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Similar improvements observed in morbidly obese, superobese patients after gastric bypass
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Quality of life and obesity-related comorbidities improved in both morbidly obese and superobese patients after gastric bypass surgery, although many superobese patients were still considered severely or morbidly obese.
“Weight loss or residual BMI is not all that matters, and all aspects of the results of bariatric surgery must be evaluated to draw meaningful conclusions about the effectiveness of a given bariatric operation,” researchers wrote in Archives of Surgery.
The researchers compared weight loss, BMI, comorbidities and quality of life in 492 morbidly obese (BMI 40 to 49) patients with 133 superobese (BMI ≥50) patients who underwent laparoscopic gastric bypass between 1999 and 2006.
Total weight loss was similar in both groups. After 18 months, morbidly obese patients lost 34.7% total body weight and maintained an average loss of 30.1% body weight six years after surgery. Superobese patients lost 37.3% total body weight after 30 months and maintained a loss of 30.7% six years later.
At the end of the study, more than 90% of morbidly obese patients had a BMI ≤35 compared with 50% of superobese patients.
Improvements in quality of life and cormorbidities were similar in both groups, according to the researchers.
“Only large randomized studies comparing Roux-en-Y gastric bypass with other bariatric procedures and studying all aspects of weight loss surgery, with long-term follow-up, will be able to establish whether one procedure is superior to the others, especially in the super-obese patient group,” the researchers wrote.
Suter M. Arch Surg. 2009;144:312-318.
The improvements in quality of life that patients experience after bariatric surgery were confirmed in the very obese and superobese and found to occur with weight loss that still left patients markedly overweight. These papers challenge the importance of ‘maximal’ weight loss and high patient volume on outcome.
– George A. Bray, MD
Endocrine Today Editorial Board member