Comparison of weight loss achieved after laparoscopic adjustable gastric banding between Afro-Caribbean, Caucasian and South Asian adult female patients in a London bariatric centre

Abstract

Introduction It has been shown that following laparoscopic adjustable gastric banding (LAGB) procedures, Afro-Caribbeans achieve poorer weight loss compared with Caucasians. The reasons for this are multifactorial. However, studies have been based on mainly female patients from the US and none to date have been from the UK. Furthermore, South Asians have not previously been compared. The aim of this study was to compare excess weight loss percentage (%EWL) outcomes up to five years following LAGB in Afro-Caribbean, Caucasian and South Asian females in a London-based teaching hospital. Methods An analysis was carried out of prospectively collected data of female patients aged ≥16 years of Afro-Caribbean, Caucasian or South Asian origin who underwent LAGB between October 2000 and December 2011. Data included demographics, co-morbidities and anthropometrics. Results Overall, 596 females underwent LAGB; 316 Caucasians (53.0%), 64 Afro-Caribbeans (10.8%) and 27 South Asians (4.5%) formed the majority of those who disclosed ethnicities. Age and initial body mass index (BMI) were comparable between Afro-Caribbeans and Caucasians (mean BMI: 47.3kg/m2 [standard deviation [SD]: 7.5kg/m2, range: 37.0–78.3kg/m2] vs 45.8kg/m2 [SD: 7.1kg/m2, range: 24.7–79.8kg/m2], p=0.225). A non-significant trend suggested less %EWL in Afro-Caribbeans than in Caucasians at 6 months, and at 1, 2, 3, 4 and 5 years (21.4% vs 24.4%, p=0.26; 27.4% vs 31.3%, p=0.27; 33.0% vs 36.8%, p=0.15; 39.0% vs 45.8%, p=0.14; 34.2% vs 45.3%, p=0.16; 37.1% vs 47.6%, p=0.67). South Asians and Caucasians had a similar age and preoperative BMI (mean BMI: 43.6kg/m2 [range: 32.5–59.1kg/m2] vs 45.8kg/m2 [range: 24.7–79.8kg/m2], p=0.08). The %EWL was greatest at three and four years among South Asians although numbers were small (n=4 and n=3 respectively). Conclusions A non-significant trend suggests poorer weight loss outcomes in Afro-Caribbeans compared with Caucasians in our cohort. Discussion of realistic weight loss outcomes as well as enhanced follow-up and dietary modifications are required for Afro-Caribbean patients. Low numbers prevent definitive conclusions regarding South Asians. Multicentre studies across England are required to better define any differences between ethnicities.

Ethnic variation in weight loss, but not co-morbidity remission, after laparoscopic gastric banding and Roux-en-Y gastric bypass

“…A number of studies report greater weight loss for Caucasian than for African American patients [12,13,[17][18][19][21][22][23], but some have not [20,[24][25][26][27][28] and 1 has found the opposite pattern in men [28]. Earlier studies finding differences in weight loss outcomes focused mainly on either RYGB [12,[17][18][19][20]27,28] or LAGB [11,[23][24][25]. Only Araia et al [26] assessed gastric sleeve, gastric banding, and RYGB, finding no difference in BMI at 1-year follow-up between African American and Caucasian patients.…”

“…Diet and exercise interventions show slightly greater weight loss in Caucasians compared to African American patients [14][15][16] and extant bariatric studies report mixed results regarding ethnic differences in surgical weight loss outcomes. Some studies have found greater weight loss in Caucasian versus African American patients [12,13,[17][18][19][20][21][22][23] and others have not [20,[24][25][26][27]. In fact, 1 study has found that African American men achieve greater weight loss than Caucasian men [28].…”