Key result
Sleeve gastrectomy achieved substantial weight loss in patients with class I obesity, with a pooled excess weight loss of 90.16% at 12 months and 75.73% at 24 months.
Why the study?
While bariatric surgery is established for severe obesity, its efficacy in class I obesity remains debated.
Does bariatric surgery improve weight loss and comorbidity remission in patients with class I obesity (BMI 30-35 kg/m2)?
Meta-Analysis (n=1,703)
Does bariatric surgery improve weight loss and comorbidity remission in patients with class I obesity (BMI 30-35 kg/m2)?
Effect estimate: 90.16% (95% CI 71.21-109.11)
Sleeve gastrectomy achieves substantial and sustained weight loss with significant diabetes remission in patients with class I obesity, though the evidence is limited by critical risk of bias.
Bariatric surgery may benefit select class I obesity patients; leaves open need for RCTs before practice change.
Purpose: Over half the global population lives in countries where obesity complications cause higher morbidity than underweight status.Obesity, a global epidemic, carries substantial health, social, and economic consequences.Class I obesity (body mass index [BMI] 30-35 kg/m 2 ) is increasingly prevalent and associated with metabolic comorbidities including type 2 diabetes mellitus (DM) and hypertension (HTN).While bariatric surgery is established for severe obesity, its efficacy in class I obesity remains debated.This metaanalysis evaluated weight loss and comorbidity remission following bariatric surgery in class I obesity. Materials and Methods:A systematic search of PubMed, Google Scholar, Cochrane Central, and ScienceDirect identified retrospective studies (2000-2024) reporting weight loss (%excess weight loss [EWL], %total weight loss, BMI) or comorbidity remission (DM, HTN) with ≥12-month follow-up in class I obesity patients undergoing bariatric surgery.Weight loss outcomes were restricted to sleeve gastrectomy (SG) for consistency.Pooled estimates and odds ratios (ORs) used random-effects models.Results: Nine retrospective studies (1,703 patients) met inclusion criteria.All had critical ROBINS-I bias risk.Following SG, pooled %EWL was 90.16% (95% CI, 71.21-109.11) at 12 months and 75.73% (95% CI, 74.66-76.80)at 24 months.Mean BMI fell to 24.70 kg/m 2 at 12 months and 25.66 kg/m 2 at 24 months.DM remission improved significantly (OR, 0.20; 95% CI, 0.07-0.57at ≤2 years; OR, 0.15; 95% CI, 0.05-0.49at >2 years).HTN remission was nonsignificant (OR, 0.80; 95% CI, 0.38-1.72 at ≤2 years; OR, 0.61; 95% CI, 0.22-1.64 at >2 years).Conclusion: SG achieves substantial sustained weight loss in class I obesity with significant diabetes remission.However, critical bias limits evidence certainty.High-quality prospective trials are urgently needed.
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Khan et al. (2026) conducted a meta-analysis in Class I Obesity (BMI 30-35 kg/m2) (n=1,703). Sleeve gastrectomy vs. Preoperative baseline was evaluated on Pooled excess weight loss (%EWL) at 12 months (90.16%, 95% CI 71.21-109.11). Sleeve gastrectomy achieved substantial weight loss in patients with class I obesity, with a pooled excess weight loss of 90.16% at 12 months and 75.73% at 24 months.
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