title: Impact of lap-band size on weight loss: does gender matter?
abstract: BACKGROUND
  Laparoscopic adjustable gastric band (LAGB) has gone through major design modifications to improve clinical endpoints and reduce complications. Little is known, however, about the effects of LAGB size on clinical outcomes, or whether outcomes differ based on gender. We set out to examine the impact of band size on surgical weight loss, reoperations, comorbidity resolution, and compare outcomes within gender.
  
  
  METHODS
  We reviewed our prospectively collected longitudinal bariatric database between 2008 and 2010, and compared patients with BMI 35-50 kg/m(2) who had undergone LAGB with the LAP-BAND® APS to those who had the larger APL. Those patients with initial BMI > 50 kg/m(2) were excluded to reduce any possible selection bias which favors larger band use in such subjects.
  
  
  RESULTS
  Three hundred ninety-four patients met our inclusion criteria; 230 (58 %) in the APS group and 164 (42 %) in the APL group. Female patients in APS group experienced significantly higher percentage excess body weight loss at 6 months, 1 year, and 2 years in comparison to female patients in APL group (p < 0.001 for all time points). In contrast, a reverse pattern was observed for male patients. No significant differences were observed between the groups regarding frequency of band adjustments, complications, or comorbidity resolution.
  
  
  CONCLUSIONS
  Male patients might benefit from APL bands, in contrast to female patients who appear to experience superior weight loss with the smaller APS bands. This study provides the first set of evidence to facilitate surgical decision making for band size selection and highlights differences between genders.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Ardestani
authors.forename: Ardalan
authors.initials: A
authors.lastname: Tangestanipoor
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Robinson
authors.forename: David B
authors.initials: DB
authors.lastname: Lautz
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Vernon
authors.forename: Ali
authors.initials: A
authors.lastname: Tavakkoli
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000453:epidemiology; D015391:Gastroplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology*; D011446:Prospective Studies; D012086:Reoperation; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss