Patients were randomly assigned to treatment with either laparoscopic gastric banding or a nonsurgical program. Nonsurgical treatment involved very-low-calorie diets, weight loss drugs, and behavioral change to improve diet and exercise habits. The researchers measured weight change and the presence of the metabolic syndrome. The metabolic syndrome is a condition in which people have at least 3 of the following abnormalities: overweight, high blood pressure, high triglyceride levels (a bad type of fat in the blood), low high-density lipoprotein cholesterol levels (“good” cholesterol), and high blood sugar levels. People with the metabolic syndrome are at risk for diabetes and heart disease. The researchers also evaluated patients' quality of life and side effects.