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Original articles|Articles in Press

The Effect of Marijuana Use on Short Term Outcomes with Bariatric Surgery

      HIGHLIGHTS:

      • Marijuana users had significantly higher total mean weight loss reduction.
      • There were no significant differences in complications or resource utilization.
      • There were no significant differences in adjusted rates of comorbidity remission.
      • Users were more likely to be current smokers and score higher on the AUDIT-C.

      ABSTRACT:

      Background

      Despite increasing marijuana use nationwide, there is limited data on implications of marijuana use on bariatric surgery outcomes.

      Objective

      We investigated associations between marijuana use and bariatric surgery outcomes.

      Setting

      Multicenter state-wide study utilizing data from the Michigan Bariatric Surgery Collaborative (MBSC), a payer-funded consortium including over 40 hospitals and 80 surgeons performing bariatric surgery statewide.

      Methods

      We analyzed data from the MBSC clinical registry on patients who underwent a laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass between June 2019 - June 2020. Patients were surveyed at baseline and annually on medication use, depression symptoms, and substance use. Regression analysis was performed to compare 30-day and 1-year outcomes between marijuana users and non-users.

      Results

      Of 6,879 patients, 574 reported baseline marijuana use and 139 reported use at baseline and 1-year. Marijuana users were more likely to be current smokers (14% vs 8%, p<0.0001), screen positive for alcohol use disorder (20.0% vs 8.4%, p<0.0001), and score higher on the PHQ-8 (6.1 vs. 3.0, p<0.0001). There were no statistically significant differences in 30-day outcomes, or comorbidity remission at 1 year. Marijuana users had higher adjusted total mean weight loss (105 lbs vs 84 lbs p<0.0001) and body mass index reduction (17 kg/m2 vs. 14 kg/m2, p<0.0001).

      Conclusion

      Marijuana use is not associated with worse 30-day outcomes or 1-year weight loss outcomes and should not be a barrier to bariatric surgery. However, marijuana use is associated with higher rates of smoking, substance use, and depression. These patients may benefit from additional mental health and substance abuse counseling.

      KEY WORDS

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