OBJECTIVES

Few published studies have reported body mass index (BMI) following different bariatric surgical procedures. This real-world study compared the rates of obesity and severe obesity at multiple time points following laparoscopic gastric bypass (LGB) or laparoscopic gastric sleeve (LGS) procedures.

METHODS

This retrospective study utilized the TriNetX EMR Research Data Network and Platform. Patients ≥20 years old undergoing LGB or LGS between January 2009 and March 2018 were identified and then excluded if they ever underwent any alternative surgical treatment for obesity. Demographic and clinical characteristics one-year pre-surgery were used for 1:1 propensity-score matching. Outcomes at 1, 3, and 5 years post-surgery included BMI <30 (non-obese) and <40 (non-super obese), using the most recent measurement or diagnosis code, were compared using standard bivariate statistics.

RESULTS

Initially 14,482 LGB and 20,890 LGS patients of similar mean age (46±12 years), proportion female (79%) and mean BMI (45±9) met the study criteria. LGB patients had significantly higher rates of comorbidity but lower rates of select medication use. Post-match (n=13,450 each) standardized differences were all <10%. At each time point significantly greater rates of LGB compared to LGS patients attained BMIs <30 (Year 1: 21.6% vs 11.6%; Year 3: 32.2% vs 16.0%; Year 5: 34.0% vs 16.7%) and <40 (Year 1: 57.2% vs 49.3%; Year 3: 66.3% vs 54.6%; Year 5: 68.6% vs 55.7%), all P<0.001. The 5-year odds ratios were BMI<40: 2.50 (CI 2.44, 2.74) and BMI<30: 1.70 (1.66, 1.83).

CONCLUSIONS

In this real-world setting, LGB patients were more likely than LGS patients to not be obese or severely obese up to 5 years following surgery. While more than half the patients in each cohort could not be classified as severely obese by year 1, the proportion of the LGB cohort to not be obese was 2-fold greater at each time point post-surgery.