Laparoscopic Adjustable Gastric Banding: Essential Role of Psychological Support

Background: A follow-up study of laparoscopic adjustable gastric banding (LAGB) in morbidly obese patients was conducted, with special emphasis on psychological aspects. Materials and Methods: 128 patients (98/30 females/males) underwent LAGB between October 1995 and March 2001. Age was 38±9 years, body mass index (BMI) 42.72±4.25 kg/m² and body weight 124±25 kg (mean±SD). Weight loss, early and late complications, band calibrations and difference between patients with and without psychotherapy were analysed. Psychological status was investigated before and during LAGB treatment using MMPI. Quality of life was investigated using MOS SF36. Results: Median BMI decreased from 42.7 preoperatively to 31.0 kg/m² after 12 months. Reduction of BMI was already significant (P<0.01) after 3 months. In the following 12 months, median BMI wavered between 31.0 and 29.5 kg/m². Best results were achieved in patients who followed psychotherapy. Conclusion: LAGB gave therapeutic success (progressive and significant weight loss). Psychotherapy was not only a simple support to diet but also an important part of the multidiscipline treatment. For best results, the team must care for patients individually and not just follow the same fixed protocol.