result of a recent study in six centers across the country might influence a change in FDA standards for the use of Lap-Band surgery. 

"I think the cut-offs of 35 and 40 (BMI) were very arbitrary," Pyror said, referencing preliminary data from the study.

Requirements for Lap-Band surgery might go down to a BMI of 35 or higher without co-morbidities and a BMI of 30 with serious co-morbidities.

The FDA might deal with the issue this spring or summer. Insurance coverage for the procedure would likely lag behind approval.

Foote said the changes can't happen soon enough for her.

"I will do it if it's going to save my life and let me live longer and not be on oxygen the rest of my life," she said.

14 Comments

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  • ThePunisher Feb 16, 2011

    she should fatten up some so she could get free surgery

  • truth9806 Feb 16, 2011

    Obama will probably make the tax payer pay for these surgeries. After all we are not responsible for anything else, why not have the Govt. take on our dieting also

  • Arapaloosa Feb 16, 2011

    Am I missing something here? I'm not a doctor, but if DIET didn't help, how is the lap-band going to help? The lap-band (if I understand it correctly) makes you feel full sooner, thus reducing the amount you eat. Sounds the same to me...

  • princessnise Feb 15, 2011

    Research has shown that morbidly obese people who have these types of surgeries are prone to other compulsive behaviors ... maybe they should be addressing the true issue before cutting.

  • HowManyOunces Feb 14, 2011

    "Isn't Great that a Federal Agency can get between you and your Doctor. For some odd reason I have yet to hear the President or the Congress complain about such interference."

    Probably b/c it is VERY profitable for the doctors to do the surgery and most overweight people want the easy out. So, the FDA knows that without restrictions, everyone would be having this very risky surgery.

    IMHO, barring those that have thyroid problem et al, WLS should be very restrictive. I have a friend that has dropped 150 lbs. through exercise, diet, and hard work. No one says that it is going to be easy.

  • fzero Feb 14, 2011

    Here's a novel idea: eat less in the first place.

  • whatelseisnew Feb 14, 2011

    "The result of a recent study in six centers across the country might influence a change in FDA standards for the use of Lap-Band surgery. "

    Isn't Great that a Federal Agency can get between you and your Doctor. For some odd reason I have yet to hear the President or the Congress complain about such interference.

  • Minerva Feb 11, 2011

    She should have had a big glass (or 2) of water before she weighed! The difference in one tenth on the BMI scale is generally only a couple of pounds - for example, for a person 5' 3" tall the difference literally is from 197 pounds to 198 pounds. Typically a person's weight can fluctuate a couple of pounds just from morning to night.

    I know people who have been just under the magic mark before who did eat worse than they had been doing in order to gain weight in order to be eligible to have the surgery. I am also a strong proponent of WLS when other methods of trying to lose weight have failed. It can not only save lives but also change lives!

  • carolinaswthrt272 Feb 11, 2011

    i agree with you foxhunter, i myself had thyroid cancer and had my thyroid removed, since then i've gained weight and it just doesn't want to come off. my dr told me the same thing, i basically have no metabolism. it's very frustrating.

  • hallmark Feb 11, 2011

    Steroids used to control some respiratory and other medical conditions also cause weight gain if taken over a period of time. Not only does this occur in humans but also in animals.

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