A randomised control trial of medical treatment versus the placement of the Lap Band in severely obese adolescents.

在我们的社会中，超重和肥胖的青少年人数大幅增加。虽然预防肥胖是最终目标，但必须寻求有效的策略来管理肥胖青少年。不幸的是，很少有研究关注青少年的这一问题，而且成功的情况也非常有限。现代肥胖手术是实现和维持严重肥胖(体重指数35 kg-m2)成年人主要体重减轻的唯一可靠方法，现在有几项小型研究证明了它在青少年中的有效性。现代的肥胖手术，包括在胃的最上部放置一个可调节的带子，已经被证明是安全有效的，需要住院24小时。在这项涉及莫纳什大学肥胖研究和教育中心和皇家儿童医院的合作研究中，我们提议首次正式测试包括可调腰带手术在内的减肥计划的有效性，并将其与全面的最佳护理行为计划进行比较，为期两年，针对严重肥胖的青少年。我们估计，合适的受试者将来自我们社区中体重指数最高的1%。经过彻底评估后，50名年龄从14岁到18岁的合适候选人将被随机分配到两个治疗计划中的一个。每个项目的强度都将是相似的。在完成为期两年的计划之前和结束时，将进行广泛的测量，包括：体重、健康状况、身体残疾、心理状况、身体形象和生活质量。此外，我们还将比较这两个项目的并发症、合规性和成本。这项研究将帮助我们评估和比较这两个方案的有效性，并提供有关现代锁孔肥胖手术在严重肥胖青少年管理中的作用的重要信息。

There has been a substantial rise in the number of overweight and obese adolescents in our community. While prevention of obesity is the ultimate goal, effective stratagies for the management of obese adolescents must be sought. Unfortunately there are few studies that have focused on this problem in adolescents and success has been very limited. Modern obesity surgery is the only reliable method of achieving and sustaining major weight loss in severely obese (body mass index > 35 kg-m2) adults and there are now several small studies that demonstrate its effectiveness in adolescents. Modern obesity surgery involving the keyhole placement of an adjustable band around the very upper part of the stomach has proven to be safe and effective and requires one 24 hr stay in hospital. In this collaborative study, involving the Monash University Centre for Obesity Research and Education and the Royal Children's Hospital, we propose to formally test, for the first time, the effectiveness of a weight loss program that includes adjustable band surgery, and compare this with a comprehensive best care behavioral program, over a period of 2-years in severely obese adolescents. We estimate that suitable subjects will come from the top 1% for body mass index in our community. After thorough assessment 50 suitable candidates with ages ranging from 14 to 18 years will be randomly allocated to one of the two treatment programs. The intensity of each program will be similar. A broad range of measues including: weight, health status, physical disability, psychological status, body image and quality of life, will be performed before and at completion of the 2-year programs. In addition we will compare the complications, compliance and cost of the two programs. This study will help us assess and compare the effectiveness of the 2 programs and provide vital information regarding the role of modern keyhole obesity surgery for the management of severely obese adolescents.