June 2008 Issues

American Society for Metabolic and Bariatric Surgery (ASMBS)

Summary: Obesity procedures were predicted to increase an average of 11% in 2008 over 2007. ♦ Gastric sleeves are catching on very quickly, and they are likely to cause total gastric band usage over the next year to decline, while gastric bypass procedures are expected to grow slightly. ♦ Bariatric surgeons are happy with, and loyal to, Allergan’s Lap-Band, but many are getting trained on J&J’s Realize because they have seen – or expect – patient demand for Realize as a result of J&J’s direct-toconsumer advertising. Thus, Lap-Band sales are likely to be hit by both sleeves and Realize. ♦ Gastric bypass safety is improving, and long-term complications of bands are increasing. ♦ Data are building that obesity surgery can cause significant remissions in diabetes, but data from large, randomized clinical trials are needed, including how long the effect lasts. Insurance coverage for bariatric procedures to treat diabetes in overweight but not obese patients is unlikely in the next 5 years. ♦ Sources were dubious about the outlook for EnteroMedics’ VBLOC, an electrical vagus nerve block system.