This procedure is a combination of the Roux-en-Y gastric bypass and the once common Vertical Banded Gastroplasty. In this operation, the implantation of a plastic band around the stomach pouch (resulting in significant restriction of food intake) in addition to the changes of absorption seen from the gastric bypass, may have been associated with 20% more excess weight loss than one would expect from gastric bypass alone. Therefore, expected weight loss is 60-90% of a patient's excess weight.

Banded Gastric Bypass is being offered as a prospective randomized and double blind trial to patients who are suffering from malignant obesity. Malignant obesity, defined as a body mass index of 50 or greater (approximately 200 pounds or more over ideal body weight) is associated with decreased quality of life, many illnesses and an increased risk of dying that has been estimated at 5-10 times greater than normal weight patients.

This research study involves the implantation of a plastic band around the stomach pouch during a standard gastric bypass procedure. The band is made of polypropylene mesh, commonly used for hernia repair as well as in Vertical Banded Gastroplasty. Patients are assigned at random (like the flip of a coin) to have the standard gastric bypass operation or the experimental procedure with a band around the stomach pouch. Patients are not told which operative group they belong to until two years after surgery. The Nurse Practitioner conducting follow-up evaluations will also be uninformed as to which group patients belong.

At this time, Banded Gastric Bypass is only being offered at our center as part of this study. If results from this study show a benefit, this may be offered outside the study in the future.