Monday, March 31, 2008

Obesity, Diabetes -The Next Big Thing in Elective Surgery: Health Industry Bands Together to Reduce Obesity and Its Complications.

What: Johnson & Johnson, Allergen, Inc, venture capitalists, surgeons, and outpatient surgery centers have banded together to promote the use of silicon gastric bands to address problem of morbid obesity, defined as 100 pound overweight, and its myriad complications – diabetes, hypertension, catastrophic cardiovascular events, heart failure, sleep apnea, and osteoarthritis of knees Gastric banding exploded 50% last year to 200,000 procedures per year, up from 35,000 in 2000, a 6 fold increase.

Why: Gastric banding fills a huge niche (no pun intended) in elective surgery field. It is relatively safe, relatively non-invasive, relatively free of complications, cheaper than gastric bypass ($17,000 v. $25,000), can be performed in an outpatient setting, is easy for surgeons to learn, does not change the basic plumbing of the GI tract, may be as effective as bypass surgery, and lessens and may even cure the diabetes that accompanies morbid obesity, and addresses a gaping need – one 1% of morbidly obese people have undergone surgery.

When: Surgeons in Europe and Australia introduced gastric bands in the 1990s. In last two years, the number of procedures has expanded dramatically since Johnson & Johnson, Botox-maker Allergen, Inc, and venture capitalists have began heavily promoting its use through websites, direct consumer ads, surgeon-training programs, and capital provision. Gastric bands are also being marketed via roadside billboards, the Internet, radio, TV, and on “Dr.Phil” and “Oprah Winfrey” programs.

Surgeons make tiny incisions, snake in a camera, and through video manipulation, wrap a band of silicon around the upper stomach, limiting the stomach size as a receptacle for food. The band may be periodically adjusted depending on patient response and weight loss.

Where: Training sessions are conducted nationwide, but biggest markets to date have been in Texas and California, and other entrepreneurial-minded environments.

Who: The number of procedures has grown enormously since Medicare, the Blue Cross Blue Shield Association, TriCare, and other insurers have started paying for procedures. It is said avoidance of complications, drugs, and diets justifies cost.


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