Patient and Parent Perspectives of Adolescent Laparoscopic Adjustable Gastric Banding (LAGB).

BACKGROUND: Adolescent obesity is a significant global health challenge and severely obese adolescents commonly experience serious medical and psychosocial challenges. Consequently, severe adolescent obesity is increasingly being treated surgically. The limited available research examining the effectiveness of adolescent bariatric surgery focuses primarily on bio-medical outcomes. There is a need for a more comprehensive understanding of the behavioural, emotional and social factors which affect adolescents' and parents' experience of weight loss surgery. METHODS: Patient and parents' perspectives of adolescent LAGB were examined using a qualitative research methodology. Individual, semi-structured interviews were conducted with eight adolescent patients and five parents. Thematic analysis was used to identify key themes in the qualitative data. RESULTS: Patients and parents generally considered adolescent laparoscopic adjustable gastric banding (LAGB) to be a life-changing experience, resulting in physical and mental health benefits. Factors considered to facilitate weight loss following surgery included parental support and adherence to treatment guidelines. Many adolescents reported experiencing surgical weight loss stigma and challenging interpersonal outcomes after weight loss for which they felt unprepared. CONCLUSIONS: Patients and parents perceived LAGB positively. There are opportunities to improve both the experience and outcomes of adolescent LAGB through parental education and enhancements to surgical aftercare programmes.

Biopsychosocial outcomes of laparoscopic adjustable gastric banding in adolescents: a systematic review of the literature.

Adolescent obesity is a significant global health challenge. Severely obese adolescents commonly experience one or more serious medical comorbidities, such as type 2 diabetes mellitus and hypertension as well as psychosocial comorbidities such as depression, disordered eating behaviour, anxiety and low self-esteem. The aims of this review are to examine the literature on biopsychosocial (e.g. weight loss, medical comorbidities, mental health, and complications) outcomes of adolescent bariatric surgery and to identify areas where current data are deficient and a need for further research is indicated. A systematic review was conducted to examine the biopsychosocial outcomes of adolescent gastric banding. Eleven studies published before May 2013 examining outcomes of adolescent laparoscopic adjustable gastric banding (LAGB) surgery were identified. Available reported data indicate that LAGB surgery was effective in achieving significant weight loss. There is also evidence of the resolution of medical comorbidities; however, reporting of medical comorbidities assessment criteria is limited. Limited consideration was given to the psychosocial outcomes of LAGB surgery. The psychosocial outcomes of adolescent LAGB are not well researched. The current literature on adolescent LAGB is limited by a focus on weight loss and biomedical outcomes. There is currently little understanding of the behavioural, emotional or social factors that influence adolescents' experience of LAGB surgery. Further research is required to examine the specific psychosocial needs and experiences of adolescent LAGB patients, so appropriate treatment approaches may be developed to ensure optimal outcomes for adolescents from LAGB surgery.