Following vertical banded gastroplasty, how successful are weight-loss results over the long term?

L.K.

Vertical banded gastroplasty (VBG) is one of the most commonly performed surgeries for the treatment of severe obesity. This procedure basically involves stapling the stomach to reduce its size. Patients tend to lose weight because they become full sooner during meals and thus reduce their intake of calories. If performed by an experienced surgeon, this procedure has excellent long-term success rates, with patients generally losing from 40-50 percent of their excess weight.

However, one must keep in mind that, even when done by an experienced surgeon, this operation is a difficult one, and has a 5-10 percent complication rate. Potential early complications include leakage at the surgical site and obstruction of the stomach. Late-onset complications include staple disruption, stomach ulcers and obstruction.

Finally, the most important thing to keep in mind is that not all obese people are good candidates for surgical treatment. Patients must first demonstrate a failure to lose weight using proper dietary, medical and behavioral interventions. They must also understand and be ready to deal (physically and psychologically) with the potential side effects of the surgical procedure.

Surgeons also require that a patient be severely obese, as defined by tables that take into account their height and weight compared to the general population. However, people with moderate obesity may also qualify for weight-reduction surgery if they have a condition related to or aggravated by their obesity (such as high blood pressure, diabetes, arthritis or sleep disturbances). Individuals considering weight-reduction surgery should discuss these issues with their doctor to determine whether they qualify and which other interventions would be helpful in their specific cases.