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Previous weight loss as a predictor of weight loss outcomes after laparoscopic adjustable gastric banding

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Abstract

Introduction

Weight loss after laparoscopic adjustable gastric banding (LAGB) can be influenced by a variety of factors. The objective of this study is to investigate whether the maximum amount of previous weight loss with diet and exercise, prior to evaluation for bariatric surgery, is predictive of postoperative weight loss success among primary LAGB patients.

Methods

A retrospective cohort study was designed from a prospectively collected database at a single institution. Inclusion criteria consisted of age ≥18 years, initial body mass index (BMI) ≥35 kg/m2, intake information on the maximum weight loss at any time prior to referral to our bariatric practice, and at least 2 years of postoperative follow-up. Patients with prior bariatric surgery were excluded. Outcomes included mean % excess weight loss (EWL), percent that achieved weight loss success (%EWL ≥ 40), and percent with suboptimal weight loss (%EWL < 20) at 2 years post-LAGB.

Results

In the study, 462 primary LAGB patients were included. Mean previous weight loss was 29.7 lb (SD 27.6, range 0–175). These patients were divided into four previous weight loss groups (0, 1–20, 21–50, >50 lb) for analysis. In adjusted multivariate analyses, patients with >50 lb of maximum previous weight loss had a significantly higher mean %EWL, (p < 0.0001) and %BMIL (p < 0.0001), were more likely to reach weight loss success (≥40 % EWL, p = 0.047), and were less likely to experience suboptimal weight loss (<20 % EWL, p = 0.027) at 2 years postoperatively.

Conclusion

Previous weight loss appears to be a significant predictor of weight loss after LAGB. With multiple options for weight loss surgery, this study helps elucidate which patients may be more likely to achieve greater weight loss with the LAGB, allowing clinicians to appropriately counsel patients preoperatively.

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Acknowledgments

The authors wish to acknowledge Heekoung Youn, MA, for technical assistance and G. Craig Wood, MS, for leading the statistical analyses sited in this publication.

Disclosures

Dr. Christine Ren-Fielding previously received research grants (S# 06-851, S#10686) and an honorarium as a speaker for Allergan Medical, and is currently a consultant for Apollo Endosurgery. Dr. Fielding previously received an honorarium as part of the Speaker’s Bureau/Faculty, a research grant (S# 06-851, S#10686) and educational grant from Allergan Medical, and is currently on the Speaker’s Bureau for Apollo Endosurgery. Dr. Kurian received a research grant (S#06-851) and an honorarium as a speaker for Allergan Medical, an honorarium as a speaker for Apollo Endosurgery and is currently on the faculty of Gore. Dr. Schwack received an honorarium as a speaker for Allergan Medical. Dr. Sethi, Dr. Beitner, and Ms. Magrath have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA

    Monica Sethi, Melissa Beitner, Melissa Magrath, Bradley Schwack, Marina Kurian, George Fielding & Christine Ren-Fielding

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  1. Monica Sethi
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  2. Melissa Beitner
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  3. Melissa Magrath
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  4. Bradley Schwack
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  5. Marina Kurian
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  6. George Fielding
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  7. Christine Ren-Fielding
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Correspondence to Monica Sethi.

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Sethi, M., Beitner, M., Magrath, M. et al. Previous weight loss as a predictor of weight loss outcomes after laparoscopic adjustable gastric banding. Surg Endosc 30, 1771–1777 (2016). https://doi.org/10.1007/s00464-015-4441-1

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  • DOI: https://doi.org/10.1007/s00464-015-4441-1

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