We previously demonstrated unacceptably high failure rates with horizontal gastroplasty. Shortly thereafter, vertical banded gastroplasty was introduced. Since April 1982 we have operated on 56 patients who were carefully selected and closely followed. There were 10 men and 46 women, aged 15 to 54 years (mean age 36 years) with preoperative weights of 93.5 to 198.6 kg (mean 125.9 kg). The mean weight loss at 6 to 12 months was 36 +/- 10 kg, or 30% of body weight. At 18 months, data were available for 48 of the 56 patients. Their weight losses were 44 +/- 11 kg, or 35% of body weight. Eight patients were lost to follow-up. The weight of nine additional patients plateaued before they lost 30% of their starting weights and another eight patients have started to regain weight after achieving satisfactory weight loss. Included are two patients with severe stenoses who regained all weight lost.