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

Abstract

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. A retrospective cohort study was designed from a prospectively collected database at a single institution. Inclusion criteria consisted of age ≥18years, initial body mass index (BMI) ≥35kg/m(2), intake information on the maximum weight loss at any time prior to referral to our bariatric practice, and at least 2years 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 2years post-LAGB. In the study, 462 primary LAGB patients were included. Mean previous weight loss was 29.7lb (SD 27.6, range 0-175). These patients were divided into four previous weight loss groups (0, 1-20, 21-50, >50lb) for analysis. In adjusted multivariate analyses, patients with >50lb 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 2years postoperatively. 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.