Outcomes of Laparoscopic Adjustable Gastric Banding in Morbidly Obese United States Adolescents

Sunday, 30 October 2011: 11:40 AM

Mary Ann Witt, CPNP, MS, BSN, RN
Department of Nursing, The College of Mount Saint Vincent, Riverdale, NY

Learning Objective 1: identify laparoscopic gastric banding as an effective and safe weight loss procedure for a select group of morbidly obese adolescents.

Learning Objective 2: evaluate the effect of weight loss on medical comorbidities and psychological profile in morbidly obese adolescents who undergo laparoscopic gastric banding.

Background: Childhood obesity has become recognized as an epidemic. Severely obese adolescents are developing medical and psychological conditions commonly seen in obese adults (e.g., hypertension, metabolic syndrome, depression). Although studies show that laparoscopic adjustable gastric banding (LAGB) is an effective and safe weight loss procedure in adolescents, data to evaluate the effect of weight loss on medical and psychological comorbidites in teenagers who undergo LAGB is limited.

Methods: Candidates for LAGB underwent rigorous assessment for compliance, psychological well-being and medical eligibility using the National Institutes of Health clinical guidelines published in 1991. Adolescents who meet criteria and were approved by our team were offered LAGB. Body weight, medical and psychological comorbidity data was included for analysis in adolescents who completed at least 6 months of follow-up visits with our multi-disciplinary team.

 Results: One hundred patients aged 14 to 19 years underwent LAGB. Seventy-one percent were female. Pre-operative medical conditions included menstrual irregularities and/or polycystic ovary syndrome in 36.7% of the females; hypertension in 19.1% of the group; metabolic syndrome in 15.6%; dyslipidemia in 14.7%; and diabetes in 2.6%.  Preoperative average weight was 136.7 kilograms, and mean body mass index (BMI) was 48.6 ± 8.6 kg/m². Average weight loss at 6 months was 12.4 kilograms (range 33.2 to -16.2) and average change in BMI was 4.4 (range 11.8 to -5.6). The majority of adolescents showed improvement or resolution of metabolic syndrome, dyslipidemia, hypertension, menstrual irregularities; and improvement in health-related quality of life and depression after LAGB.

Conclusions:  Laparoscopic adjustable gastric banding may be an effective weight loss tool for a select group of morbidly obese teenagers. Short-term results suggest that weight loss may improve or potentially reverse medical and psychological comorbidities in adolescents who undergo LAGB. Further study to evaluate the long-term outcomes of LAGB in this adolescent population is warranted.