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Role of Preoperative Body Mass Index on Estimated Weight Loss, Total Weight Loss, and Remission of Comorbidities After Bariatric Surgery

Cristian Milla Matute, MD, Maria C Fonseca Mora, MD, Mauricio Sarmiento Cobos, MD, Joel S Frieder, MD, Emanuele Lo Menzo, MD, PhD, FACS, Samuel Szomstein, MD, FACS, FASMBS, Raul J Rosenthal, MD, FACS, FASMBS. Cleveland Clinic Florida

INTRODUCTION: Currently, bariatric surgery (BS) is the only long-term treatment for obesity. Demographic, medical and social variables have been thoroughly evaluated as influential on BS outcomes. We found scarcity of literature in regards to the impact of preoperative BMI (Body Mass Index) on BS total weight loss and remission of comorbidities. The aim of this study is to understand the impact of preoperative BMI on BS outcomes.

METHODS: After IRB approval, a retrospective review of all patients who underwent bariatric surgery from 2004-2017 was performed. Demographics and comorbidities were analyzed. Patients were assigned into three BMI groups; 30-39.9, 40-49.9, >50. Total weight loss, excess body mass index loss, and comorbidities were analyzed at a 12-month postoperative follow-up period. Student’s T-test and ANOVA was used for means and Chi-Square for categorical values, all tests were two-tailed and performed at a significant level of <0.05.

RESULTS: A total of 1,389 patients were analyzed. This population was predominantly female 70% (n=972), the most common procedure performed was LSG (Longitudinal Sleeve Gastrectomy) 65.3% (n=903) and had a mean age of 54±11ys. From this total population 42% (n=583) were between 30-39.9 Kg/m2 BMI, 43% (n=595) in 40-49.9BMI and 15% (n=211) was above 50BMI. At 12 months follow-up the category 30-39.9BMI had a 66%EBMIL (Percentage of Excess Body Mass Index Loss), the category 40-49.9BMI had 59%EBMIL and the category above 50BMI had 55%EBMIL (p=0.02). Regarding Total Weight Loss, category 30-39.9BMI lost 21.9±14kg, category 40-49.9BMI lost 32.3±17kg and category above 50BMI lost 49.3±22kg (p=0.001). When analyzing remission of comorbidities, we observed equal remission rates of Diabetes, High Blood Pressure, and Dyslipidemia amongst all three BMI categories and all were found to have statistical significance.

CONCLUSIONS: Bariatric patients with BMI ranging from 30-39.9km/m2 had higher % EBMIL, yet patients with BMI above 50 had greater total weight loss. Remission of comorbidities rates were similar among all categories and equally statistically significant. Although many other variables contribute to the weight loss results, it seems that proportionally the initial BMI has an influence the final weight loss outcome.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95292

Program Number: P067

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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