Improvement in comorbid illness after placement of the Swedish Adjustable Gastric Band.
BACKGROUND
Obesity and its related comorbid illnesses have become a national health priority. We report comorbidity and quality of life (QoL) data after weight loss with gastric banding using the Swedish Adjustable Gastric Band (SAGB).


METHODS
Data were collected prospectively for 838 consecutive morbidly obese patients who underwent laparoscopic adjustable gastric banding (LAGB) between January 2001 and July 2007. Patients were followed-up by a multidisciplinary team consisting of a surgeon, physician, dietician, and exercise consultant, all of whom were involved in the evaluation of clinical outcomes. Continuous data were reported as mean +/- SD; categorical data were reported as number and percentage. Patients served as their own controls.


RESULTS
Respective preoperative mean age, weight, and body mass index (BMI) were 44 years (range 16-76), 122 kg (range 86-240), and 44 kg/m2 (range 35-86), respectively. SAGB implantation was accomplished by the pars flaccida technique with no conversion to an open procedure. Mature follow-up data were available for 35% of patients at 24 months and 21% at 36 months. In the total cohort of 838 patients, BMI (mean +/- SD) decreased to 32 +/- 5 kg/m2 and 32 +/- 7 kg/m2 at 24 months and 36 months, respectively. Percentage excess weight loss (%EWL) (mean +/- SD) was 32% +/- 14% (n = 506), 47% +/- 15% (n = 461), 52% +/- 16% (n = 291), and 54% +/- 23% (n = 175) at 6, 12, 24, and 36 months, respectively (P < .001). There were 545 patients identified with comorbid illness at >6-month follow-up. After a median follow-up of 13 months (range 6-36 months), resolution and/or improvement of comorbidities was as follows: type 2 diabetes mellitus, 79%; metabolic syndrome, 78%; hypertension, 67%; dyslipidemia, 66%; gastroesophageal reflux, 66%; asthma, 57%; arthritis/joint pain, 70%; polycystic ovarian syndrome, 48%; and depression, 57%. There was a significant improvement in QoL (as measured by the Short Form-36 Health Survey [SF-36]), bringing patients' QoL to a level consistent with that of community norms in all 8 domain scores. Of 342 patients surveyed with the Beck Depression Inventory (BDI-II), a statistically significant improvement in depressive mood was also observed (P < .001).


CONCLUSIONS
Weight loss achieved by use of the SAGB provides a dramatic reduction in many serious comorbid illnesses as well as improvement in the psychosocial wellbeing of morbidly obese patients.
Brancatisano
Anthony
A
Institute of Weight Control, Sydney, Australia. tony.brancatisano@iwcs.net.au
Wahlroos
Sara
S
Brancatisano
Roy
R
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D002908:Chronic Disease; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology