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June 16, 2010

Laparoscopic Gastric Banding vs Lifestyle Intervention in Severely Obese Adolescents—Reply

JAMA. 2010;303(23):2356. doi:10.1001/jama.2010.782

In Reply: In response to Dr Richardson, at the planning stages of the trial we sought to ensure that we provided an intensive and comprehensive program of care for adolescents in the lifestyle group. This included monitoring by an adolescent physician and a bariatric physician, but not pharmacotherapy because there is still an insufficient evidence base for its use in the long-term care of adolescents.

The adequacy of the lifestyle intervention can be judged by the outcomes. The patients in the lifestyle group achieved weight loss that was at least comparable with that achieved in other published trials.1 The lifestyle group lost a mean of 6.2 kg at 12 months but then regained to a 3 kg weight loss at 24 months. We are not aware of studies that have had better outcomes than this.1 This is a very wide gap when compared with the mean weight loss of 34.6 kg in the gastric banding group.