The Impact of Preoperative BMI (Obesity Class I, II, and III) on the 12-Month Evolution of Patients Undergoing Laparoscopic Gastric Bypass

Abstract

Background

Whether or not the initial body mass index (BMI) influences weight loss and comorbidities improvement after bariatric surgery continues to be a matter of debate. The main reason for this is a lack of studies including obesity class I.

Methods

Retrospective study with patients submitted to gastric bypass at a single institution. They were classified based on initial BMI (obesity class I, II, and III), and a comparative analysis of their metabolic profile (glucose, HbA1c%, C-peptide, insulin and diabetes medication), lipid profile (triglycerides, total cholesterol, HDL, LDL), and clinical data (systolic/diastolic blood pressure and cardiovascular risk) was performed at 0 and 12 months. Diabetes remission and weight loss were also analyzed.

Results

Two-hundred and twenty patients were included (23 in group 1, 113 in group 2, and 84 in group 3). Initial weight, BMI, and number of patients with T2DM were statistically different in group 1; other parameters were homogenous. At 12 months, every group had similar improvement of the metabolic profile, excepting serum insulin. Diabetes remission was 57.9, 61.1, and 60% for group 1, 2, and 3. For weight loss, there were differences between groups when using BMI and percentage of excess weight loss, but not with percentage of total weight loss. The non-metabolic and clinical data improved without differences, except for total cholesterol and LDL.

Conclusions

The metabolic, lipid, and clinical profiles associated with obesity present similar improvement 1 year after laparoscopic gastric bypass, despite different baseline BMI. Diabetes remission and percentage of total weight loss were also similar.

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Corresponding author

Correspondence to Carlos Zerrweck.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Approved by the local (Institutional Register 212-010-14-15) and national committees (CONBIOÉTICA-09-CEI-001-2016040) to perform surgery in class I obesity. This retrospective analysis was approved by the local ethics committee (Institutional Register 212-010-13-16).

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Cite this article

Ramírez, E.M., Espinosa, O., Berrones, R. et al. The Impact of Preoperative BMI (Obesity Class I, II, and III) on the 12-Month Evolution of Patients Undergoing Laparoscopic Gastric Bypass. OBES SURG 28, 3095–3101 (2018). https://doi.org/10.1007/s11695-018-3281-1

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Keywords

  • Bariatric surgery
  • Metabolic surgery
  • Preoperative body mass index
  • Diabetes remission
  • Laparoscopic gastric bypass
  • Total weight loss
  • Obesity class I
  • Obesity class II
  • Obesity class III