Long-term outcomes of patients with obesity who underwent sleeve gastrectomy or Roux-en-Y gastric bypass surgery in Korea

Despite global evidence supporting metabolic and bariatric surgery (MBS), there is limited data on its long-term durability specifically in Korean patients with obesity. This study presents the first comprehensive long-term assessment of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in the Korean population, examining the effects on weight loss, comorbidities, and quality of life (QoL). Patients who underwent MBS between 2003 and 2021 at two Korean medical centers were retrospectively identified (n = 768). A total of 270 patients (35.16%) completed an online questionnaire and met inclusion criteria. Outcomes were analyzed across three follow-up periods: short-term (0-2 years), medium-term (2-5 years), and long-term (over 5 years). The percentage of total weight loss (%TWL) was maintained across all follow-up periods: 30.34 ± 7.67% (short-term), 29.35 ± 9.92% (medium-term), and 28.83 ± 9.46% (long-term). Most obesity-related comorbidities, including diabetes, hypertension, hyperlipidemia, and fatty liver disease, showed significant improvement post-surgery, with benefits persisting beyond 5 years. QoL assessed using EuroQol 5-Dimension 3-level (EQ-5D-3L) improved across all follow-up groups, though after covariate adjustment, EQ-5D-3L improvements were greater in the short-term group compared to the long-term group. This first long-term Korean MBS cohort demonstrates sustained weight loss, comorbidity resolution, and QoL improvements that persist beyond 5 years post-surgery. These findings support the durability of bariatric procedures for Korean patients with obesity, though the slight decline in QoL improvements over time suggests the importance of long-term follow-up care to maximize sustained benefits.