The National Obesity Surgery Centre

As America’s waistlines expand so does the demand for weight loss by gastric banding. The question now is whether gastric band surgery is right for teens as well as adults?

The 30-60 minute procedure can trigger significant weight loss and is reversible. It is considered to be a less  invasive alternative to the gastric bypass. The surgery is approved for adults but many teens already get it on an ’off label’ basis.

There is little doubt that the surgery is effective. According to ABC News teens who underwent gastric band surgery lost 10 times more weight than teens who embarked on a regime of diet and exercise. But data from an ongoing study suggests that gastric bands are less effective for teens than adults.

CBS News

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The gastric band is a medical device, not a magical device. In other words, the gastric band will aid the patient but it will not do all of the work. Success with the gastric band depends on patient compliance. Some teens will be mature enough to work with it but others will not. At the National Obesity Surgery Centre we consider patients over the age of 16 years for a gastric balloon but you must be over 18 years for a gastric band.

Imagine the scene. It’s after dinner and you are already full. Then someone puts a luscious chocolate confection in front of you. The sight and the smell and even the word “cake” stimulate the reward and pleasure circuits of the brain. These reactions mask the signals from the stomach that tell you that your dinner is not yet digested and you are already full.

Scientists are now using sophisticated brain imaging technology to understand how the lure of food can overwhelm the body’s built-in mechanism to regulate hunger and fullness. This is called ‘hedonic’ versus ‘homeostatic’ eating. One thing is clear. Obese people react much more hedonistically to sweet and fat laden foods than healthy weight people do.

In a study presented at the International Conference on Obesity in Stockholm, researchers showed pictures of high calorie, fat laden foods to ten obese women and ten non-obese women and monitored their brain reactions on MRI scans. In the obese women, the images triggered a strong response in the ventral tegmental area. This is a tiny spot in the mid brain where dopamine, the ‘desire’ chemical is released.

When obese people see high-calorie food, a network of brain areas involved in reward, attention, emotion and memory are activated. The areas communicate with each other, making it very hard to resist. Similar reactions occurred in the obese subjects when they heard the words “chocolate brownie” – but not when they heard about lower calorie foods such as cabbage and carrot.

If you are of normal weight, your homeostatic mechanisms are controlling this area of the brain. In the overweight group, there is some sort of dysfunction in the homeostatic signal. Studies have found that a diet of sweet, high fat foods can blunt the body’s built in fullness signals.

Wall Street Journal

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Interesting. Looks like the neuroscientists might finally be the people to discover the answer to the problem of obesity. But how many years will it take?  In the meantime, we have not found a better, more successful method of weight loss and weight maintenance than the gastric balloon and the gastric band.