It’s a medical procedure that has grown in popularity right along with America’s expanding waist size.

Gastric banding, also known as lap-banding, is a surgical procedure in which a band is placed around the upper part of the stomach. This creates a little pouch that can hold only a small amount of food. With smaller stomachs people eat less, thereby enabling them to lose weight. Due to its invasive nature, the surgery is only used in patients who have been obese for at least five years, and who have not been successful at traditional weight loss programs centered on diet and exercise. For most patients who have the procedure, studies indicate there is weight loss, but new research shows the success rate could be substantially better, and complications abound.

Recently published in the journal Archives of Surgery, the study involved researchers tracking the medical history of about one-hundred-and-fifty patients who had undergone the banding procedure. The researchers looked at several factors regarding the outcome of the surgery, such as overall weight loss success and the general long-lasting integrity of the band itself.

Upon evaluation, the investigators found that twelve years after the surgery, most patients had lost an average of forty-two percent of their excess weight. But the researchers also discovered that almost twenty percent of patients suffered from major complications. In fact, almost half needed removal of the original band, and nearly sixty percent required further surgeries.

Even so, most said they were happy with the outcome. Given the recent upswing in the procedures, the investigators said the findings are compelling, and that all prospective band patients need to be fully informed of the possible outcomes, particularly the likelihood of further surgery.