Beyond Weight Loss: Evaluating the Multiple Benefits of Bariatric Surgery After Roux-en-Y Gastric Bypass and Adjustable Gastric Band
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Despite the evidence for benefits beyond weight loss following bariatric surgery, assessments of surgical outcomes are often limited to changes in weight and remission of type 2 diabetes mellitus. To address this shortfall in assessment, the King’s Obesity Staging System was developed. This system evaluates the individual in severity stages of physical, psychological, socio-economic and functional disease. These are categorised into disease domains arranged so as to allow an alphabetic mnemonic as Airways, Body Mass Index (BMI), Cardiovascular, Diabetes, Economic, Functional, Gonadal, Health Status (perceived) and (body) Image.
In this cohort study, patients were assessed before and 12 months after surgery using the modified King’s Obesity Staging Score. We studied 217 consecutive patients undergoing Roux-en-Y gastric bypass (RYGB; N = 148) and laparoscopic adjustable gastric band (LAGB; N = 69) using the modified King’s Obesity Staging System to determine health benefits after bariatric surgery.
Preoperatively, the groups had similar BMI, but the RYGB group had worse Airways, Cardiovascular, and Diabetes scores (p < 0.05). After surgery, RYGB and LAGB produced improvements in all scores. In a subgroup paired analysis matched for preoperative Airways, BMI, Cardiovascular, and Diabetes scores, both procedures showed similar improvements in all scores, except for BMI where RYGB had a greater reduction than LAGB (p < 0.05).
Both RYGB and LAGB deliver multiple benefits to patients as evaluated by the modified King’s Obesity Staging System beyond BMI and glycaemic markers. A validated staging score such as the modified King’s Obesity Staging System can be used to quantify these benefits.
KeywordsBariatric surgery Outcomes Gastric bypass Band Modified King’s Obesity Staging System
We would also like to acknowledge the REALIZE C-Band v Gastric Bypass Outcomes in UK grant; number:IIS2001-100094 EES Grant No. 29250, from Ethicon EndoSurgery Inc. ADM is funded by a MRC Clinical Research Training Fellowship (G0902002). Patients were treated by a multidisciplinary team comprising surgeons, psychiatrists, physicians, psychologists, dieticians, theatre staff and nursing staff. Without the involvement of all of these individuals in the care of our patients, this paper would not have been possible, and we thank all of the team for their vital contribution.
Conflict of Interest
All authors state that they have no conflict of interest to declare.
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