Bariatric surgery has proved the most effective weight-loss method in very obese patients, but long-term outcomes haven't been adequately studied, in part because surgical techniques have advanced so quickly. Now, after evaluating patient outcomes three years after bariatric surgery, researchers have discovered that severely obese patients experienced most of their weight loss within the first year of their procedure.

The study used data from the Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, a multicenter observational cohort study conducted at 10 hospitals across the United States. Nearly 2,500 patients undergoing a first bariatric procedure between 2006 and 2009 were recruited for study participation and followed until 2012. Most of the patients (n = 1,738) underwent a Roux-en-Y gastric bypass (RYGB). Laparoscopic adjustable gastric banding (LAGB) was performed in 610 patients, and 110 underwent another type of bariatric surgery. Only the largest groups (RYGB and LAGB) were included in the analysis. Patient data were collected at baseline, six months after the procedure, at one year, and annually thereafter.

The patients' ages ranged from 18 to 78 years; 79% were women. The baseline mean body mass index was 46 kg/m2. Analysis of selected comorbidities showed that at baseline, 33% of patients had diabetes, 63% had dyslipidemia, and 68% had hypertension.

Three years after surgery, the median percentage of body weight lost was 31.5% among RYGB patients and 15.9% among LAGB patients, with the greatest amount of weight lost in the first year after surgery. The median weight loss was 41 kg (90.2 lbs.) among RYGB patients and 20 kg (44 lbs.) among LAGB patients. At least a partial remission of diabetes was seen in 67.5% of RYGB patients and in 28.6% of LAGB patients at year three. Dyslipidemia remission occurred in 61.9% of RYGB patients and in 27.1% of LAGB patients. Hypertension remission was seen in 38.2% of RYGB patients and in 17.4% of LAGB patients.

Despite the impressive overall outcomes, considerable variability was observed over the three years in patients' patterns of weight loss and comorbidity, suggesting that patients may need additional support for the lifestyle changes that are necessary in the aftermath of bariatric surgery.

Reference