Weight Loss and Durability of Gastric Banding in Adolescents with Severe Obesity; 8-year Follow-up of a Randomized Controlled Trial

Objective Metabolic and bariatric surgery is an established treatment for severe obesity. Laparoscopic adjustable gastric banding (LAGB) was once considered a promising option for adolescents. However, long-term data in this population are lacking. We aimed to evaluate the long-term effectiveness of LAGB in adolescents extending beyond 3 years postoperatively. Methods Adolescents with severe obesity were randomly assigned to the intervention group (LAGB and multidisciplinary lifestyle intervention [MLI]) or the control group (MLI), with annual follow-ups for 3 years. We conducted a follow-up analysis of this cohort after 8.6 years (range: 5.0-12.5). Results A total of 59 patients were randomized (29 LAGB + MLI and 30 MLI only). Early differences in weight loss were observed during the first 2 years, but no significant difference persisted after 8.7 years (mean difference body mass index: 1.8 kg/m(2), 95% CI: -3.2, 6.8). The band removal rate was high (52%). Conclusion After nearly 9 years, LAGB resulted in minimal weight loss and had a high removal rate in adolescents with severe obesity. Our study was limited by loss to follow-up, self-reported weights, and crossover. Nonetheless, these findings confirm the lack of efficacy that has led to the global decline in LAGB procedures and underscore the shift toward more effective surgical procedures.