Reprinted from Eating Disorders Review
September/October 2010 Volume 21, Number 5
©2010 Gürze Books
Adjustable gastric banding for obesity achieves only modest weight loss and even that benefit deteriorates over time, according to a report presented at the American Society of Metabolic and Bariatric Surgery in Las Vegas, NV in June. Edo Aarts, MD, of Rijnstate Hospital, Arnhem, The Netherlands, noted that 5 years after surgery, about 75% of his patients maintained a 25% excess weight loss. At 10 years, the success rate dropped to less than 33%. Surgeons at Rijnstate Hospital perform more than 800 gastric banding procedures annually, more than any other hospital in The Netherlands; more than 3,000 patients have had the procedure since it was introduced in the 1990s. Dr. Aarts and colleagues evaluated the long-term results of adjustable gastric banding in 201 patients who had undergone the procedure during the years 1995 to 2003; all had rigorous follow-up at 3-month intervals during the first year and then annually thereafter, and complete follow-up data was available for an average of 9.6 years.
Using excess weight loss of 25% or more to define treatment success, the Dutch surgeons found that about 80% of the patients retained weight loss during the first 3 years; after this there was a steady decline to 64% of patients at 5 years, and 20% at 10 years.
Control of diabetes, hypertension, and gastroesophageal reflux all deteriorated significantly over time. The incidence of new-onset diabetes and hypertension increased during follow-up, as did the proportion of patients requiring acid-suppression therapy.
On the basis of the study’s results, surgeons at the Dutch center are re-evaluating their use of adjustable gastric banding as a treatment for obesity. Questions also remain about the long-term effects of adjustable gastric banding to other gastric procedures. What role, if any, adjustable gastric banding will play in the future has yet to be determined, according to Dr. Aarts.