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Randomized Controlled Trial
. 2013 Sep;23(9):1345-53.
doi: 10.1007/s11695-013-0990-3.

Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity: long-term follow-up of a prospective randomised trial

Paul E O'Brien  1 , Leah Brennan, Cheryl Laurie, Wendy Brown
Affiliations
Randomized Controlled Trial

Intensive medical weight loss or laparoscopic adjustable gastric banding in the treatment of mild to moderate obesity: long-term follow-up of a prospective randomised trial

Paul E O'Brien et al. Obes Surg. 2013 Sep.

Abstract

Background: Proven short-term effectiveness of obesity therapy should be re-evaluated in the long-term. The objective of this paper is to determine the long-term (10 years) outcome for patients from a randomised controlled trial (RCT).

Methods: A RCT in 2002 compared laparoscopic adjustable gastric band (LAGB) for obesity with non-surgical therapy. Follow-up has been conducted at 10 years. Eighty patients (BMI 30-35) were randomised to a non-surgical or a surgical program. Outcome data are available on 37 (92.5 %) of the surgical patients and 27 (62.5 %) of the non-surgical patients at 10 years.

Results: Weight change, the metabolic syndrome, quality of life, adverse events and direct costs of the surgical cohort were the main results of the study. A durable weight loss is present in the surgical group with a mean (SD) 10-year weight loss of 14.1 (7.7) kg (63.4 % EWL), better than the non-surgical group (mean (SD) = 0.4 (10.5) kg; p < 0.001). The metabolic syndrome was reduced from 14 to 4 of the 37 patients who completed 10 years within the LAGB groups. Proximal gastric enlargements occurred in 17 (30 %) of the 57 who had LAGB and removal of the band occurred in 7 (12 %). The annual maintenance costs including additional surgery was AUD $765 per patient per year.

Conclusions: Bariatric surgery with the LAGB can achieve long-term weight reduction which is better than a program of non-surgical therapy. There is also a sustained reduction of the metabolic syndrome. There is a significant maintenance requirement after LAGB.

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