Pills or Surgery for Weight Loss?

Lap-Band is short for laparoscopic adjustable gastric banding. It's an operation. Through small incisions in the abdomen, a surgeon inserts a viewing scope (laparoscope) and instruments with which he or she can encircle the top of the stomach with an adjustable band. That creates a small pouch for a stomach. People cannot eat large quantities of food. They fill up quickly. They lose weight.

The "pros" of this operation include a considerable weight loss, which brings protection against diabetes, high blood pressure and arthritic knees and hips. Cholesterol almost always drops.

The "cons" are the fact it is an operation, and all operations have the potential for complications. It requires anesthesia, another possible risk. The band might need readjusting down the road. There's always a threat of infection from any surgical procedure.

Orlistat has been around for some time and is sold as the prescription drug Xenical. Alli can be obtained without a prescription. It contains a smaller dose of orlistat. This medicine inhibits the intestinal enzyme lipase, which breaks up fat so that it can be digested. Less fat is absorbed. Weight is lost. A major "pro" for Alli is not having to undergo surgery. Some "cons" are possible loose stools, an increase in gas and a decreased absorption of vitamins A, D, E and K, which require fat to pass into the blood. That can be remedied by taking those vitamins in pill form.