Background: We studied whether weight loss by intragastric balloon would predict the outcome of subsequent gastric banding with regard to weight loss and BMI reduction.Methods: A prospective cohort of patients with a body mass index (BMI) >40 kg/m 2 received an intragastric balloon for 6 months followed by laparoscopic adjustable gastric banding (LAGB). Successful ballooninduced weight loss was defined as ≥10% weight loss after 6 months. Successful surgical weight loss was defined as an additional 15% weight loss in the following 12 months. Patients were divided in group A, losing ≥10% of their initial weight with 6 months' balloon treatment, and group B, losing <10% of their initial weight.Results: In 40 patients (32 female, 8 male; age 36.6 yr, range 26-54), the mean BMI decreased from 46.5 to 40.5 kg/m 2 (P<0.001) after 6 months of balloon treatment and to 35.2 kg/m 2 (P<0.001) 12 months after LAGB. Group A (25 patients) and group B (15 patients) had a significant difference in BMI decrease, 12.4 vs 9.0 kg/m 2 (P<0.05), after the total study duration of 18 months. However, there was no difference in BMI reduction (4.7 kg/m 2 vs 5.8 kg/m 2 ) in the 12 months after LAGB. 6 patients in group A lost ≥10% of their starting weight during 6 months balloon treatment as well as ≥15% 12 months following LAGB. 6 patients in group B lost <10% of their starting weight after 6 months of BIB, but also lost ≥15% 12 months following LAGB.Conclusion: Intragastric balloon did not predict the success of subsequent LAGB.

The QOL improved substantially independent of changes in BMI. Because of the divergent outcomes of generic and disease-specific QOL questionnaires, prospective studies should examine the sensitivity to changes of both kinds of QOL questionnaires.