The growing obesity epidemic in the U.S. has hit teens pretty hard. There are several serious interventions that can help people lose weight, including surgery. All of the options for weight loss open to adults aren't open to teens — at least not yet.

Gastric banding is being promoted as a safer and less invasive alternative to gastric bypass surgery. Sometimes called by the product name, Lap Band, gastric banding involves slipping a small, inflatable silicon ring around the upper part of the stomach. Surgeons make tiny incisions, and insert the band using a laparoscope. The band is tightened or loosened by adjusting the saline-filled balloon lining the inside of the band. A small access port is implanted below the abdominal wall, and the doctor can add or remove saline from the band via a syringe. This port is largely unnoticed by the patient. The stomach pouch is now very small. The patient's appetite is suppressed and they feel full on far less food.

Gastric banding is not currently approved by the Food and Drug Administration for use in adolescents in the U.S. However, several clinical trials have been done using the device on obese teens with good results. It is expected that the FDA will approve the Lap Band this year for use in teens aged 14 to 18. In studies, much like with gastric bypass surgery, obesity-related diseases (such as type 2 diabetes, hypertension, and hyperlipidemia) were either completely reversed or significantly improved in adolescent patients.

Some physicians consider gastric banding safer than gastric bypass because there is no risk of gastric or intestinal leak, and since the small intestines is not bypassed key nutrients continue to be absorbed. It is less invasive, but nutrient malabsorption could be a problem with some banding patients, same as with gastric bypass patients, and could have an effect on a teen's growth and development. Gastric bypass surgery patients initially lose weight faster, but by three years post-surgery, the weight loss is about equal for both bypass and banding patients.

Earlier this year, the Journal of the American Medical Association (JAMA) published a government-sponsored study done in Melbourne, Australia, which detailed how 50 obese teens, aged 14 to 18, lost 76 pounds within two years of having gastric banding surgery. Obese teens in the control group lost only 6.6 during that time pounds through diet and exercise. The lap bands were donated by the device's maker Allergan, which is currently conducting clinical trials in the U.S. with teens using their lap band.

JAMA editors noted that in the results of the Australian study, while promising, did have complications that were a cause for concern. Specifically, seven of the teenage participants had to have re-operations. Another unexpected side effect of the Australian study was several pregnancies. Evidently, the weight loss sparked sexual activity in young people who, due to their weight, had been sexually inactive. The researchers believe sex counseling may be a good idea for formerly obese young adults.

The gastric band costs slightly less than gastric bypass at approximately, $12,000 to $25,000. Patient preparation, in terms of counseling, weight loss education, and adoption of a healthy diet and exercise regimen, is the same as with gastric bypass patients.