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Impact of Lap-Band Size on Weight Loss: Does Gender Matter?
Ali Ardestani, MD, MSc, Ardalan Tangestanipoor, MD, Malcolm K. Robinson, MD, David B. Lautz, MD, Ashley H. Vernon, MD, Ali Tavakkolizadeh, MD
Brigham and Woman's Hospital, Boston, MA, Harvard Medical School, Boston, MA
Background: Laparoscopic Adjustable Gastric Band (LAGB) has gone through major design modifications to improve clinical endpoints. Little is however known about the effects of LAGB size on clinical outcomes. We set out to review the impact of band size selection on weight loss, complications and comorbidity resolution, focusing on gender based differences.
Methods: We reviewed our longitudinal bariatric database between 2008 and 2010, and compared patients who had undergone LAGB with the LAP-BANDŽ APS to those who had the larger APL. In order to eliminate any bias introduced by using the larger band in patients with higher BMIs, those with BMI > 50 kg/m2 were excluded.
Results: 394 patients met our inclusion criteria; 230 (58%) in the APS group and 164 (42%) in the APL group. Female patients in APS group had significantly higher percentage Excess Body Weight Loss (%EBWL) at 6 months, 1 year, and 2 years in comparison to female patients in APL group (p<0.001 for all time points), however a reverse pattern was observed for male patients (Figure 1). No significant difference was observed between the groups regarding frequency of fills, complications, reoperations or comorbidity resolution.
Conclusion: While men might benefit from APL bands, women experience superior weight loss with smaller APS bands. This study provides the evidence to facilitate surgical decision making for band size selection and highlights differences between genders.
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