Adolescent laparoscopic adjustable gastric banding (LAGB): prospective results in 137 patients followed for 3 years

Background: Evidence supports weight loss surgery as an effective long-term weight reduction therapy in adults. Methods: Few adolescent obesity surgery series report outcomes for laparoscopic gastric banding (LAGB). We studied a population of morbidly obese teenagers who underwent LAGB to evaluate its safety and effectiveness in this age group. Three hundred and six morbidly obese adolescent candidates for LAGB were screened. Enrollees were evaluated monthly by the nutritionist and the surgical team to monitor compliance with recommended changes in diet and exercise. Patients also underwent psychiatric and endocrine evaluations. Those who made good changes in eating and exercise habits over a 6-month period were offered LAGB. The setting was a university hospital in the United States. Results: One hundred thirty-seven adolescent patients underwent LAGB. The mean weight gain between enrollment and LAGB was 4.7 kg. Mean preoperative weight, body mass index (BMI), and excess BMI were 136.1 kg, 48.3 kg/m(2), and 23.6 kg/m(2), respectively. Mean BMI at 6, 12, 18, 24, and 36 months was 43.8, 41.6, 41.5, 40.5, and 39.3. Excess BMI loss was 28.4%, 35.9%, and 41.1% at 1, 2, and 3 years postop. Co-morbid conditions improved or resolved with weight loss after LAGB. Thirty patients (22%) underwent one or more additional operations for complications. Twenty-seven patients (20%) converted to other weight loss procedures or had their bands removed. Conclusion: LAGB is a safe weight loss operation in adolescents. Morbidly obese adolescents can lose weight successfully and experience health improvement following LAGB, but the role of LAGB in the younger population requires long-term evaluation. (Surg Obes Relat Dis 2015;11:101 109.) (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.