Predictive Factors of Outcome After Gastric Banding

Abstract

This nationwide survey shows that the best profile for a success after gastric banding is a patient <40 years, with an initial BMI <50 kg/m, willing to change his eating habits and to recover or increase his physical activity after surgery and who has been operated by a team usually performing >2 bariatric procedures per week. This study emphasizes that obesity surgery requires a significant experience of the surgical team and a multidisciplinary approach to improve behavioral changes.

Post-operative Psychosocial Predictors of Outcome in Bariatric Surgery

“…Self-reported adherence to the post-operative dietary guidelines predicted greater weight loss [49] [52]. Similarly, failure to change eating habits increased the risk two-fold of losing <50 EWL% two years post-operatively [8]. Lower dietary intake, calculated from patient food diaries at 8 years after surgery, was associated with >50 EWL% [53].…”

“…Nineteen additional studies were identified in the current review that examined post-operative exercise and weight loss outcomes [5, 8, 31, 33, 36-38, 50-53, 56-63], and all but three [31, 53, 58] found that patient-reported post-surgery exercise frequency was significantly associated with weight loss outcome.…”

“…The definition of “successful” weight loss following these procedures varies, but reduction of at least 50% of the patient's excess weight (i.e., 50% excess weight loss; 50% EWL), is a commonly used metric [8]. Using this criterion, approximately 20-30% of patients experience either insufficient initial weight loss or weight loss followed by excessive regain [9-11].…”

Is Bariatric Surgery Effective in Reducing Comorbidities and Drug Costs? A Systematic Review and Meta-Analysis

“…The weight reduction is clinically significant when followed by the resolution of, or improvement in, comorbidities and when it is accompanied by a significant reduction in predicted risk of major complications [5,31]. It is possible that studies that identified excess weight loss of <50 % were not able to detect a significant improvement in comorbidities; in these cases, the reduction in BMI was not sufficient to have an impact on drug use and drug costs.…”

“…BS has been able to reverse or improve comorbidities associated with obesity, such as hypertension, diabetes mellitus (DM), and dyslipidemia. Surgical treatment is considered successful when over 50 % of the patient's excess weight has been lost and the weight loss maintained at least 5 years after the procedure, but success is often determined by the patient's perceived improvement in quality of life [5,6]. The surgical procedure is not free of risks and requires long-term nutritional and pharmacologic monitoring [7].…”