Obesity Surgery

, Volume 19, Issue 1, pp 3–12 | Cite as

Successful Multi-Intervention Treatment of Severe Obesity: A 7-year Prospective Study with 96% Follow-up

  • Rudolf Steffen
  • Natascha Potoczna
  • Norman Bieri
  • Fritz F. HorberEmail author
Research Article



No long-term, high participation study of the outcome of bariatric surgery has examined how a multi-intervention approach to the treatment of severe obesity can achieve and sustain weight loss after an initial bariatric procedure.


We employed a multi-intervention treatment that combines adjustable gastric banding with intensive follow-up to support patient life-style change and use of an algorithm allowing reoperation—to bypass, if necessary—in the event of complications. Four hundred four severely obese patients with an average BMI = 42.6 at the outset had initial AGB surgery and were followed with a high rate of face-to-face consultations for 7 years. Seventy-five percent of the patients retained a gastric band throughout the study. Weight loss, complications, and comorbidities were studied, and quality of life was assessed using Bariatric Analysis and Reporting Outcome System (BAROS).


Three hundred eighty-eight (96%) patients completed the 7-year follow-up. Average BMI reduction at 5 years was 28% and remained stable through year 7, at which the mean excess weight loss was 61%. The preoperative prevalence of metabolic syndrome, 59.7%, decreased to 13.3% at 7 years and was abolished for patients with more than 40% loss of initial BMI. Similar changes were seen for all components of metabolic syndrome. More than 60% of patients had a “good” or higher BAROS score; 10.1% were considered failures. Patients converted to gastric bypass, and those retaining gastric bands throughout the study had very similar outcomes.


Long-term, multi-intervention treatment of severe obesity can achieve and preserve weight loss and thus improved quality of life and sustained reduction or disappearance of all components of metabolic syndrome, for a high proportion of severely obese patients with preoperative BMI between 35 and 55.


Severe obesity Gastric banding Metabolic syndrome Quality of life BAROS Long-term outcome Multi-intervention strategy 



The authors thank Christopher Ritter for editorial assistance and Monika Scheumann and B. Zivkovic for careful data collection.


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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Rudolf Steffen
    • 2
  • Natascha Potoczna
    • 1
  • Norman Bieri
    • 1
  • Fritz F. Horber
    • 1
    Email author
  1. 1.Department of Surgery and Internal MedicineKlinik LindbergWinterthurSwitzerland
  2. 2.Private Praxis Dr. SteffenBernSwitzerland

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