Exp Clin Endocrinol Diabetes 2005; 113 - V9_71
DOI: 10.1055/s-2005-862855

Predictors of weight loss

C Hoff 1, T Ricklin 2, R Steffen 3, R Branson 1, N Potoczna 1, G Piec 1, F Horber 1
  • 1Klinik Hirslanden, Stoffwechsel- und Osteoporosezentrum, Zürich, Switzerland
  • 2Klinik Hirslanden, Chirurgie, Zürich, Switzerland
  • 3Praxis für Chirurgie, Bern, Switzerland

Background: Laparoscopic gastric banding implanted for weight reduction in severLaparoscopic gastric banding implanted for weight reduction in severely obese patients allows the reversible individualized adjustment of the amount of restriction during postoperative follow up. Whether preoperative age, sex and BMI might modulate outcome after laparoscopic gastric banding is vastly unknown.

Material and Methods: Since 1997, 410 severely obese patients were prospectively investigated following placement of a Swedish Adjustable Gastric Band. 404 patients (98.5%) (BMI 42.6„b0.2 kgm2, range 32.7–55.2) completed four-year follow up. Weight, BMI, complications and BAROS-questionnaire (Bariatric Analysis and Reporting Outcome System) have been recorded at least yearly.

Results: Four years after gastric banding BMI decreased by 11.1„b0.2kg/m2. Younger women (<50 years) lost more weight compared to older men (>50 years; 11.9„b0.3kg/m2 vs. 8.4„b0.7kg/m2, P<0.001), whereas older women (>50 years) and younger men (<50 years) lost similar amounts of weight (10.3„b0.4kg/m2 vs. 10.1„b0.6kg/m2). Patients with a preoperative BMI >50kg/m2 lost more weight than those with BMI <35kg/m2 (15.3„b1.1kg/m2 vs. 6.6„b0.5kg/m2, P<0.001). 16.8% of patients (n=68) had complications due to the gastric band system. Compared to women men had more band leaks (7.0% vs. 0.9%, P<0.001), older men (>50years) had more band slippage than older women (8.3% vs. 1.2%, P<0.001). Interestingly, in patients with preoperative BMI >50kg/m2 band related complications were lower than in patients with BMI below 50kg/m2. (8.0% vs. 18.2%, p<0.050), but port and tube related complications were higher (16.0% vs. 5.5%, p<0.001). According the BAROS-Score, nearly 70% of patients had good to excellent results. Younger women (<50 years) experienced best overall outcome.

Conclusions: Adjustable gastric banding is an effective treatment of severe obesity. Age, sex and BMI are important modulators of outcome and have to be considered, when evaluating patients with severe obesity for bariatric surgery.