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, 14 (9), 1304-1309

Do Patients With Higher Baseline BMI Have Improved Weight Loss With Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy?

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Do Patients With Higher Baseline BMI Have Improved Weight Loss With Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy?

Deepali Jain et al. Surg Obes Relat Dis.

Abstract

Background: As sleeve gastrectomy (SG) becomes the most common bariatric procedure, it remains unclear for which patients laparoscopic Roux-en-Y gastric bypass (LRYGB) may be advantageous. Some contend that patients with higher initial body mass index (BMI) achieve better weight loss with LRYGB.

Objectives: This study evaluates weight loss in SG versus LRYGB patients based on preoperative BMI.

Setting: Community teaching hospital, Baltimore, Maryland.

Methods: A convenience cohort of 4935 individuals, undergoing bariatric surgery from 2001 to 2015, was studied to examine 5-year postsurgical trends in weight loss stratified by baseline BMI and procedure. Student t tests compared mean weight loss of baseline BMI groups (<45 versus ≥45; <50 versus ≥50; and <55 versus ≥55) and line graphs and plotted 95% confidence intervals of mean weight loss by year were examined to discern differences in percent excess weight loss (%EWL) by procedure type.

Results: All patients were more likely to be female (79%) and Caucasian (62.5%). Nearly twice as many patients underwent LRYGB (N = 3236) compared with SG (N = 1699). In patients in the BMI <45, 50, and 55 kg/m2 categories, there was no significant difference in %EWL based on procedure. However, in those patients in the BMI ≥45 and 55 kg/m2 categories, there is significantly higher %EWL in the LRYGB group over SG.

Conclusion: In conclusion, patients with lower baseline BMI had improved %EWL regardless of procedure, but those patients with higher baseline BMI who underwent LRYGB did have higher %EWL than those undergoing SG at 2 years follow-up. BMI is one of many key factors when selecting a procedure for an individual patient.

Keywords: BMI; Bariatric surgery; Gastric bypass; Sleeve gastrectomy; Super-obesity.

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