title: Previous weight loss as a predictor of weight loss outcomes after laparoscopic adjustable gastric banding.
abstract: Weight loss after laparoscopic adjustable gastric banding (LAGB) can be influenced by a variety of factors. The objective of this study is to investigate whether the maximum amount of previous weight loss with diet and exercise, prior to evaluation for bariatric surgery, is predictive of postoperative weight loss success among primary LAGB patients.
  
  
  
  A retrospective cohort study was designed from a prospectively collected database at a single institution. Inclusion criteria consisted of age ≥18 years, initial body mass index (BMI) ≥35 kg/m(2), intake information on the maximum weight loss at any time prior to referral to our bariatric practice, and at least 2 years of postoperative follow-up. Patients with prior bariatric surgery were excluded. Outcomes included mean % excess weight loss (EWL), percent that achieved weight loss success (%EWL ≥ 40), and percent with suboptimal weight loss (%EWL < 20) at 2 years post-LAGB.
  
  
  
  In the study, 462 primary LAGB patients were included. Mean previous weight loss was 29.7 lb (SD 27.6, range 0-175). These patients were divided into four previous weight loss groups (0, 1-20, 21-50, >50 lb) for analysis. In adjusted multivariate analyses, patients with >50 lb of maximum previous weight loss had a significantly higher mean %EWL, (p < 0.0001) and %BMIL (p < 0.0001), were more likely to reach weight loss success (≥40 % EWL, p = 0.047), and were less likely to experience suboptimal weight loss (<20 % EWL, p = 0.027) at 2 years postoperatively.
  
  
  
  Previous weight loss appears to be a significant predictor of weight loss after LAGB. With multiple options for weight loss surgery, this study helps elucidate which patients may be more likely to achieve greater weight loss with the LAGB, allowing clinicians to appropriately counsel patients preoperatively.
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA. monica.sethi@nyumc.org.
authors.forename: Monica
authors.identifier: 0000-0001-7784-0954
authors.initials: M
authors.lastname: Sethi
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Beitner
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Magrath
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Schwack
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Kurian
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: George
authors.initials: G
authors.lastname: Fielding
authors.affiliation: Division of Bariatric Surgery, Department of Surgery, New York University School of Medicine, 530 First Avenue, Suite 10Z, New York, NY, 10016, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Ren-Fielding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004035:Diet Therapy; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery* / Q000628:therapy; D057234:Preoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; Dietary history; Laparoscopic adjustable gastric band; Preoperative weight loss; Previous weight loss