BackgroundLaparoscopic adjustable gastric band (LAGB) has been an established bariatric procedure for the last three decades and was, for many years, the first-choice procedure for the treatment of chronic obesity. However, more recently, the popularity of the LAGB has been in sharp decline and has been replaced by other procedures such as the Roux-En-Y gastric bypass and sleeve gastrectomy. A key driver in this decline has been the high revision and early explanation rates reported in some studies.MethodsThis was a retrospective study of 2246 patients who underwent LAGB at a large private clinic in the UK between June 2004 and October 2014.Results2246 patients were included in the study; 1945 (84.6%) were women. All patients were followed up for 2 years following their procedure and subsequent follow up was at the discretion of patients. Mean follow up duration was 43.7 +/− 29.3 months. Operative mortality was zero and there were no in-hospital returns to theatre. Mean preoperative weight and body mass index (BMI) were 111.2 ± 22.1 kg and 39.9 ± 6.7 kg/m2 respectively. Mean excess % BMI loss at 1-, 2-, 5- and 8-years of follow-up was 43.1 ± 25.4, 47.9 ± 31.9, 52.4 ± 41.7 and 57.1% ± 28.6 respectively. There was no significant difference in mean excess % BMI loss between those < 50 or ≥ 50 years old (p value = 0.23) or between patients with an initial BMI of < or ≥ 50 kg/m2 (p value = 0.65). Complications over nine years occurred in 130 (5.8%) patients and included: 39 (1.7%) slippage or pouch dilatation, 2 (0.04%) erosions and 76 (3.4%) problems related to the access port or LAGB tubing. The overall re-operation rate for LAGB complications was 4.2% over 9 years with a LAGB explantation rate of 1.5%. 39 LAGBs were converted to a sleeve or gastric bypass procedure, 11 of these due to complications.ConclusionThis is the first study to report on LAGB outcomes from a private clinic in the UK. LAGB is a safe procedure, which delivers significant and durable weight loss with acceptable complications rates and low re-operation rate.

Background In Argentina, there is evidence suggesting the obesity prevalence follows a social gradient. We analyze geographical differentials and trends in obesity burden according to socio-demographic conditions in Argentina (2005-2013). Methods The geographical distribution (n = 24 provinces) of the obesity burden in adult population of Argentina in 2005, 2009, and 2013 was analyzed by using mapping techniques. The National Survey of Chronic Diseases Risk Factors datasets were used to estimate and map the age-standardized prevalence of obesity (ASPO) and group-specific prevalence (% obesity) by province and year. Population groups were defined according to socio-demographic factors: age, sex, income level, education, and poverty level (by unsatisfied basic needs –UBN). Results Most of the provinces had an increasing ASPO between 2005 and 2013. In 2013, 75% of the provinces showed an ASPO above 20% in men, while 50% of the provinces exceed this ASPO value in women. In both sexes, the middle-aged group presented the most unfavorable situation. Overall, all the socio-demographic groups considered showed growing trends in obesity prevalence, although there were geographical disparities. Among the middle-income level population, a marked rising change was observed from 2009 to 2013. The population with incomplete primary education presented higher prevalence for all the years studied compared to the population with university education. Conclusions Since 2005, there was an overall increase in obesity prevalence in Argentina, with persistence of geographical disparities according to socio-demographical conditions. Key messages An overall rising trend in obesity prevalence was observed in Argentina. Geographical disparities by social groups were observed.