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Healthy Balance

New Guidelines for Patients Considering Weight Loss Surgery

Peter T. Hallowell, MD, a surgeon and the director of the bariatric program at UVA, contributed this post.

Obesity has become an epidemic in America.

More than a third of Americans are obese, meaning their weight could be hurting their health. Obesity increases the risk for chronic health conditions, including:

  • Diabetes
  • Heart disease
  • Cancer

For most people who are obese, or simply overweight, the first step toward weight loss should be a healthy diet and exercise. But some severely overweight people may find that diet and exercise are not enough. For these people, gastric banding might be an option.

Weight-Loss Surgery: New Possibilities

The federal Food and Drug Administration (FDA) has broadened the eligibility guidelines for a surgical procedure called gastric banding that can help obese people who have tried to lose weight and failed.

How have the FDA recommendations changed?
Previously, the FDA recommended the procedure for people with a body mass index (BMI) of 40 or more, or those with a BMI of 35 or above with a serious weight-related medical condition. (BMI is an estimate of body fat based on height and weight.)

Now, after reviewing the safety and effectiveness of gastric banding, the FDA has relaxed the guidelines, opening the surgery to people who have:

  • A BMI of 30 to 34
  • A minimum of 30 pounds to lose
  • A serious weight-related condition

What is Gastric Banding?

This minimally invasive procedure installs a silicone band around the top portion of the stomach. This limits the amount of food you can consume, so you feel full faster.

How Is Banding Different from Gastric Bypass?

Compared with gastric bypass, the most common weight-loss surgery in the nation, banding:

  • Has a low risk of complications
  • Can be reversed
  • Is less invasive

Like all medical procedures, there are risks, and the procedure may not be right for everyone. Consultation with an experienced team is recommended.

Gastric banding is not a magic bullet:

  • You must have already tried to lose weight through diet and exercise
  • You have to be willing to carry through with lifestyle changes after surgery
  • The band may require periodic adjustment after surgery (this is done by injecting saline solution into a port under the skin).


It’s important to remember that these FDA guideline changes are new. Many insurance companies may not pay for the surgery for those with a BMI of 30 to 34. If you need your insurance to cover the procedure, it’s important to check with your insurance provider before proceeding.

Bariatric Surgery Experience at UVA

Gastric banding is just one of the bariatric surgeries available at UVA. Our bariatric surgery program is the only program in Central Virginia recognized by the American College of Surgeons as a Level 1a Accredited Bariatric Center of Excellence. That guarantees patients will get care from a team that’s nationally recognized for providing the highest levels of care to bariatric patients for more than 25 years.

Have you or do you know anyone who has had gastric banding? We’d love to hear your story.

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