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.

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).

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%).

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.

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.

Received: 08 July 2025

Accepted: 14 January 2026

Accepted Manuscript online:
19 January 2026

Article published online:
31 January 2026

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