Status checked on October 6, 2026 accessdata.fda.gov
The Lap-Band (adjustable gastric band) explained: how it works, FDA approval history, long-term weight and diabetes results, why it declined, risks and reoperations, what to do if you have one, cost and insurance.
Fact-checked against FDA labels and official sources; not yet reviewed by a licensed clinician. This page is education, not medical advice. Talk to your doctor before starting, stopping or changing any treatment.
Key facts
- Type
- Medical
- Approach
- Surgical
- Sedation
- General anesthesia (laparoscopic surgery)
- Permanence
- Revisable
- Device status
- LAP-BAND Adjustable Gastric Banding System · PMA approval
- Performed by
- Bariatric surgery
Key takeaways
- The FDA approved the LAP-BAND in 2001 (PMA P000008) and expanded its use to BMI 30-34 with a condition in 2011.[1]
- U.S. band procedures fell from 55,932 in 2011 to 773 in 2023.[5]
- Average total weight loss five years after a band was 11.7%, versus 18.8% after sleeve and 25.5% after bypass.[7]
- About 26% of band patients had a bariatric reoperation within seven years in LABS.[8]
- The band has the lowest risk of vitamin deficiencies and is reversible.[4]
In short: The Lap-Band is an adjustable gastric band: an inflatable silicone ring placed around the top of the stomach to create a small upper pouch, which can be tightened or loosened after surgery. The FDA approved it in 2001, and it was once one of the most common weight-loss operations in the U.S., with about 56,000 bands placed in 2011. By 2023 that number had fallen to 773, because the band leads to less weight loss than the sleeve or bypass and often needs another operation later. It remains FDA approved and covered by Medicare, and it is reversible with the lowest risk of vitamin shortages, but most surgeons now offer other operations first.
This page explains how the band works, its FDA history, what long-term studies found, why it declined, the risks, what to do if you already have a band, and costs. It is education only; InstaTuck does not sell or arrange surgery. Talk with a licensed doctor and get evaluated at an accredited program before any decision.
Lap-Band at a glance
- June 5, 2001FDA approval of the LAP-BAND system (PMA P000008)FDA PMA database
- 55,932 to 773bands placed in the U.S., 2011 vs 2023ASMBS estimates
- 11.7%average total weight loss 5 years after a band (vs 25.5% after bypass)PCORnet, Annals of Internal Medicine 2018
- About 26%of band patients had a bariatric reoperation within 7 yearsLABS, JAMA Surgery 2018
Checked on October 6, 2026
What the Lap-Band is and how it works
In a laparoscopic operation under general anesthesia, the surgeon places a silicone band around the upper part of the stomach, leaving only a small portion above it for food, as the FDA describes it. Because the band is inflatable, it can be adjusted after surgery to change how tight it is, which affects how quickly food passes and how soon a person feels full. Nothing is cut or rerouted, so the band can be adjusted or removed. The NIH notes that it requires frequent follow-up visits for adjustments and leads to less weight loss than other types of surgery.
ASMBS lists the band’s advantages as the lowest rate of early complications, reversibility, going home the day of surgery and the lowest risk of vitamin deficiencies. Its disadvantages are frequent adjustments, slower weight loss, the risk of band slippage or erosion into the stomach, high reoperation rates and possible swallowing problems.
FDA status
The LAP-BAND Adjustable Gastric Banding System was approved through premarket approval (PMA P000008) on June 5, 2001, for adults with severe obesity and a BMI of at least 40, or at least 35 with one or more severe obesity-related conditions, or 100 pounds or more over ideal weight, who had not succeeded with supervised diet, exercise and behavior programs. The approval order adds that patients must commit to significant, lifelong changes in eating habits. On February 16, 2011, the FDA expanded the indication to adults with a BMI of 30 to 34 who have at least one obesity-related condition and have not lost weight with non-surgical methods. In the study behind that expansion, 80% of patients lost at least 30% of their excess weight and kept it off for a year, results varied widely, more than 70% had device-related side effects (most often vomiting and difficulty swallowing), and 7 of 149 needed another procedure, including 4 band removals. The FDA’s device database lists Medtimo, Inc. as the current holder of the approval, and the FDA’s weight-loss device page still lists the Lap-Band.
The band's history in five dates
- 2001FDA approves the LAP-BAND for BMI 40+, or 35+ with a severe condition.
- 2011FDA expands use to BMI 30 to 34 with an obesity-related condition; bands are about 35% of U.S. procedures.
- 2013ASMBS estimates show the sleeve as the most common operation, ahead of the bypass and the band.
- 2018Seven-year LABS results: 14.9% weight loss and about 26% reoperations with the band.
- 2023773 bands in the U.S., 0.3% of procedures.
Why the band declined
ASMBS estimates show the band falling from 55,932 procedures in 2011 (about 35% of the total) to 773 in 2023 (0.3%), while the sleeve rose from 28,124 to 157,254. An analysis of the national NSQIP database found the band’s share of first bariatric operations fell from 28.8% in 2010 to 3.1% in 2014 as the sleeve took over. The published data point to three reasons:
- Less weight loss. In the PCORnet study, average total weight loss was 13.7% at one year and 11.7% at five years after a band, versus 25.2% and 18.8% after a sleeve and 31.2% and 25.5% after a bypass.
- More reoperations. In LABS, 160 of 610 band patients (about 26%) had a bariatric reoperation within seven years, compared with 14 of 1,738 bypass patients.
- Smaller effect on diabetes. In LABS, 20.3% of band patients with diabetes were in remission at seven years, versus 60.2% after bypass.
| Item | Adjustable band | Gastric sleeve |
|---|---|---|
| 2011 | 55,932 | 28,124 |
| 2012 | 34,946 | 57,090 |
| 2013 | 25,060 | 75,359 |
| 2014 | 18,335 | 99,781 |
| 2015 | 11,172 | 105,448 |
| 2017 | 6,318 | 135,401 |
| 2019 | 2,375 | 152,413 |
| 2021 | 1,121 | 152,866 |
| 2023 | 773 | 157,254 |
Best estimates from available data.
Source: ASMBS, Estimate of Bariatric Surgery Numbers, 2011-2023 (checked on October 6, 2026)
| Item | 1 year | 5 years |
|---|---|---|
| Adjustable band | 13.7% | 11.7% |
| Gastric sleeve | 25.2% | 18.8% |
| Gastric bypass | 31.2% | 25.5% |
3,192 band, 29,693 sleeve and 32,208 bypass patients; observational.
Source: Arterburn D et al., Annals of Internal Medicine 2018 (PCORnet Bariatric Study) (checked on October 6, 2026)
What long-term studies found
The LABS study followed 610 band patients at 10 U.S. hospitals for up to seven years. Average weight loss at seven years was 18.8 kg (about 41 pounds), or 14.9% of starting weight, with little regain (1.4%) between years 3 and 7. Cholesterol problems were less common than before surgery, but diabetes and high blood pressure were not significantly lower after the band, unlike after a bypass. Diabetes remission among band patients was 30.7% at one year and 20.3% at seven years. The band does have the lowest risk of nutritional problems: the 2016 ASMBS guideline reports iron deficiency in 14% after a band, against 20% to 55% after a bypass, and the 2019 guideline lists one multivitamin a day as the minimum after a band versus two after other operations.
| Item | Adjustable band | Gastric bypass |
|---|---|---|
| 1 year | 30.7% | 71.2% |
| 3 years | 29.3% | 69.4% |
| 5 years | 29.2% | 64.6% |
| 7 years | 20.3% | 60.2% |
175 band and 488 bypass patients who had diabetes before surgery.
Source: Courcoulas AP et al., JAMA Surgery 2018 (LABS) (checked on October 6, 2026)
Risks and complications
Early risks are lower than with other operations: in PCORnet, major adverse events within 30 days were 2.9% after a band, versus 2.6% after a sleeve and 5.0% after a bypass. Over the long term, the NIH and ASMBS list band slipping (displacement) or erosion into the stomach, swallowing problems and vomiting, and the need for repeated adjustments and further operations. Because the band leaves the anatomy intact, alcohol-related risk appears lower than after a bypass: in LABS-2, having a bypass rather than a band roughly doubled the odds of alcohol use disorder symptoms. Ask your team about symptoms that need urgent care with a band in place, such as being unable to keep anything down.
If you already have a band
Many people still live with bands placed in the 2000s and 2010s. The 2019 AACE, TOS and ASMBS guideline recommends frequent nutritional follow-up and band adjustments after a band, and visits at about 1 month, every 1 to 2 months until stable, and then yearly. If weight returns, the guideline calls for an evaluation that includes checking whether the band still restricts; new symptoms such as vomiting or trouble swallowing are also a reason to see your team. Options then include adjustment, removal, or revision to a sleeve or bypass. For anyone with a band who becomes pregnant, the guideline says the band should be adjusted as needed for healthy weight gain for the baby.
Band, sleeve and bypass side by side
| Adjustable band | Gastric sleeve | Gastric bypass | |
|---|---|---|---|
| What is done | Inflatable band around the top of the stomach | About 80% of the stomach removed | Small pouch joined to the small intestine |
| Reversible | Yes | No | Difficult |
| Total weight loss at 5 years (PCORnet) | 11.7% | 18.8% | 25.5% |
| Major adverse events in 30 days (PCORnet) | 2.9% | 2.6% | 5.0% |
| Iron deficiency reported (ASMBS 2016) | 14% | Under 18% | 20% to 55% |
| Minimum multivitamins a day (2019 checklist) | 1 | 2 | 2 |
| U.S. procedures in 2023 (ASMBS) | 773 | 157,254 | 63,132 |
The table shows the trade-off that moved surgeons away from the band: it is the gentlest operation on the body and on nutrition, but it brings the smallest and least predictable weight loss, and many bands are later removed or converted. For someone who already has a band that works and causes no problems, regular follow-up and adjustment remain the guideline approach. Our sleeve vs bypass comparison and life after bariatric surgery guide cover the next steps for people weighing a change.
Cost and insurance
Medicare covers laparoscopic adjustable gastric banding nationally for people with a BMI of 35 or more, at least one obesity-related condition and previous unsuccessful medical treatment; open banding is not covered (NCD 100.1, checked on October 6, 2026). ASMBS gives an average cost range for bariatric surgery overall of $17,000 to $26,000, without a band-specific figure. With a band, budget for adjustment visits and the possibility of a later removal or revision. See our insurance hub and costs hub.
Alternatives
Today most people considering surgery compare the gastric sleeve and gastric bypass (see sleeve vs bypass). For those who want to avoid surgery, there are endoscopic options such as endoscopic sleeve gastroplasty and the temporary gastric balloon, and FDA-approved medicines such as Wegovy and Zepbound. The bariatric surgery guide compares every operation.
Who explores it
FDA labeling (PMA P000008): adults with a BMI of 40+, or 35+ with a severe obesity-related condition (2001), expanded in 2011 to BMI 30-34 with an obesity-related condition, after non-surgical methods have not worked.
How it works
An inflatable silicone band around the top of the stomach leaves a small pouch for food (FDA); it can be adjusted after surgery (NIDDK). Nothing is cut or rerouted.
Typical results
Average total weight loss 13.7% at 1 year and 11.7% at 5 years (PCORnet); 14.9% at 7 years (LABS). Diabetes remission 30.7% at 1 year and 20.3% at 7 years (LABS).
Ranges from published studies; individual results vary.
Recovery
Often same-day discharge (ASMBS); normal diet generally resumed soon after surgery (2019 guideline); frequent adjustment visits, about every 1 to 2 months until stable, then yearly.
Risks
- Band slippage (displacement) or erosion into the stomach (NIDDK, ASMBS)
- Swallowing problems and vomiting; more than 70% had device-related side effects in the 2011 expansion study
- High reoperation rates: about 26% within 7 years in LABS
- Need for frequent adjustments
- Major adverse events within 30 days: 2.9% (PCORnet)
FDA authorization
| Device | Pathway | Number | Date |
|---|---|---|---|
| LAP-BAND Adjustable Gastric Banding System | PMA approval | P000008 | June 5, 2001 |
Clearance (510(k)) means the FDA found a device similar to one already on the market; it is not the same as approval.
Cost and insurance
| Price | Amount | Basis | Checked on |
|---|---|---|---|
| Typical total (national data) | 17,000-26,000 USD | average cost range for bariatric surgery overall (ASMBS; not band-specific) | October 6, 2026 |
Prices change often and depend on pharmacy, plan and location. Insurance can change what you pay. Every price shows the date we checked it.
Medicare covers laparoscopic adjustable gastric banding nationally for people with a BMI of 35 or more, an obesity-related condition and previous unsuccessful medical treatment; open banding is non-covered.
Insurance information checked on October 6, 2026.
Advantages and limitations
Advantages
- Lowest early complication rates; often same-day discharge (ASMBS)
- Adjustable and reversible; nothing is cut or rerouted
- Lowest risk of vitamin deficiencies (NIDDK, ASMBS)
Limitations
- Least weight loss of the standard operations (11.7% at 5 years, PCORnet)
- About 26% reoperations within 7 years (LABS)
- Frequent adjustments; slippage, erosion and swallowing problems
- Smaller effect on diabetes than a bypass
Choosing a provider
Check board certification, where the procedure is done (accredited facility), how many of these procedures the provider performs, and what follow-up care is included. Find a Bariatric Surgeon: credentials, accredited centers and what to ask
Alternatives
SurgicalGastric Sleeve Surgery: eligibility, results, risks and costSurgical · 2+ weeks
SurgicalGastric Bypass: how it works, results and long-term careSurgical · 2+ weeks
Medical deviceEndoscopicEndoscopic Sleeve Gastroplasty (ESG): what to knowEndoscopic
FDA approved for weight managementPrescriptionInjectionWegovy (semaglutide): uses, side effects, cost and FDA statusSemaglutide: one ingredient, several brands · Injection · WeeklyRelated procedures
Research mentioning it
A History of Bariatric Surgery: From 1954 to the SleeveA history of bariatric surgery from the original papers and FDA and Medicare records: the 1954…
Weight-Loss Devices FDA Has Authorized: Balloons, Capsules and MoreEvery weight-loss device the FDA has authorized, from the Lap-Band to swallowable balloons and gel capsules:…
The History of Weight Loss: Every Method From 1860s Diets to 2026 PillsThe history of weight loss from Banting's 1863 diet to 2026 GLP-1 pills: calorie counting, group…Related guides
Bariatric Surgery: types, eligibility and life afterBariatric surgery explained: sleeve, bypass, duodenal switch and band compared, the 2022 eligibility guidelines, results, risks,…
Find a Bariatric Surgeon: credentials, accredited centers and what to askHow to find a qualified bariatric surgeon: board certification, MBSAQIP accredited centers, the evaluation steps, risks,…Tools for this topic
Questions to ask a professional
- Why would you suggest a band for me rather than a sleeve or bypass?
- How many bands have you placed or removed, and what are your reoperation rates?
- How often will adjustments be needed, and what do they cost?
- If I already have a band, does it still work well, and what are my options if not?
- What symptoms mean I should call you urgently?
Frequently asked questions
Is the Lap-Band still available?
Yes. It remains FDA approved (PMA P000008) and the FDA still lists it among weight-loss devices, but it is now rarely used: 773 bands were placed in the U.S. in 2023, according to ASMBS estimates.
Why did the Lap-Band become less popular?
Studies showed less weight loss than with the sleeve or bypass (11.7% vs 18.8% and 25.5% at five years in PCORnet) and high reoperation rates (about 26% within seven years in LABS), while the sleeve offered more weight loss with low early risk.
How much weight do you lose with a gastric band?
On average 13.7% of body weight at one year and 11.7% at five years (PCORnet), and 14.9% at seven years (LABS). Results vary widely.
Can the Lap-Band be removed?
Yes. ASMBS and the NIH describe the band as reversible. Some people have another operation, such as a sleeve or bypass, when the band is removed; see revision surgery.
What are the risks of a gastric band?
Band slippage or erosion, swallowing problems and vomiting, and the need for repeated adjustments and further operations. Early complications are lower than with other operations (2.9% major adverse events within 30 days in PCORnet).
Does Medicare cover the Lap-Band?
Medicare covers laparoscopic adjustable gastric banding for people with a BMI of 35 or more, an obesity-related condition and prior unsuccessful medical treatment.
I have a band and my weight is coming back. What should I do?
See a bariatric team. Guidelines call for an evaluation that includes checking whether the band still restricts; options include adjustment, removal or revision.
How often does a band need adjusting?
The 2019 guideline suggests visits around 1 month, then every 1 to 2 months until stable, then yearly, with adjustments as needed.
References
- PMA P000008: LAP-BAND Adjustable Gastric Banding System (approval order and current applicant). U.S. Food and Drug Administration, 2001. (accessed October 7, 2026) Government page
- FDA Expands Use Of Banding System For Weight Loss (FDA news release, republished). Med Device Online, 2011. (accessed October 6, 2026) News (reported facts only)
- Weight-Loss and Weight-Management Devices (content current as of 2026-03-12). U.S. Food and Drug Administration. (accessed October 7, 2026) Government page
- Bariatric Surgery Procedures. American Society for Metabolic and Bariatric Surgery. (accessed October 6, 2026) Society statement
- Estimate of Bariatric Surgery Numbers, 2011-2023. American Society for Metabolic and Bariatric Surgery. (accessed October 7, 2026) Society statement
- Trends in Utilization of Bariatric Surgery, 2010-2014: Sleeve Gastrectomy Dominates. Surgery for Obesity and Related Diseases, 2017. doi:10.1016/j.soard.2017.01.031 · PMID 28256393 (accessed October 6, 2026) Other
- Arterburn D, et al.. Comparative Effectiveness and Safety of Bariatric Procedures for Weight Loss: A PCORnet Cohort Study. Annals of Internal Medicine, 2018. doi:10.7326/M17-2786 · PMID 30383139 · NCT02741674 (accessed October 6, 2026) Other
- Courcoulas AP, et al.. Seven-Year Weight Trajectories and Health Outcomes in the LABS Study. JAMA Surgery, 2018. doi:10.1001/jamasurg.2017.5025 · PMID 29214306 · NCT00465829 (accessed October 6, 2026) Other
- King WC, et al.. Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery. JAMA, 2012. doi:10.1001/jama.2012.6147 · PMID 22710289 (accessed October 6, 2026) Other
- Types of Weight-loss Surgery. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 6, 2026) Government page
- Side Effects of Weight-loss Surgery. National Institute of Diabetes and Digestive and Kidney Diseases (NIH). (accessed October 6, 2026) Government page
- Parrott J, Frank L, Rabena R, et al.. ASMBS Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surgery for Obesity and Related Diseases; American Society for Metabolic and Bariatric Surgery, 2017. PMID 28392254 (accessed October 6, 2026) Guideline
- Mechanick JI, Apovian C, Brethauer S, et al.. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures: 2019 Update (AACE/TOS/ASMBS/OMA/ASA). Endocrine Practice, 2019. doi:10.4158/GL-2019-0406 · PMID 31682518 (accessed October 6, 2026) Guideline
- Metabolic and Bariatric Surgery (fact page, incl. average cost). American Society for Metabolic and Bariatric Surgery. (accessed October 6, 2026) Society statement
- National Coverage Determination 100.1: Bariatric Surgery. Centers for Medicare and Medicaid Services. (accessed October 7, 2026) Government page
Facts checked on October 6, 2026
Educational information, not medical advice. Talk with a qualified healthcare professional about your own situation. In an emergency call 911.