Abstract Morbid obesity is frequently associated with other characteristics of metabolic syndrome and is related to an increased risk of cardiovascular disease. This study aimed at evaluating time–course changes in body weight, body mass index (BMI), insulin sensitivity indexes and lipid profile in severely obese patients who underwent adjustable silicone gastric banding. We studied 19 obese subjects before and 6–36 months after surgery. An oral glucose tolerance test was performed in all non-diabetic patients. All subjects were evaluated using insulin sensitivity indexes (ISI-HOMA and QUICKI), lipid profile, and anthropometric parameters (WHR, WC, BMI), and body composition was assessed with bioelectrical impedance analysis (BIA). Most of the weight reduction occurred within the first 6–12 months, fol- lowed by near stabilisation or even weight regain. We found a significant decrease in fasting insulin, improvement in waist–hip ratio, reduction in BMI and fat mass percent. We observed an improvement in insulin sensitivity evaluated by means of ISI-HOMA and QUICKI. Bariatric surgery was an effective therapeutic approach for these obese patients because it reduced both weight and insulin resistance, along with improving metabolic parameters. Improvement in metabolic parameters appears to precede body weight reduction. Key words Obesity • BMI • Insulin resistance • Gastric banding • Cardiovascular risk factors Introduction Morbid obesity is frequently associated with other charac- teristics of metabolic syndrome [i.e. hyperglycaemia, hy- perinsulinaemia, insulin resistance, decreased high-density lipoprotein (HDL) cholesterol, hypertriglyceridaemia, ele- vated fibrinogen levels and hyperuricaemia] and is related to an increased risk of cardiovascular disease [1–4]. Treatment of obesity based on dietary measures is unsatis- factory because obesity relapses. Bariatric surgery has been proposed as a tool for achieving stable reduction of body weight in morbidly obese patients. Adjustable sili- cone gastric banding (LAGB) is a minimally invasive and reversible surgical procedure that yields a significant reduction in gastric volume and hunger sensation. The aim of this study was to evaluate time–course changes in cardiovascular risk factors, namely body weight, body mass index (BMI), insulin sensitivity index- es and lipid profile, in severely obese patients who under- went LAGB. Acta Diabetol (2003) 40:S263–S265 DOI 10.1007/s00592-003-0082-2 © Springer-Verlag 2003 L.M. Mariani • M.A. Marini • A. Veneziani • A. Bertoli • R. Lauro Morbid obesity: evaluation of metabolic indexes after adjustable silicone gastric banding L.M. Mariani • M.A. Marini • A. Bertoli () • R. Lauro Department of Internal Medicine University of Tor Vergata, Rome, Italy E-mail: bertolia@rdn.it A. Veneziani Department of General Surgery Catholic University, Rome, Italy