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Lap band surgery availability widened

The Food and Drug Administration (FDA) has just approved new guidelines for lap band surgery. The new guidelines mean an additional 26 million overweight Americans are now eligible for the operation.

But what does that really mean?

Special Section: Dr. Jennifer Ashton Dr. Jennifer Ashton's Twitter page

CBS News Medical Correspondent Dr. Jennifer Ashton, who conducted a year of obesity surgery research in her career, said on "The Early Show" she's not surprised by the new guidelines.

She explained, "(The guidelines) have to do with the criteria under which patients are eligible for obesity surgery. In the past, if patients needed to be obese with a BMI or body mass index of 35 to 40. Now, they've lessened that number so they're including patients with a body mass index of 30 to 40, with one other obesity-related illness like diabetes or high blood pressure, thereby including an additional 26 million people under the potential surgical candidates' category."

Ashton added the FDA is sending a message about the obesity epidemic in the U.S.

"I think what it's telling us is that the obesity epidemic has reached a proportion in this country whereby diet and exercise and medications and surgery all need to be used in conjunction with each other or we will be seeing the effects not only in our health, but in our dollars and cents," she said. "It's costing billions and billions of dollars a year to treat obesity in this country. The actual lap band procedure has been out since 2001. Hundreds of thousands of patients have had it done. We know it has a fairly good safety profile and that it is effective."

She added, "We have to remind people, this is not a quick fix. This is not something that can be undertaken lightly. It has to be done in conjunction with diet and exercise and sometimes medication. It is a major step for someone undergoing this procedure."

Co-anchor Erica Hill noted, "It's a major surgery, too. It's a major expense. It's very expensive."

Ashton said, "Absolutely."

But what about gastric bypass surgery -- how is it different from lap band surgery?

"A lap band is what's considered a restrictive obesity surgery procedure," Ashton said. "A simple band goes around the upper portion of the stomach and makes it more difficult for the patient to eat more food. So it just restricts the volume or quantity of the food the patient takes in. The gastric bypass is what we call a malabsorptive procedure, so it affects the absorption of calories. People tend to lose more weight with the gastric bypass, but it's a much more extensive surgical procedure, much higher risks. And the lap band is much lower risk, reversible, so it's more readily available."

But Ashton advised any time you consider surgery, there are risks and benefits.

She said, "The risks with any surgery, especially when you're talking about someone who is obese and the anesthesia problems, bleeding problems, infection, the band can slip and need to be replaced. Benefits: People do lose a lot of weight, but it is a lifestyle change. And I know patients who've actually had to gain weight to meet the old criteria so they could have this surgery. Hopefully these new guidelines will prevent that from happening."

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