Lap-Band maker targets teenagers

Reported May 22, 2011

With sales of its Lap-Band weight-loss device declining, Allergan Inc. has its eyes on a new set of potential customers — overweight teenagers.

The Irvine company has asked the Food and Drug Administration to approve Lap-Band surgeries for adolescents as young as 14, and is conducting clinical trials on teenage patients, said Cathy Taylor, a company spokeswoman.

Allergan says the device — a silicon ring fitted around the stomach to reduce food intake — has proved a safe and effective way for obese adults to shed pounds. With an estimated one-third of U.S. children now overweight, the benefits should be extended to teenagers, Taylor said.

"We identified a significant need with this patient population in terms of the increasing rate of obesity in younger populations," Taylor said. "Obesity, if left untreated, correlates to life-threatening diseases."

But many doctors and health experts are concerned that there are not enough data about the Lap-Band's long-term safety and effectiveness, something that would be particularly relevant when considering the device for children.

"It's hard to imagine taking a device … and putting it around the stomach and giving it a warranty for 50 or 60 years," said Mary Brandt, head of adolescent bariatric surgery at Texas Children's Hospital in Houston.
 

Brandt said she believes gastric bypass, surgically shrinking the stomach, is a better option because it does not require installing a foreign object in the body.

A recent European study found that many adult Lap-Band patients had "relatively poor long-term outcomes" and required additional surgeries to have the devices removed or replaced. Allergan took issue with that study, saying it was based on too small a pool of patients and that the device has been improved in recent years.

The procedure is performed under general anesthesia, and complications can occur. In the last two years, four Southern California adults have died within days of undergoing Lap-Band surgery.

Health experts said Lap-Band surgery should be a last resort for the morbidly obese, only after less radical methods, such as diet and exercise, have been exhausted.

"I'm concerned that FDA approval would send the wrong message, that this is a safe way to lose weight," said Diana Zuckerman, president of the National Research Center for Women and Families. "There are risks to this."

Doctors can already perform Lap-Band surgery on minors whose parents give their consent. FDA approval would allow Allergan for the first time to market the product for use on adolescents, said Jeffrey Gibbs, a former FDA attorney now in private practice in Washington specializing in medical device law. And it could make it more likely that insurers would pay for it, Gibbs said.

Taylor Blackburn of Palmdale had the Lap-Band installed in 2008, at age 14. Two years later, the Palmdale teenager had it removed after experiencing stabbing abdominal pains and diarrhea, her mother, Susan Blackburn, said.

"She got zero results. She was gaining weight," Blackburn said. "It was very discouraging for her."

Taylor Blackburn underwent gastric bypass surgery last year. She has lost 70 pounds, her mother said.

Allergan spokeswoman Cathy Taylor declined to comment, saying it "wouldn't be appropriate for us to comment on a patient when we are not privy to all the details."

More generally, Allergan executives have said the Lap-Band has proved effective at helping patients lose weight safely and has advantages over some other bariatric surgeries. Unlike bypass surgery, Lap-Band surgery is relatively easy to reverse and has a lower mortality rate, said Allergan Chief Executive David E.I. Pyott.

Jacy Johns, a Jacksonville, Fla., student, got the Lap-Band at her mother's urging when she was 15. She said it has transformed her life for the better.

Johns had tried Slim-Fast and Atkins diets without success. Before her June 2008 surgery, she weighed 225 pounds at 5 feet, 5 inches and looked to be developing diabetes. Afterward, she lost 95 pounds and joined her high school cross-country team. She recently attended prom.

Credits: By Stuart Pfeifer, Los Angeles Times and details at
http://www.latimes.com/health/la-fi-lap-band-teens-20110524,0,7353694.story