Does Lap-Band Work on Low BMI but Overweight People?

Hello,
Thank you for your excellent question. You are wise to consider options to improve your health and reduce your risk of the obesity-related health disorders that run in your family.
While insurance will typically not cover the lap band for patients with a BMI under 30, patients in this BMI category may stand to benefit from the procedure (through weight loss and lifestyle modifications.) There are certain situations, I offer the lap band to patients in this category, and their health typically improves as a result.
While there are many excellent surgeons outside of the United States, I caution you that neither patients nor physicians have the same protections of standards of institutional safety that are enforced in the US.
A video appointment with a bariatric surgeon will help you better understand the risks and potential benefits of the lap band in your specific situation.
Best regards,
Dr. Moein

In my opinion, the risks are generally not worth the benefits when compared to other methods of weight loss. To the best of my knowledge, bariatric surgeons reserve this option for people who are significantly higher than their ideal body weight (approximately 80 lbs on average). However, the indications may vary according to percieved risks and benefits in individual cases. Seek qualified surgeons and obtain at least two opinions plus the advice of a nutritionist.

Lap Band surgery is designed to lead to safe and sustained weight loss for individuals who are overweight or obese.    If someone has a BMI within the normal range is it unlikely that there would much benefit derived from the procedure.  Although Lap Band surgery is a very safe procedure, it would only be advised if there was benefit to be obtained.  It is unlikely that someone with a BMI in the normal range would achieve substantial weight loss, nor would that necessarily be desirable.  Therefore the Lap Band is not approved for use (in Canada) unless the BMI is greater than 30 with health issues related to the weight (co-morbidities) or all individuals with BMI greater than 35.

If you have a low BMI such 32 to 35 and diabetes and high triglycerides you may want to consider a more metabolic operation such as gastric bypass.  If you have metabolic conditions such as diabetes at a low BMI then the lap band may not work well for you.  Please consult with a bariatric surgeon that performs all operations on a routine basis to see what is best for you.

The FDA recently approved the use of the Lap-Band in lower BMI patients.  The Lap-Band is the lowest risk weight loss surgery procedure currently available.  Most insurance companies will not cover surgery in patients with a BMI of 30 - 35.  Non-surgical diets have very high failure rates.

the lap band has FDA approval for BMI 30-40 with a weight related illness; but it can help patients with lower bmi's in certain instances, but note that this would be considered an "off label" use of the device, and as such, you would be paying for this out of pocket, and be financially responsible for costs of treatment for complications from the band.  so in general, yes it can help, but there is the reality of financial responsibility

I think that the Lap Band is a weight loss solution that works most effectively on patients who need to lose less than 100 lbs.  It can be extremely effective for overweight patients who need to only lose 20-30 pounds, but have not found success with diet programs or weight loss medications.  Unfortunately,  insurance will not cover the procedure at BMI less than 35.  Another safe and effective option for patients with BMI 25-30 is the newly-approved stomach balloon.  

The Lap-Band is the only FDA approved device for low BMI patients. But, now for a BMI of 28. However, I would strongly suggest you see a lap-band surgeon - because often people weigh more than they think and are shorter than they think- so you may fit into the guidelines recently approved by the FDA. In terms of a more "metabolic" operation - the research shows the Lap-Band has every bit of an effect as the more invasive operations.

The FDA recently ruled that banding is safe may be effective for patients with lower BMI than previously recommended.  The previously accepted lower limit has been 35.  That limit has now been lowered to 30.

This does NOT mean that your insurance company will pay for your surgery.  No insurance company will cover bariatric surgery unless you meet the NIH Guidelines:  BMI of 40 or greater, or BMI of 35-40 with comorbidities.

I will also caution you to research the procedures carefully.  Yes, it's true that gastric banding is minimally invasive and safe, but it is also a fact that success rate for this procedure is lower than for any other weight loss operation.  It also has the highest reoperation rate and LOWEST rate of patient satisfaction.