Patient case (clinical description): A 50-year-old woman comes to the clinic with intermittent ear discharge and sense of hearing loss on her left ear.  Past medical history is significant for obesity, hyperlipidemia, and diabetes mellitus.  Her medications include Metformin, Atorvastatin and Vit D supplement. Vital signs are normal. BMI is 37. Otoscopy shows a small perforation in the left tympanic membrane and a pearly mass behind the membrane.  Conduction hearing loss is noted in the left ear.  The remainder of the ear, nose, and throat examination is normal.

Patient's own account: I went to the clinic the other day because I had some fluid in my ear and I felt like I could not hear as well as I used to in my left ear. I'm a 50-year-old woman, and I have been obese for a while now. I have diabetes and cholesterol. I take some medication. I take metformin, atorvastatin, and vitamin D supplements. When I was admitted, my vitals were normal. My BMI is 37. When they looked into my ears, they said that my left tympanic membrane was broken and there was some fluid behind the membrane. During the hearing test, they could assess that my left ear suffers from hearing loss. They also performed ear, nose, and throat examinations that turned out to be normal.

Clinical trial: Safety and Effectiveness Study of The Swedish Adjustable Gastric Band (SAGB) in the Treatment of Morbid Obesity

Eligibility criteria:
Inclusion Criteria:

          -  Able to comprehend, follow and give signed informed consent;

          -  18 to 60 years of age (inclusive);

          -  Five year history of morbid obesity;

          -  Body Mass Index (BMI) >40 kg/m2 and <55 kg/m2, or BMI >35 kg/m2 and <40 kg/m2 with one
             or more significant medical conditions related to obesity (co-morbid conditions of
             type 2 diabetes, hyperlipidemia, obstructive sleep apnea, hypertension, metabolic
             syndrome, or osteoarthritis of the hip or knee) for which the subject is being
             treated, and which are generally expected to be improved, reversed, or resolved by
             weight loss.

          -  100 lbs. overweight or 1.5 times ideal weight;

          -  Documented failure of conservative, non-surgical means of weight reduction within one
             year prior to the Screening Visit, including failure of supervised diet, exercise and
             or behavior modification programs, and pharmacologic therapy;

          -  Willing to commit to significant lifestyle changes that include diet, eating, and
             exercise habits for the duration of the clinical trial;

          -  Able to commit to long-term follow-up, including band adjustment visits:

          -  Living within the contiguous U.S. and is within a 100 mile radius of the study center;

          -  Absence of significant psychopathology that could limit the subject's ability to
             understand the procedure, comply with medical, surgical, and/or behavioral
             recommendations, as documented during screening assessment;

          -  Agrees to refrain from any type of reconstructive surgery that would affect body
             weight such as abdominal lipoplasty or liposuction, mammoplasty, or removal of excess
             skin for the follow-up period following SAGB placement; and

          -  Candidate for surgical weight loss intervention (i.e., meets accepted health criteria
             for major surgery).

        Exclusion Criteria:

          -  Women of childbearing potential who are not practicing an effective method of birth
             control or who are pregnant or lactating;

          -  Previous malabsorptive or restrictive procedures performed for the treatment of
             obesity;

          -  Documented history of drug and/or alcohol abuse within two years of the Screening
             Visit;

          -  History of impaired mental status including, but not limited to active substance
             abuse, a history of schizophrenia, borderline personality disorder, uncontrolled
             depression, suicidal attempts within the past two years or current suicidal tendencies
             or ideations;

          -  Presence of any of the following medical conditions;

               -  Inflammatory diseases of the gastrointestinal tract, including severe intractable
                  esophagitis, gastric ulceration, duodenal ulceration, or specific inflammation
                  such as Crohn's disease that have been active within the past 10 years;

               -  Congenital or acquired anomalies of the GI tract, including atresias or stenosis,

               -  Severe cardiopulmonary disease or other serious organic disease that makes the
                  subject a high-risk surgical candidate;

               -  Uncontrolled hypertension;

               -  Portal Hypertension;

               -  Uncontrolled Diabetes Mellitus;

               -  Chronic or acute upper gastrointestinal bleeding conditions, e.g. gastric or
                  esophageal varices;

               -  Cirrhosis;

               -  Congenital or acquired intestinal telangiectasia;

               -  Esophageal or gastric disorders including severe preoperative reflux,
                  dysmotility, or Barrett's Esophagus;

               -  Presence of hiatal hernia;

               -  Prior surgery of the foregut including hiatal hernia repair or prior gastric
                  surgery;

               -  Chronic pancreatitis;

               -  Immunocompromised such as that resulting from chronic oral steroid use,
                  chemotherapeutic agents, or immune deficiency disorders;

               -  Conditions that, in the opinion of the investigator, may jeopardize the subject's
                  well-being and/or the soundness of this clinical study;

          -  History or presence of pre-existing autoimmune connective tissue disease, i.e.,
             systemic lupus erythematosus or scleroderma;

          -  Presence of terminal illness with life expectancy <5 years;

          -  Use of prescription or over the counter weight reduction medications or supplements
             within one month of the Screening Visit and for the duration of study participation;

          -  Acute or chronic infection (localized or systemic);

          -  Known or suspected allergy to silicone or other materials contained in the Swedish
             Adjustable Gastric Band;

          -  History of intolerance to implanted devices;

          -  Not ambulatory; and

          -  Participation in another clinical trial within 8 weeks of the Screening Visit and for
             the duration of this trial.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 60 Years

Eligibility (NLI label): Contradiction