Laparoscopic Adjustable Gastric Banding (LAGB) as a Treatment for Morbid Obesity in Adolescents
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Insomnia Sleep Studies, Obesity Weight Loss, Endocrine, Gastrointestinal, Pulmonary |
| Therapuetic Areas: | Endocrinology, Gastroenterology, Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 14 - 19 |
| Updated: | 4/21/2016 |
| Start Date: | September 2005 |
| End Date: | July 2016 |
LAGB Laparoscopic Adjustable Gastric Banding as a Treatment for Morbid Obesity in Adolescents
Laparoscopic adjustable gastric banding (LAGB) has been used worldwide to help selected
morbidly obese adults to lose weight. The FDA has approved LAGB only for patients 18 years
or older. Our hypothesis that LAGB can be used to assist selected adolescents between 14 and
17 years lose weight and that the procedure can be performed safely in this age group. We
are also evaluating the effects of weight loss after LAGB on known comorbid conditions such
as sleep apnea syndrome and insulin resistance, and also on psychological health.
morbidly obese adults to lose weight. The FDA has approved LAGB only for patients 18 years
or older. Our hypothesis that LAGB can be used to assist selected adolescents between 14 and
17 years lose weight and that the procedure can be performed safely in this age group. We
are also evaluating the effects of weight loss after LAGB on known comorbid conditions such
as sleep apnea syndrome and insulin resistance, and also on psychological health.
Seventy to ninety-eight percent of obese children become obese adults. Comorbidities of
obesity such as type II diabetes, fatty liver disease, hyperlipidemia, hypertension, asthma,
sleep apnea, and depression are becoming increasing common in adolescents as more
adolescents become obese. The only consistently durable and effective weight loss programs
for the morbidly obese patients are those that include bariatric surgical procedures. The
investigators believe that the best initial bariatric surgical option for adolescents is
LAGB because of its low complication rates, adjustability, and reversibility. Obese
adolescents ages 14-17 who meet criteria for entry will be enrolled to determine the degree
of success of LAGB as measured by % excess weight loss, decreased % body fat, decreased body
mass index (BMI), reduction in comorbid conditions, and metabolic parameters (including
serum lipids and glucose tolerance) at intervals of 3 months, 6 months, 1 year, then
annually for a total of 5 years postoperatively. Eligible patients will have been followed
for 6 months by physicians in the Center for Adolescent Bariatric Surgery and: 1) will
attended a minimum of 75% of visits and 2) will have failed to lose at least 20% of excess
weight. Following evaluation by the team (which will include evaluations by a nutritionist,
an endocrinologist, a psychologist/psychiatrist, a pediatric nurse practitioner, and a
surgeon) a patient may be offered LAGB.
obesity such as type II diabetes, fatty liver disease, hyperlipidemia, hypertension, asthma,
sleep apnea, and depression are becoming increasing common in adolescents as more
adolescents become obese. The only consistently durable and effective weight loss programs
for the morbidly obese patients are those that include bariatric surgical procedures. The
investigators believe that the best initial bariatric surgical option for adolescents is
LAGB because of its low complication rates, adjustability, and reversibility. Obese
adolescents ages 14-17 who meet criteria for entry will be enrolled to determine the degree
of success of LAGB as measured by % excess weight loss, decreased % body fat, decreased body
mass index (BMI), reduction in comorbid conditions, and metabolic parameters (including
serum lipids and glucose tolerance) at intervals of 3 months, 6 months, 1 year, then
annually for a total of 5 years postoperatively. Eligible patients will have been followed
for 6 months by physicians in the Center for Adolescent Bariatric Surgery and: 1) will
attended a minimum of 75% of visits and 2) will have failed to lose at least 20% of excess
weight. Following evaluation by the team (which will include evaluations by a nutritionist,
an endocrinologist, a psychologist/psychiatrist, a pediatric nurse practitioner, and a
surgeon) a patient may be offered LAGB.
Inclusion Criteria:
- Ages 14-17 upon entry
- BMI >40 or >35 with associated medical comorbidities (e.g., sleep apnea, hypertension
Exclusion Criteria:
- severe psychiatric illness
- eating disorder with purging
- previous weight loss surgery
- stated inability to comply with pre-op and post-op visits
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