Laparoscopic gastric banding and body composition in morbid obesity

Gastric banding induced considerable and rapid weight loss in morbid obesity. Nevertheless data on changes in body composition following gastric banding are scanty. In this study, we evaluated the 2-year changes in body composition in a small group of morbidly obese women treated by laparoscopic adjustable gastric banding (LAGB) associated with a well balanced low-calorie diet.

We studied 20 premenopausal morbid obese women with BMI ranging from 35 to 57 (kg/m2) before, and 6, 12 and 24 months after laparoscopic adjustable gastric banding (LAGB). A well balanced 5.4 MJ/day hypocaloric diet was prescribed after surgery. Total body water (TBW), fat-free mass (FFM) and fat mass (FM) were investigated using conventional bioelectrical impedance analysis (BIA). Tissue hydration was also assessed by impedance vector analysis and the RXc graph method. The subjects showed a total weight loss of 28% of baseline body weight. In the first 6 months after surgery, patients lost 18.5+/-5.9 kg of body weight (17.6+/-6.2 kg of FM and 0.7+/-1.4 kg of FFM). From 6 to 12 months, a further 12.5+/-7.5 kg of body weight was lost (10.5+/-8.2 kg of FM and 2.2+/-3.8 kg of FFM). During the last 12 months, weight loss was 3.0+/-2.3 kg (1.9+/-3.7 kg of FM and 1.1+/-2.9 kg of FFM). The weight loss observed after LAGB was mainly due to a decrease in FM, whereas TBW, FFM and BCM were only slightly and non-significantly reduced. No changes in body hydration status were observed after surgery.

LAGB associated with a well balanced low-calorie diet achieved a satisfactory 2-year weight loss, while sparing FFM and not causing body fluid alterations.