Adolescent obesity has been on the rise in the last few years: around 17.4% adolescents in the U.S. were obese in 2004, an increase from 14.8% in 2000. It is associated with several health effects such as Type 2 diabetes, obstructive sleep apnea, hypertension, as well as serious psychosocial disabilities. Obese adolescents have lower life expectancy than average weight ones.

Some experts argue that the solution for adolescent obesity lies in lifestyle programs that address changes in diet, exercise, and behavior in order to promote weight loss. However, recent evidence suggests that most of these programs are ineffective in producing substantive weight loss. Many adolescents also regain some or most of the weight after the program is over.

A new study published last week in the Journal of the American Medical Association suggests that gastric banding, also known as lap-band surgery, might be very effective in helping obese adolescents lose excessive weight and improve their health and quality of life.

There are two types of weight loss surgeries: gastric banding and gastric bypass. While gastric bypass is more common, gastric banding is generally less invasive, safer, and has a low complication rate. It is called a “restrictive surgery” because the surgeon uses a special technique to reduce to the size of the stomach.

Typically, in a gastric banding surgery, the surgeon places an adjustable silicone band around the upper part of the stomach. The silicone band squeezes the stomach to become a pouch with about an inch-wide outlet that can only hold about an ounce of food. The band can be tightened or loosened through injections of saline (sterile salt water) through the skin. If necessary, the procedure can be reversed and the stomach generally returns to its normal size in time.

Gastric bypass surgery, on the other hand, combines the creation of a small stomach pouch to restrict food intake and construction of bypasses of segments of the small intestine to reduce calorie and nutrient absorption.

In the study, 50 obese adolescents in Australia were assigned either to a supervised lifestyle intervention or to undergo gastric banding, and were followed up for two years. While weight measures and health status improved in both groups, the extent of the weight loss was substantially greater for those in the gastric banding group, which also showed improved health and quality of life. Those in the lifestyle group were not able to achieve substantial weight loss. In the gastric banding group, however, 84% achieved more than 50% of excess weight loss and the effect was durable over the two years of follow-up.

The authors of the study warn though that “the gastric banding approach to weight loss is not a quick fix. For optimal effectiveness, it requires long term supportive follow-up by trained health professionals.”