Weight-loss gastric band complications, removals on the rise in Canada

CTV National News: Warning about weight loss Gastric bands, a popular surgery for weight loss, can have drastic side-effects and serious medical consequences. Avis Favaro reports.

After many failed diets, Julie Bick turned to bariatric surgery in a desperate bid to lose weight.

The 50-year-old nurse and grandmother in Cobourg, Ont., had hoped that a gastric band, designed to temporarily reduce the size of her stomach, would help her shed pounds. Instead, she ended up feeling sick and miserable, suffering from constant indigestion and an unusual cough after undergoing the procedure in 2013.

Tests showed that Bick’s gastric band, which was supposed be around her stomach, was actually tightly wrapped around her esophagus, causing gastric reflux and other problems.

“Of course, I was angry,” Bick told CTV News. She had spent $16,000 to have the gastric band put in place at a private clinic.

Bick’s story is increasingly common across Canada. Gastric bands promoted and sold as weight loss devices by private clinics are becoming a public health problem.

Doctors have no idea how many Canadians have had the gastric bands put in because the procedures are usually done outside of the publicly funded health care system.

But data from the Canadian Institute for Health Information (CIHI) show that the number of gastric band removal procedures performed in Canada jumped from 113 in 2010-11 to 619 in 2016-17.  (The data does not include procedures performed in Quebec).

“We are certainly seeing lots of patients now who are having gastric bands removed for one reason or the other.” Dr. David Urbach, a bariatric surgeon at Women’s College Hospital in Toronto, told CTV News.

“Often it is a consequence of them not working in the long run or having side-effects. (The bands) are not meant to be a lifetime intervention,” he said. “As surgeons we are seeing more and more patients who have gastric bands that need to be removed.”

Bick eventually asked doctors to remove her gastric band and perform a gastric bypass surgery, a more permanent weight loss measure that divides the stomach and rearranges the small intestine. Three weeks after the operation, she has lost 35 pounds.

“What I learned about gastric bands is that it doesn’t always work,” Bick told CTV News. “It’s not foolproof…it’s not a long-term solution.”

Public health care costs

Some gastric band removals result in long hospital stays, and big costs to the public health care system.

Jamie, a B.C. woman who asked CTV News not to use her last name, had a gastric band implanted in 2005 to help her lose weight. She was 23 and weighed about 300 pounds at the time.

But this May, Jamie started having problems that sent her to the emergency room three times.

“I was vomiting, I had horrible chills, I would be shaking,” she told CTV News.

On Jamie’s fourth ER visit, doctors discovered that the gastric band had created a hole in her stomach. They had to remove the band from the hole and close it, but that led to more complications. After spending more than two weeks in hospital, she is now improving.

Jamie said she paid $12,000 for the Lap-Band device in 2005, but doctors estimate that her hospital stays and procedures probably cost the health care system well over $100,000.

Both Bick and Dr. Urbach said it’s unfair that the public health care system is now on the hook for complications related to procedures performed in private clinics.

“It is a little bit unfair that a private clinic can perform these procedures and if there are downstream problems it is really the public system that becomes responsible for caring for the patients and for paying for costs of care down the road,” Dr. Urbach said.

Although gastric bands are less popular now than in previous years, Jamie said she wants people to be aware of all the risks involved.

Jamie is planning to join a proposed class-action lawsuit against Allergan Inc., the maker of the Lap-Band device.

“We have been contacted by dozens of people who have been implanted with this device. We believe, however, that there are many more patients out there in Canada who are simply unaware of this lawsuit,” lawyer David Moriarty of Rosenberg Kosakoski LLP, the firm spearheading the legal action, told CTV News.

The proposed class-action lawsuit, filed in a B.C. court, has not yet been certified by a judge and none of the allegations in it have been proven in court.

In an email to CTV News, Dr. Laurent Biertho, the president of the Canadian Association of Bariatric Physicians and Surgeons (CABPS), said that gastric bands are “definitely being used less often.”  Some private clinics continue to offer the bands, which are still endorsed by international bariatric societies because they are reversible.

Doctors say better options include gastric bypass surgery, which is permanent but offers better long-term weight control. Another procedure being offered is a sleeve gastrectomy, which also surgically reduces the size of the stomach to about 15 per cent of its original size. It is also irreversible and provides a long-term weight loss solution.

With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St. Philip