Morbid obesity patient

Hi, I’m a general practitioner and need an opinion on one of my patients.

She is a 55-year-old morbidly obese female, with a BMI of 42 in need of bariatric care. The patient has already undergone LAGB with a therapeutic failure event 10 years ago. Her dietary history includes multiple regimes and the patient has had several cycles of weight loss and gain. Comorbidities include hypertension and type 2 diabetes (insulin independent), both treated and evolving within normal values.

My question to colleagues is if this patient would benefit from a new bariatric surgery intervention despite the previous incidence of LAGB failure? If so, what type could she have as the best option? Or would any of you recommend a trial of psychological treatment associated with dietary management before a surgical intervention?

Thank you in advance for your comments!

Yours sincerely, AP