Patient factors associated with undergoing laparoscopic adjustable gastric banding vs roux-en-y gastric bypass for weight loss

Caroline M. Apovian, Karen W. Huskey, Sarah Chiodi, Donald T. Hess, Benjamin E. Schneider, George L. Blackburn, Daniel B. Jones, Christina C. Wee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 commonly performed bariatric procedures in the US with different profiles for risk and effectiveness. Little is known about factors that might lead patients to proceed with one procedure over the other. Study Design We recruited and interviewed patients seeking bariatric surgery from 2 academic centers in Boston (response rate 70%). We conducted multivariable analyses to identify patient perceptions and clinical and behavioral characteristics that correlated with undergoing gastric banding (n = 239) vs gastric bypass (n = 297). Results After adjustment for socio-demographic and clinical factors, we found that older patients (odds ratio [OR] 1.03; 95% CI 1.00 to 1.05) and those with higher quality of life scores and higher levels of uncontrolled eating were more likely to undergo gastric banding as opposed to gastric bypass. In contrast, patients with type 2 diabetes (OR 0.46; 95% CI 0.28 to 0.77), those who desired greater weight loss, and those who were willing to assume higher mortality risk to achieve their ideal weight were less likely to proceed with gastric banding. After initial adjustment, male sex and lower body mass index were associated with a likelihood of undergoing gastric banding; however, these factors were no longer significant after adjustment for other significant correlates such as patients' perceived ideal weight, predilection to assume risk to lose weight, and eating behavior. Conclusions Patients' diabetes status, quality of life, eating behavior, ideal weight loss, and willingness to assume mortality risk to lose weight were associated with whether patients proceeded with gastric banding as opposed to gastric bypass. Other clinical factors were less important.

Original languageEnglish (US)
Pages (from-to)1118-1125
Number of pages8
JournalJournal of the American College of Surgeons
Volume217
Issue number6
DOIs
StatePublished - Dec 1 2013

Fingerprint

Gastric Bypass
Weight Loss
Stomach
Weights and Measures
Feeding Behavior
Odds Ratio
Quality of Life
Bariatrics
Social Adjustment
Bariatric Surgery
Mortality
Type 2 Diabetes Mellitus
Body Mass Index
Eating
Demography

Keywords

  • Abbreviations and Acronyms
  • BMI
  • body mass index
  • Impact of Weight on Quality of Life-lite Questionnaire
  • IWQOL-lite
  • SOS-TFEQ-18
  • Swedish Obese Subjects Three Factor Eating Questionnaire

ASJC Scopus subject areas

  • Surgery

Cite this

Patient factors associated with undergoing laparoscopic adjustable gastric banding vs roux-en-y gastric bypass for weight loss. / Apovian, Caroline M.; Huskey, Karen W.; Chiodi, Sarah; Hess, Donald T.; Schneider, Benjamin E.; Blackburn, George L.; Jones, Daniel B.; Wee, Christina C.

In: Journal of the American College of Surgeons, Vol. 217, No. 6, 01.12.2013, p. 1118-1125.

Research output: Contribution to journalArticle

Apovian, Caroline M. ; Huskey, Karen W. ; Chiodi, Sarah ; Hess, Donald T. ; Schneider, Benjamin E. ; Blackburn, George L. ; Jones, Daniel B. ; Wee, Christina C. / Patient factors associated with undergoing laparoscopic adjustable gastric banding vs roux-en-y gastric bypass for weight loss. In: Journal of the American College of Surgeons. 2013 ; Vol. 217, No. 6. pp. 1118-1125.
@article{2f551c9ea71c4834a6316f3539d8f8cc,
title = "Patient factors associated with undergoing laparoscopic adjustable gastric banding vs roux-en-y gastric bypass for weight loss",
abstract = "Background Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 commonly performed bariatric procedures in the US with different profiles for risk and effectiveness. Little is known about factors that might lead patients to proceed with one procedure over the other. Study Design We recruited and interviewed patients seeking bariatric surgery from 2 academic centers in Boston (response rate 70{\%}). We conducted multivariable analyses to identify patient perceptions and clinical and behavioral characteristics that correlated with undergoing gastric banding (n = 239) vs gastric bypass (n = 297). Results After adjustment for socio-demographic and clinical factors, we found that older patients (odds ratio [OR] 1.03; 95{\%} CI 1.00 to 1.05) and those with higher quality of life scores and higher levels of uncontrolled eating were more likely to undergo gastric banding as opposed to gastric bypass. In contrast, patients with type 2 diabetes (OR 0.46; 95{\%} CI 0.28 to 0.77), those who desired greater weight loss, and those who were willing to assume higher mortality risk to achieve their ideal weight were less likely to proceed with gastric banding. After initial adjustment, male sex and lower body mass index were associated with a likelihood of undergoing gastric banding; however, these factors were no longer significant after adjustment for other significant correlates such as patients' perceived ideal weight, predilection to assume risk to lose weight, and eating behavior. Conclusions Patients' diabetes status, quality of life, eating behavior, ideal weight loss, and willingness to assume mortality risk to lose weight were associated with whether patients proceeded with gastric banding as opposed to gastric bypass. Other clinical factors were less important.",
keywords = "Abbreviations and Acronyms, BMI, body mass index, Impact of Weight on Quality of Life-lite Questionnaire, IWQOL-lite, SOS-TFEQ-18, Swedish Obese Subjects Three Factor Eating Questionnaire",
author = "Apovian, {Caroline M.} and Huskey, {Karen W.} and Sarah Chiodi and Hess, {Donald T.} and Schneider, {Benjamin E.} and Blackburn, {George L.} and Jones, {Daniel B.} and Wee, {Christina C.}",
year = "2013",
month = "12",
day = "1",
doi = "10.1016/j.jamcollsurg.2013.08.004",
language = "English (US)",
volume = "217",
pages = "1118--1125",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Patient factors associated with undergoing laparoscopic adjustable gastric banding vs roux-en-y gastric bypass for weight loss

AU - Apovian, Caroline M.

AU - Huskey, Karen W.

AU - Chiodi, Sarah

AU - Hess, Donald T.

AU - Schneider, Benjamin E.

AU - Blackburn, George L.

AU - Jones, Daniel B.

AU - Wee, Christina C.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Background Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 commonly performed bariatric procedures in the US with different profiles for risk and effectiveness. Little is known about factors that might lead patients to proceed with one procedure over the other. Study Design We recruited and interviewed patients seeking bariatric surgery from 2 academic centers in Boston (response rate 70%). We conducted multivariable analyses to identify patient perceptions and clinical and behavioral characteristics that correlated with undergoing gastric banding (n = 239) vs gastric bypass (n = 297). Results After adjustment for socio-demographic and clinical factors, we found that older patients (odds ratio [OR] 1.03; 95% CI 1.00 to 1.05) and those with higher quality of life scores and higher levels of uncontrolled eating were more likely to undergo gastric banding as opposed to gastric bypass. In contrast, patients with type 2 diabetes (OR 0.46; 95% CI 0.28 to 0.77), those who desired greater weight loss, and those who were willing to assume higher mortality risk to achieve their ideal weight were less likely to proceed with gastric banding. After initial adjustment, male sex and lower body mass index were associated with a likelihood of undergoing gastric banding; however, these factors were no longer significant after adjustment for other significant correlates such as patients' perceived ideal weight, predilection to assume risk to lose weight, and eating behavior. Conclusions Patients' diabetes status, quality of life, eating behavior, ideal weight loss, and willingness to assume mortality risk to lose weight were associated with whether patients proceeded with gastric banding as opposed to gastric bypass. Other clinical factors were less important.

AB - Background Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding are 2 commonly performed bariatric procedures in the US with different profiles for risk and effectiveness. Little is known about factors that might lead patients to proceed with one procedure over the other. Study Design We recruited and interviewed patients seeking bariatric surgery from 2 academic centers in Boston (response rate 70%). We conducted multivariable analyses to identify patient perceptions and clinical and behavioral characteristics that correlated with undergoing gastric banding (n = 239) vs gastric bypass (n = 297). Results After adjustment for socio-demographic and clinical factors, we found that older patients (odds ratio [OR] 1.03; 95% CI 1.00 to 1.05) and those with higher quality of life scores and higher levels of uncontrolled eating were more likely to undergo gastric banding as opposed to gastric bypass. In contrast, patients with type 2 diabetes (OR 0.46; 95% CI 0.28 to 0.77), those who desired greater weight loss, and those who were willing to assume higher mortality risk to achieve their ideal weight were less likely to proceed with gastric banding. After initial adjustment, male sex and lower body mass index were associated with a likelihood of undergoing gastric banding; however, these factors were no longer significant after adjustment for other significant correlates such as patients' perceived ideal weight, predilection to assume risk to lose weight, and eating behavior. Conclusions Patients' diabetes status, quality of life, eating behavior, ideal weight loss, and willingness to assume mortality risk to lose weight were associated with whether patients proceeded with gastric banding as opposed to gastric bypass. Other clinical factors were less important.

KW - Abbreviations and Acronyms

KW - BMI

KW - body mass index

KW - Impact of Weight on Quality of Life-lite Questionnaire

KW - IWQOL-lite

KW - SOS-TFEQ-18

KW - Swedish Obese Subjects Three Factor Eating Questionnaire

UR - http://www.scopus.com/inward/record.url?scp=84888007967&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888007967&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2013.08.004

DO - 10.1016/j.jamcollsurg.2013.08.004

M3 - Article

C2 - 24083911

AN - SCOPUS:84888007967

VL - 217

SP - 1118

EP - 1125

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 6

ER -