Weight loss after gastric banding is associated with pouch pressure and not pouch emptying rate.
BACKGROUND
Morbid obesity defined as BMI > 40 is a growing problem. It is primarily treated with diet, lifestyle changes, and medicine. However, at present, surgery remains the only effective option for the management.


METHODS
Seventeen patients were studied 2 months after laparoscopic gastric banding. The aims were to evaluate the association between (1) the extent of pouch filling and satiety, (2) gastric emptying and weight loss, and (3) the pouch pressure during a meal and the sensation of satiety and weight loss.


RESULTS
The preoperative weight was 146 kg (range 108-202 kg). The average weight loss was 21 kg between the banding and the examination. The half time (T (50%)) for the pouch emptying was 3 min (quartiles 3-12.5) and the time to 90% of pouch emptying (T (90%)) was 40 min (24.5-60). The sensation of satiety lasted 75 min (57.5-105), and the feeling of hunger started after 90 min (40-90). Neither T (50%) nor T (90%) correlated to the weight loss (R = 0.006, P > 0.5 and R = 0.1, P > 0.5). The sensation of satiety did not correlate to T (50%) or T (90%) (R = 0.6, P = 0.12 and R = 0.5, P = 0.15). No association was found between the sensory data and the pressure decline. Significant association was found between the load of the meal expressed as the area under the pouch pressure curve and the weight loss (R = 0.786, P = 0.015).


CONCLUSIONS
The satiety sensation lasted much longer than the pouch emptying and the pressure increase. The pressure load correlated to the weight loss. This indicates that neuroendocrine mechanisms caused by the accumulated mechanical load are most important for maintaining satiety.
Pedersen
Jan Bech
JB
Mech-Sense, Aalborg Hospital Science and Innovation Center, DK-9100, Aalborg, Denmark.
Larsen
Jens Fromholt
JF
Drewes
Asbjørn Mohr
AM
Arveschoug
Anne
A
Kroustrup
Jens Peter
JP
Gregersen
Hans
H
D019540:Area Under Curve; D005746:Gastric Emptying / Q000502:physiology*; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods; D006801:Humans; D006815:Hunger; D008365:Manometry; D009767:Obesity, Morbid / Q000601:surgery*; D010147:Pain Measurement; D011312:Pressure; D012527:Satiation; D016896:Treatment Outcome; D015431:Weight Loss