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Eur J Pediatr Surg
DOI: 10.1055/a-2788-9950
Original Article

Weight Loss and Durability of Gastric Banding in Adolescents with Severe Obesity; 8-year Follow-up of a Randomized Controlled Trial

Authors

  • Fien de Boom 

    1   Department of Surgery, Maastricht University, Maastricht, Zuid-Limburg, The Netherlands

  • Ali Talib

    2   Department of Surgery, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands

  • Yvonne G. M. Roebroek

    2   Department of Surgery, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands

  • Givan F. Paulus 

    3   Department of Surgery, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands

  • Bjorn Winkens

    4   Department of Methodology and Statistics, Maastricht University, Maastricht, LI, Netherlands

  • Nicole D. Bouvy

    5   Department of Surgery, Leiden University Medical Center, Leiden, South Holland, The Netherlands

  • L. W. Ernest van Herum

    6   Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Abstract

Objective

Metabolic and bariatric surgery is an established treatment for severe obesity. Laparoscopic adjustable gastric banding (LAGB) was once considered a promising option for adolescents. However, long-term data in this population are lacking. We aimed to evaluate the long-term effectiveness of LAGB in adolescents extending beyond 3 years postoperatively.

Methods

Adolescents with severe obesity were randomly assigned to the intervention group (LAGB and multidisciplinary lifestyle intervention [MLI]) or the control group (MLI), with annual follow-ups for 3 years. We conducted a follow-up analysis of this cohort after 8.6 years (range: 5.0–12.5).

Results

A total of 59 patients were randomized (29 LAGB + MLI and 30 MLI only). Early differences in weight loss were observed during the first 2 years, but no significant difference persisted after 8.7 years (mean difference body mass index: 1.8 kg/m2, 95% CI: −3.2, 6.8). The band removal rate was high (52%).

Conclusion

After nearly 9 years, LAGB resulted in minimal weight loss and had a high removal rate in adolescents with severe obesity. Our study was limited by loss to follow-up, self-reported weights, and crossover. Nonetheless, these findings confirm the lack of efficacy that has led to the global decline in LAGB procedures and underscore the shift toward more effective surgical procedures.

Keywords

obesity - pediatric obesity - metabolic and bariatric surgery - randomized controlled trial

Contributors' Statement

F.D.B.: formal analysis, resources, software, validation, visualization, and writing—original draft, review, and editing. A.T.: conceptualization, data curation, funding acquisition, investigation, methodology, supervision, and writing—review and editing. Y.G.M.R.: data curation, funding acquisition, investigation, methodology, supervision, validation, and writing—review and editing. G.F.P. and L.W.E.V.H.: conceptualization, data curation, funding acquisition, investigation, methodology, project administration, supervision, and writing—review and editing. B.W.: conceptualization, formal analysis, investigation, methodology, supervision, and writing—review and editing. N.D.B.: conceptualization, funding acquisition, investigation, methodology, supervision, and writing—review and editing.




Publication History

Received: 08 July 2025

Accepted: 14 January 2026

Accepted Manuscript online:
19 January 2026

Article published online:
31 January 2026

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