Weight-loss surgery unavailable to many who need it

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.

Posted 4:23 p.m. Feb 10, 2011 — Updated 1:00 a.m. Feb 11, 2011

DURHAM, N.C. — 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.

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