> 50% EWL is the cut-off used by most bariatric surgeons as the definition of "success" for bariatric surgery (as in, if you needed to lose 150 lbs, you're a "success" if you lose and maintain a 75 lb weight loss - many SMOs would still be morbidly obese by that definition).

In this long term study, only 44% achieved a > 50% EWL = 56% FAILURE RATE

Obes Surg. 2011 May;21(5):582-7.

Long-term results of a prospective study on laparoscopic adjustable gastric banding for morbid obesity.

Van Nieuwenhove Y, Ceelen W, Stockman A, Vanommeslaeghe H, Snoeck E, Van Renterghem K, Van de Putte D, Pattyn P.

Source

Department of Gastrointestinal Surgery, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium. [email protected]

Abstract

BACKGROUND:

The objective of this study was to study the long-term outcome of adjustable gastric banding in the treatment of morbid obesity. In Europe, the preference for gastric band has declined in favor of Roux-Y-gastric bypass.

METHODS:

This is a follow-up of a prospective study on a large cohort of patients after laparoscopic gastric banding (LAGB) for morbid obesity.

RESULTS:

Complete data were collected on 656 patients (88%) from a cohort of 745 patients. After a median follow-up of 95 months (range 60-155), the mean BMI dropped from 41.0 ± 7.3 to 33.2 ± 7.1 kg/m², with a 46.2 ± 36.5% excess weight loss (EWL). A more than 50% EWL was achieved in 44% of patients. The band was still in place in 77.1% of patients; conversion to gastric bypass after band removal was carried out in 98 (14.9%) patients, while a simple removal was done in only 52 (7.9%) patients. Band removal was more likely in women and patients with a higher BMI.

CONCLUSIONS:

After LAGB, band removal was necessary for complications or insufficient weight loss in 24% of patients. Nearly half of the patients achieved a more than 50% EWL, but in 88%, a more than 10% EWL was observed. LAGB can achieve an acceptable weight loss in some patients, but the failure in one out of four patients does not allow proposing it as a first-line option for the treatment of obesity.

Obes Surg. 2011 May;21(5):582-7.

Long-term results of a prospective study on laparoscopic adjustable gastric banding for morbid obesity.

Van Nieuwenhove Y, Ceelen W, Stockman A, Vanommeslaeghe H, Snoeck E, Van Renterghem K, Van de Putte D, Pattyn P.

Source

Department of Gastrointestinal Surgery, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium. [email protected]

Abstract

BACKGROUND:

The objective of this study was to study the long-term outcome of adjustable gastric banding in the treatment of morbid obesity. In Europe, the preference for gastric band has declined in favor of Roux-Y-gastric bypass.

METHODS:

This is a follow-up of a prospective study on a large cohort of patients after laparoscopic gastric banding (LAGB) for morbid obesity.

RESULTS:

Complete data were collected on 656 patients (88%) from a cohort of 745 patients. After a median follow-up of 95 months (range 60-155), the mean BMI dropped from 41.0 ± 7.3 to 33.2 ± 7.1 kg/m², with a 46.2 ± 36.5% excess weight loss (EWL). A more than 50% EWL was achieved in 44% of patients. The band was still in place in 77.1% of patients; conversion to gastric bypass after band removal was carried out in 98 (14.9%) patients, while a simple removal was done in only 52 (7.9%) patients. Band removal was more likely in women and patients with a higher BMI.

CONCLUSIONS:

After LAGB, band removal was necessary for complications or insufficient weight loss in 24% of patients. Nearly half of the patients achieved a more than 50% EWL, but in 88%, a more than 10% EWL was observed. LAGB can achieve an acceptable weight loss in some patients, but the failure in one out of four patients does not allow proposing it as a first-line option for the treatment of obesity.

 looks to me like this is the single most important thing a pre-op could come to OH and hear. 

 It's the most important thing I learned here, and I'll be forever grateful.

Diana, I wish I knew this back when I was getting the band.  I don't know whether or not it would have changed my mind but at least I would have had all the facts.  When I got banded 3 1/2 years ago, my surgeon was the #1 band surgeon in NYC and I bought everything he sold me hook, line and sinker and I paid for it dearly.  Which is why when I revised, I changed surgeons.

Thank you for all that you do to teach people they have choices and to do their research carefully.

It is SO important to ignore advertising and get DATA. I'm sorry you were one of the many who bought a sales pitch from someone whose ethics SHOULD have precluded being a salesman. (That's a peeve of mine, surgeons SELLING these devices. The practice of medicine should be evidence based and patient centered. The band evidence just gets worse all the time.)

Oh but Elizabeth, he wrote a book with Muhammed Ali's daughter about the band, he had to be doing the right thing for me, he couldn't just be selling me something, could he? (sarcasm here)

What really bothers me is that I am SO no the naive type, I usually do so much research into everything I do, especially considering I'm in the healthcare field. But I STILL bought the less invasive bull**** and I'm so pissed at myself for that. And now I'm considered a Band Basher because I warn people of the dangers of the band. Too ******g Bad! After what it did to me, I will warn everyone and anyone of what can happen to them. If someone had warned me, I may have only needed one surgery instead of two.

Thank you for your kind words!

I agree 100%. My sister got her band because her surgeon advertised on billboards (can anyone say Spiegel?) She is paying for it dearly right now and we are working on getting her a revision to a VSG. Unfortunately, I was out of the country when she did it and I didn't know what she had done until it was over.

I'm surprised it's only that much of a failure rate, honestly. Only three people out of dozens I know personally have had complications, revisions and band removal. (I've included myself in this equation.)

My original surgeon sold me on the band because he wanted to start making money hand over fist, I'm convinced. And I fell for it. I assumed he'd have my best interests in mind. Live and learn.

These studies both reference relatively small cohorts. I suspect that a truly BIG study of this nature were undertaken, the failure rate would be significantly higher.

~I assumed he'd have my best interests in mind. Live and learn.~

Now that is the sad part! Some Drs. after seeing patient after patient return with complication, no weight loss, no restriction, etc.........continue to do the band knowing full well that statistically the patient will NOT do well long term with the band! How can some of them sleep at night?!

If the Dr. were to tell the patient about what the band is REALLY like and they still want it............so be it. But I feel there is a MORAL OBLIGATION there to INFORM the pre-op!

It infuriates me to see ppl posting on here "my Dr. said I'm an excellent candidate for the band!" WTF?!?!?!