title: Predictors and correlates of follow-up visit adherence among adolescents receiving laparoscopic adjustable gastric banding.
abstract: BACKGROUND
  Adherence behaviors have not been examined among adolescents undergoing laparoscopic adjustable gastric banding (LAGB). In addition, studies of youth receiving bariatric surgery have not considered the influence of psychopathology on postoperative adherence. The purpose of this study was to evaluate predictors and correlates of adherence to post-surgery visits among a sample of adolescents undergoing LAGB.
  
  
  METHODS
  Postoperative visits with surgical staff were analyzed over the 2 years after surgery (n = 101 adolescents). Growth mixture modeling examined trends in adherence.
  
  
  RESULTS
  A 3-class solution provided the best fit to the data. The classes from the final model were characterized by class 1 (61.6%) demonstrating high levels of adherence over the 24 months after LAGB, class 2 (28.5%) showing a more gradual decline in adherence, and class 3 (9.9%) with an accelerated decline in adherence. Higher levels of preoperative depressive symptoms and more preoperative episodes of loss of control overeating decreased the likelihood of adherence. Class 3 adolescents had significantly higher estimated 24-month body mass indices than classes 1 or 2.
  
  
  CONCLUSIONS
  Variable patterns of follow-up visit adherence were identified among adolescents receiving LAGB, which were predicted by depressive symptoms and loss of control overeating. The trajectory characterized by a rapid decline in adherence to follow-up visits was also associated with less weight loss.
authors: Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York. Electronic address: syskor@nyspi.columbia.edu.
authors: Robyn
authors: R
authors: Sysko
authors: Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
authors: Tom B
authors: TB
authors: Hildebrandt
authors: Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
authors: Simona
authors: S
authors: Kaplan
authors: Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
authors: Stephanie K
authors: SK
authors: Brewer
authors: Center for Adolescent Bariatric Surgery, Department of Surgery, Columbia University Medical Center, New York, New York.
authors: Jeffrey L
authors: JL
authors: Zitsman
authors: Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute, New York, New York; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
authors: Michael J
authors: MJ
authors: Devlin
mesh_terms: D000293:Adolescent; D001071:Appointments and Schedules; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D009819:Office Visits / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000706:statistics & numerical data
keywords: Adherence; Adolescents; Bariatric surgery; Follow-up; Laparoscopic adjustable gastric banding