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Laparoscopic Gastric Banding vs Lifestyle Intervention in Severely Obese Adolescents

Larry A. Richardson, MD
JAMA. 2010;303(23):2356. doi:10.1001/jama.2010.781.
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To the Editor: In their randomized controlled trial, Dr O’Brien and colleagues1 assessed the effectiveness of laparoscopic gastric banding compared with lifestyle intervention in achieving weight loss in severely obese adolescents. The trial would have been more credible had the study compared gastric banding with a structured nonsurgical, medically managed weight loss program.

The lifestyle group in the study was allowed a wide variation of diets, as well as inadequate exercise requirements and little physician supervision; it was not offered a comprehensive weight management program, which should include counseling on diet and nutrition, exercise, behavior, and prescription medications if needed. The gastric banding program was based on a much more structured system, including specific protein-rich meals and periodic band adjustments. Had the lifestyle group received adequately clinical monitoring, the results may have been quite different.


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June 16, 2010
Paul E. O’Brien, MD, FRACS; Susan M. Sawyer, MD, FRACP; John B. Dixon, MBBS, PhD, FRACGP
JAMA. 2010;303(23):2356. doi:10.1001/jama.2010.782.
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