Last Updated: 2009-05-01 16:39:34 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Many severely obese patients who undergo weight-loss surgery remain severely obese after the operation, and yet their quality of life and obesity-related diseases, like diabetes and high blood pressure, improve, new research shows
As reported in the Archives of Surgery, Dr. Michel Suter of Hopital du Chablais, Aigle-Monthey, Lausanne, Switzerland, and colleagues assessed the outcomes of 133 super-obese patients and 492 morbidly obese patients who underwent gastric bypass weight-loss surgery.
Morbid obesity and super obesity are standard classifications based on a person's body weight for height, a measure known as the body mass index or BMI. A normal BMI runs from 18.5 to 24.9, while morbid obesity ranges from 40 to 49 and super obesity is 50 or higher. For a man who is 6 feet tall, the minimum weights for morbid obesity and super obesity are 295 and 369 pounds, respectively.
Surgery took longer for super obese patients than for morbidly obese patients, and they also stayed in the hospital about one day longer. Complication rates, including death, however, were comparable in each group.
The morbidly obese patients lost a maximum of 15 BMI units after 18 months and maintained an average loss of 13 BMI units after six years, which corresponds to a 30.1 percent loss in body weight. The super-obese patients had a maximum weight loss of 21 BMI units and maintained an average loss of 17 BMI units after six years, corresponding to a 30.7 percent loss in body weight.
After 6 years, more than 90 percent of morbidly obese patients maintained a BMI less than 35, compared with less than 50 percent of super-obese patients. Twenty-five percent of the super obese patients remained in the morbidly obese range.
Despite these differences, both groups experienced similar improvements in quality of life and in cholesterol levels, blood sugar levels, high blood pressure, sleep disturbances, heartburn, and low back pain.
"As even modest weight loss results in marked improvement of several obesity-related (problems), it is no surprise that similar percentages of body weight loss in morbidly obese and super obese patients result in similar effects, at least for the first six post-operative years," Suter's team comments.
"Although a significant amount of weight loss is maintained long after (weight loss) surgery, slow long-term weight regain has been noted after every...procedure," they add, "hence longer follow-up will be necessary to evaluate whether these improvements persist over time and whether and how much long-term weight regain, a recognized problem especially in the super obese, affects them."
SOURCE: Archives of Surgery, April 2009.
Dr. Sears comments:
The average weight loss for gastric bypass surgery is 30 percent of total weight, so Manuel Uribe's loss to date of 42 percent of his total weight is even more impressive. He did it by just following an anti-inflammatory diet and taking high-dose fish oil.