Individuals with diabetes often associate gastric banding with fewer complications and lower prices over the long run than gastric bypass, the most frequently performed and cheapest weight loss surgery in the U.S., researchers say. Both processes reduce the quantity of care desired and related health care costs for individuals with type 2 diabetes in the months immediately following operation. But by four years later, heath care use and costs increased for patients who underwent bypass surgery, while continuing to decline among those who got banding, says researcher Jason Lebowitz, a PharmD candidate at the University of Southern California in Los Angeles. Allergan Inc. which makes the Lapband laparoscopic gastric banding apparatus, financed the research.
Considering Pros and Cons of Cheapest Weight Loss Surgery
Specialists say the research demonstrates why it is essential for people considering weight loss surgery to comprehend the tradeoffs.
Other studies have shown that bypass surgery appears to help patients lose more weight. It may also help treat diabetes more effectively than banding, says Philip Schauer, MD, professor of surgery at the Cleveland Clinic Lerner College of Medicine. He wasn’t involved with the new work.
Bypass operation additionally seems to function nicely over the long run, he tells. In a recent study, 89% of people with type 2 diabetes who underwent gastric bypass surgery went into remission. 57% were still in remission after five years. Bypass may offer more stunning results because the process reroutes digestion, avoiding some of the small intestine, he says.
Banding does tend to be the cheapest weight loss surgery and also safer, at least in the short term. About 1% to 2% of patients have short-term complications, compared to 5% of bypass patients, Schauer says. On the other hand, the weight loss from banding processes is smaller, he says.
“In general, if diabetes is quite intense, and a patient is on several drugs. He’ll need a more powerful process like bypass,” Schauer says. “But we are still striving to comprehend which process works better for which patient. We do not have the correct equilibrium defined.”
Higher Prices of Bypass Weight Loss Surgery
Lebowitz and colleagues hypothesized that patients’ prescription and medical claims might serve as a proxy for how well each procedure performed over the long run.
So they analyzed prescription claims and other medical records from almost 2,900 individuals with type 2 diabetes who underwent weight loss surgery. 2,537 had bypass operation and 329 had a banding process.
In the year before the process, individuals who experienced banding filled a mean of 21 prescriptions; by the year later, the amount had dropped to 16 and by year four, to 13.
By comparison, individuals who’d bypass operation average a mean of 28 prescriptions in the year before the process; by the year later, the amount had dropped to 19 and by year four, it crept back up to 20.
The typical variety of hospital visits dropped 25% over a four-year span in the banding group; while rising 15% in the bypass group.
By year four, the banding patients were spending more than $4,000 on their care; while bypass patients spent more than $9,000.
What’s the Conclusion?
The researchers hypothesize the higher prices related to bypass resulted from surgical complications and issues associated with poor absorption of nutrients and drugs after digestion is rerouted.
The study didn’t consider the price of the operation itself, which is about $20,000 to $30,000 for either process, says Ted Okerson, MD, senior medical director for apparatus at Allergan Inc. in Irvine, Calif. It’s definitely not the cheapest fat loss surgery out there.
One of the study’s weakness is that it didn’t take into account how ill a patient was or how many other states he’d. As an example, some studies have indicated that sicker patients, who’d presumably have higher health care prices and want more attention, are more likely to have bypass operation.