Key result
Bariatric surgery linked to ~63% excess weight loss and high resolution of HTN and T2DM.
Why the study?
There is a high prevalence of obesity in the Arabian Gulf with relatively little research on bariatric surgery outcomes in patients with super morbid obesity.
Does bariatric surgery improve weight loss and cardiometabolic comorbidities in patients with super morbid obesity?
Cohort (n=144)
No
Does bariatric surgery improve weight loss and cardiometabolic comorbidities in patients with super morbid obesity?
Bariatric surgery is highly effective for weight loss and resolution of cardiometabolic comorbidities such as hypertension and diabetes in patients with super morbid obesity at 12 months.
Bariatric surgery data in super morbid obesity require cautious interpretation; leaves open need for prospective trials before practice change.
Introduction: There is currently a high prevalence of obesity in the Arabian Gulf yet relatively little research on bariatric surgery. In this study we investigate the efficacy of bariatric surgery in patients with super morbid obesity, defined as a Body Mass Index (BMI) of ≥ 50 kg/m2 . Methods: All records of bariatric surgery at a single centre were examined. Outcomes measured include Body Mass Index (BMI), percentage Excess Weight Loss (%EWL), Obstructive Sleep Apnoea (OSA), Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM). Statistical relationships between %EWL against age, type of surgery and gender were analysed. Results: 144 patients were found to meet the inclusion criteria. Mean pre-operative BMI was 56.9 ± 6.1 kg/m2 . 90 (62.5%) patients underwent sleeve gastrectomy, 24 (16.7%) had one anastomosis gastric bypass, 16 (11.1%) had biliopancreatic diversion (Scopinaro’s procedure), and 14 (9.7%) had sleeve gastrectomy with transit loop bipartition. 12 months post-operatively, mean BMI was 37.7 ± 7.5 kg/m2 , with a mean %EWL of 62.9% ± 17.9%. There was 100% OSA resolution, 95.3% HTN resolution, and 79.4% T2DM resolution. %EWL was found to decrease slightly with increased age, however no difference in %EWL was found between types of surgery or genders. Conclusion: Bariatric surgery is effective and may be justified in patients with super morbid obesity, including the elderly population. However, there is a great need for larger, longitudinal studies. This would be made possible by hospitals employing more regular and systematic reporting of data, and encouragement of patients to follow up.
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Abualsel et al. (2020) conducted a cohort in Super morbid obesity (n=144). Bariatric surgery was evaluated on Percentage Excess Weight Loss (%EWL). Bariatric surgery in patients with super morbid obesity achieved a mean excess weight loss of 62.9% at 12 months, with 100% resolution of OSA, 95.3% of HTN, and 79.4% of T2DM.
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