OXON HILL, MD. — Obesity-related comorbidities are likely to improve or resolve in patients who undergo laparoscopic adjustable gastric banding after losing 20%–50% of their excess weight, according to a prospective study of patients with body mass indexes of 30–40 kg/m
The results indicate that even when less than 50% of excess weight is shed—which is often considered to be the cutoff for treatment failure—beneficial effects begin to occur, Samuel Sultan said at the annual meeting of the American Society for Metabolic and Bariatric Surgery.
Mr. Sultan and his coinvestigators in the department of surgery at New York University followed 50 patients for 2 years to determine the minimum percentage of excess weight loss that would provide the maximum probability of resolving or improving obesity-related comorbidities. Each patient had to have a history of obesity for at least 5 years as well as a history of failed attempts to lose weight by traditional methods.
All but one of the patients received the 9.5-cm band in the Lap-Band System. The patients' mean age was 47 years (ranging from 18 to 60 years), and most (96%) were women. The mean volume of saline added at each adjustment was 1.9 mL, according to Mr. Sultan, a medical student at the university.
After 2 years of prospective follow-up, losses of 20%–50% of excess weight provided the greatest probability of resolving or improving a variety of obesity-related comorbidities (see chart). At 2 years, 80% of all comorbidities had improved or resolved.
The patients' mean percentage of excess weight lost at 6 months was 41%, followed by 59% at 1 year and 61% at 2 years. Their body mass index dropped from a mean of 35 to 27 kg/m
Allergan Inc., which makes the Lap-Band System, funded the study. Some of the investigators have received honoraria for teaching and being on an advisory committee for Allergan.
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