Laparoscopic Gastric Banding as a Universal Method for the Treatment of Patients with Morbid Obesity

Introduction: This study analyzed the influence of potentially negative predictors such as sweet-eating behavior, super-obesity, social and psychological status, family and education situation, intake of sedative drugs, and the distance between hospital and home on the outcome of laparoscopic adjustable gastric banding (LAGB). Methods: 77 women and 29 men with mean age 40.6 years (28-47) underwent LAGB. Preoperative mean body weight was 146 kg (99-179), and mean BMI was 48.1 kg/m² (36.4-73.5). The influence of the abovementioned potentially negative predictors on weight loss was the primary end point. Results: Mean follow-up was 44.6 ± 19.7 months. Follow-up was possible in all but 6 patients. Median excess weight loss (EWL) was 52.1% (range 28.6-72.2%). Univariate analysis revealed no influence of the investigated negative predictors on the weight reduction. Median EWL in 24 sweet-eater patients was 55.6% compared to 55.4% in 82 non-sweet-eaters (P =0.65). A significant difference in the weight reduction was found between super-obese and non-superobese groups (P <0.001). Conclusions: LAGB should be recommended without limitation as the operation of choice for morbidly obese patients. Gastric bypass operations should be recommended only in cases of unsuccessful LAGB.