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Adolescent Gastric Banding: a 5-Year Longitudinal Study

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Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) is used to treat obesity in adults. Less is known about long-term results of the procedure in adolescents.

Objectives

To evaluate LAGB 5-year outcomes in teenagers with severe obesity.

Setting

Children’s hospital, USA.

Methods

Adolescents (14–18 years) underwent LAGB in an FDA-approved observational clinical trial. Outcomes including anthropometric measurements, comorbid conditions, complications, and band retention were collected through 60 months.

Results

One hundred thirty-seven subjects underwent LAGB (94 female, 43 male; 43% white, 37% Hispanic, 17% black; 4% other). Mean age and body mass index (BMI) pre-operatively were 17.0 + 1.2 years and 48.3 + 8.2 kg/m2, respectively. Comorbidities were present in 71%. Maximum weight loss occurred by 36 months (mean % excess weight loss (EWL) 40.6 + 35.2, mean % excess BMI loss (EBMIL) 41.6 + 34.9) and was maintained through 5 years for most subjects. There were no significant differences in weight loss by gender. Twenty-three (18%) of 127 adolescents reporting at 60 months achieved 50% excess weight loss. Postoperative heartburn and emesis occurred in 70% and 32%, respectively. Complications requiring additional surgery occurred 80 times in 63 patients. Thirty-three (26%) of 127 subjects contacted at 5 years had undergone band removal.

Conclusion

In this study, fewer than 20% of adolescents with severe obesity lost > 50% of their excess weight following LAGB. Nearly 50% of patients required additional surgery. With reports of success following sleeve gastrectomy and gastric bypass, we believe that LAGB is not a preferred choice to treat adolescents with obesity.

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Author information

Authors and Affiliations

  1. Division of Pediatric Surgery, Morgan Stanley Children’s Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA

    Jeffrey L. Zitsman

  2. Department of Surgery, Vagellos College of Physicians and Surgeons of Columbia University, 3959, Broadway, NY, 10032, USA

    Jeffrey L. Zitsman & Mary F. DiGiorgi

  3. Mailman School of Public Health, Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA

    Adina Z. Zhang

  4. Department of Pediatrics, Vagellos College of Physicians and Surgeons of Columbia University, 3959, Broadway, NY, 10032, USA

    Janet Schauben Kopchinski & Ilene Fennoy

  5. Division of Pediatric GI/Nutrition, Morgan Stanley Children’s Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA

    Janet Schauben Kopchinski

  6. Eating and Weight Disorders Program, Icahn School of Medicine at Mt. Sinai, 3959, Broadway, NY, 10032, USA

    Robyn Sysko

  7. Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, 3959, Broadway, NY, 10032, USA

    Michael J. Devlin

  8. Department of Psychiatry, Vagellos College of Physicians and Surgeons, Columbia University, 3959, Broadway, NY, 10032, USA

    Michael J. Devlin

  9. Division of Pediatric Endocrinology, Morgan Stanley Children’s Hospital of New York Presbyterian/Columbia University Irving Medical Center, 3959, Broadway, NY, 10032, USA

    Ilene Fennoy

Authors
  1. Jeffrey L. Zitsman
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  2. Mary F. DiGiorgi
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  3. Adina Z. Zhang
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  4. Janet Schauben Kopchinski
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  6. Michael J. Devlin
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  7. Ilene Fennoy
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Corresponding author

Correspondence to Jeffrey L. Zitsman.

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Electronic supplementary material

ESM 1

Study protocol (DOCX 19 kb)

ESM 2

Schedule of visits and procedures (DOCX 19 kb)

ESM 3

Weight loss and change in BMI among ethnic groups (PDF 119 kb)

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Zitsman, J.L., DiGiorgi, M.F., Zhang, A.Z. et al. Adolescent Gastric Banding: a 5-Year Longitudinal Study. OBES SURG 30, 828–836 (2020). https://doi.org/10.1007/s11695-019-04321-5

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  • DOI: https://doi.org/10.1007/s11695-019-04321-5

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