Highlights
- •This study includes 1,296 patients across many institutions in the US with class I obesity.
- •Patients lost up to 20% of their initial BMI.
- •At around two years after the surgery, the likelihood of being in remission from type 2 diabetes reached 45%.
- •Remission probabilities for hypertension are 60% for RYGB and 50% for SG, three years after the surgery; hyperlipidemia are close to 50% and 25% for RYGB and SG at two years.
- •There was no difference between the BMI trajectories and remission from T2D when comparing the two groups.
Abstract
Background
NIH-established indications for bariatric surgery were set close to 3 decades ago.
Objectives
The purpose of this study was to evaluate outcomes in patients undergoing bariatric
surgery with class I obesity, a class that does not fall into current indications.
Setting
University Hospital.
Methods
De-identified records from a clinic system’s Electronic Health Record database were
accessed to identify adult patients undergoing Roux-en-Y gastric bypass (RYGB) (n
= 566) and sleeve gastrectomy (SG) (n = 730). Patients were compared in terms of resolution
of co-morbidities and weight loss outcomes at 3 years following surgery. A mixed effects
model was used, adjusting for the type of surgery, the number of quarters after the
surgery when the averaged measurements were taken, and the interaction between these
two variables.
Results
Patients lost up to 20% of their initial body mass index (BMI). Being of younger age,
female, and having an obesity-related co-morbidity were associated with greater weight
loss. At around 2 years after the surgery, the likelihood of being in remission from
type 2 diabetes reached 45%. Remission probabilities for hypertension are 60% for
RYGB and 50% for SG, 3 years after the surgery. On the other hand, the probabilities
of remission from hyperlipidemia are close to 50% and 25% for RYGB and SG at 2 years.
There was no difference between the BMI trajectories and remission from type 2 diabetes
(T2D) when comparing the 2 groups.
Conclusions
Bariatric surgery is effective in weight loss and resolution of comorbidities in patients
with class I obesity. This data further supports the need to revisit the current indication
criteria.
Key words
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Article Info
Publication History
Published online: January 24, 2022
Accepted:
January 12,
2022
Received:
August 12,
2021
Footnotes
The study was funded by OptumLabs, the research and development arm of UnitedHealth Group.
Identification
Copyright
© 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Comment on: Real-world retrospective analysis of outcomes in patients undergoing bariatric surgery with class 1 obesitySurgery for Obesity and Related DiseasesVol. 18Issue 5
- PreviewThe rationale that bariatric surgery should be performed in patients with body mass index (BMI) ≥35 kg/m2 is getting weaker [1]. For bariatric surgery, evidence of durable weight loss and effective co-morbidity resolution in class I obesity has been accumulated, and some countries, including Korea, are implementing insurance benefits for class I obesity with co-morbidities. Altieri et al. (2021) [2] conducted a significantly meaningful study that presented additional evidence of the usefulness of bariatric surgery in cases of class I obesity.
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