title: Conversion to gastric bypass in patients with unsuccessful weight loss after gastric banding may depend on mental quality of life.
abstract: BACKGROUND
  A low quality of life has been regarded a cue to action. Some patients with unsuccessful weight loss after laparoscopic adjustable gastric banding (LAGB) undergo a conversion of gastric banding to gastric by-pass. This study examines whether patients who did or did not undergo conversion to gastric bypass differed in quality of life before and after gastric banding.
  
  
  METHODS
  Of 34 patients with unsuccessful weight loss after gastric banding (excess body mass index loss < 25%), 14 had a conversion to gastric bypass 2 years or more after gastric banding. All patients completed the RAND-36 quality of life questionnaire before gastric banding. After gastric banding, 24 patients (70.6%) filled out the RAND-36 at 6, 12, and 24 months.
  
  
  RESULTS
  Pre-banding and postbanding mental quality of life was lower in the conversion compared to the non-conversion group.
  
  
  CONCLUSIONS
  Our results suggest that a relatively stable lower mental quality of life is a signal for further intervention. The bariatric team and patients should be aware that mental health may play a role in the decision for conversion to gastric bypass. The possible mechanisms underlying this finding, and limitations of the study are discussed.
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, HE Nijmegen, The Netherlands. J.Larsen@pwo.ru.nl
authors.forename: Junilla K
authors.initials: JK
authors.lastname: Larsen
authors.forename: Hanna
authors.initials: H
authors.lastname: Zijlstra
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshort
authors.forename: Rinie
authors.initials: R
authors.lastname: Geenen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass; D015391:Gastroplasty / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D009767:Obesity, Morbid / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology*; D012086:Reoperation; D011795:Surveys and Questionnaires; D013997:Time Factors; D017211:Treatment Failure; D015431:Weight Loss