Weight-Independent Percentile Chart of 2880 Gastric Bypass Patients: a New Look at Bariatric Weight Loss Results

Background

Percentile charts would be ideal for assessing sufficient weight loss in bariatric surgery. They allow comparing individual results to the outcome of many others, at any postoperative time. Unfortunately, percentile charts can be problematic when comparing unequally heavy peers, a circumstance not uncommon among bariatric patients. We investigate the relevance of this disadvantage and combine new insights to improve the practical use of percentile charts in bariatric surgery.

Methods

Laparoscopic Roux-en-Y gastric bypass outcome expressed with body mass index (BMI), excess weight loss (%EWL), total weight loss (%TWL), and alterable weight loss (%AWL), a new metric rendering outcome independent of baseline BMI, is used to build percentile curves p97/p90/p75/p50/p25/p10/p03 with the lambda–mu–sigma method. We used the %AWL p25 curve as baseline BMI-independent reference for sufficient weight loss and compared it to p25 curves based on common metrics and to traditional criteria ≥50 % EWL, <25 % EWL, and BMI?<?35 kg/m².

Results

We operated 2880 patients, with baseline BMI of 43.4 kg/m², follow-up 71 %, and mean of 23.3 (0–87.6)?months. Independent %AWL outcome is presented in one percentile chart. Percentile curves p25/p50/p75 show 40/48/57 % AWL at nadir 15/16/19 months, 35/45/54 % AWL at 3 years, and 30/38/47 % AWL at 7 years. Traditional criteria and p25 curves based on %EWL and BMI match with most sufficient results (high sensitivities), but overlook many insufficient results (low specificities).

Conclusions

We present the first baseline BMI-independent bariatric weight loss percentile chart. It allows comparing heavier patients to lighter peers and vice versa, at any postoperative time, up to 7 years. With these advantages, we compared it to traditional bariatric criteria like ≥50 % EWL and found that they are weak in recognizing insufficient weight loss. The visual aspect of consecutive results plotted on a chart among the percentile curves of peers conveys a strong, intuitive message on the personal progress of postoperative weight loss.

     

Weight Loss Percentile Charts of Large Representative Series: a Benchmark Defining Sufficient Weight Loss Challenging Current Criteria for Success of Bariatric Surgery

Background

The frequently used 35 kg/m² body mass index (BMI) and 50 % excess weight loss (%EWL) criteria are no longer adequate for defining the success of a bariatric or metabolic surgery. It is not clear whether they are still useful to simply determine the sufficiency of a patient’s postoperative weight loss. An alternative way of defining sufficient weight loss is presented, using weight loss percentile charts of large representative series as a benchmark.

Methods

Gastric bypass weight loss results from the Bariatric Outcomes Longitudinal Database (BOLD) with ≥2 years of follow-up are presented with percentiles in function of postoperative time and their nadir results in function of initial BMI using different outcome metrics. These percentiles are compared with the BMI35 and 50 %EWL criteria.

Results

Of 49,098 patients eligible for ≥2 years of follow-up, 8,945 had reported weight loss at ≥2 years (20.0 % male, mean initial BMI 47.7 kg/m²). They reached nadir BMI at a mean of 603 days. Their 50th percentiles surpassed both 50 %EWL and BMI35 after 135 days. More than 95 % achieved 50 %EWL; more than 75 % achieved BMI35. BMI and %EWL results are influenced more by initial BMI than total weight loss (%TWL) results.

Conclusions

BOLD gastric bypass weight loss data are presented with percentile curves. BMI and %EWL are clearly not suited for this purpose. Provided that follow-up data are solid, %TWL-based percentile charts can constitute neutral benchmarks for defining sufficient postoperative weight loss over time. Criteria for overall success, however, should consider clear goals of health improvement, including metabolic aspects. Frequently used criteria 50 %EWL and BMI35 are inadequate for both. Their static weight loss components do not match the found percentiles and their health improvement components do not match known metabolic criteria.     

Total Weight Loss as the Outcome Measure of Choice After Roux-en-Y Gastric Bypass

Background

Currently, there is no agreement on the best method to describe weight loss (WL) after bariatric surgery. The aim of this study is to evaluate short-term outcomes using percent of total body weight loss (%TWL).

Methods

A single-institution retrospective study of 2420 patients undergoing Roux-en-Y gastric bypass (RYGB) was performed. Suboptimal WL was defined as %TWL?<?20 % at 12 months.

Results

Mean preoperative BMI was 46.8?±?7.8 kg/m². One year after surgery, patients lost an average 14.1 kg/m² units of body mass index (BMI), 30.0?±?8.5 %TWL, and 68.5?±?22.9 %EWL. At 6 and 12 months after RYGB, mean BMI and percent excess WL (%EWL) significantly improved for all baseline BMI groups (p?<?0.01, BMI; p?=?0.01, %EWL), whereas mean %TWL was not significantly different among baseline BMI groups (p?=?0.9). The regression analysis between each metric outcome and preoperative BMI demonstrated that preoperative BMI did not significantly correlate with %TWL at 1 year (r?=?0.04, p?=?0.3). On the contrary, preoperative BMI was strongly but negatively associated with the %EWL (r?=??0.52, p?<?0.01) and positively associated with the BMI units lost at 1 year (r?=?0.56, p?<?0.01). In total, 11.3 % of subjects achieved <20 %TWL at 12 months and were considered as suboptimal WL patients.

Conclusion

The results of our study confirm that %TWL should be the metric of choice when reporting WL because it is less influenced by preoperative BMI. Eleven percent of patients failed to achieve successful WL during the in the first year after RYGB based on our definition.

     

Correlation Between Age and Weight Loss after Bariatric Surgery

Background

Conflicting evidence exists regarding age as a predictive factor in excess weight loss after bariatric surgery. The objective of this cross-sectional study is to evaluate differences in excess BMI loss (%EBMIL) 1 year after surgery in patients older and younger than 45 years.

Methods

Adult obese patients fulfilling selection criteria underwent either Roux-en-Y gastric bypass or sleeve gastrectomy and were grouped according to age < and ≥45 years with follow-up at least 1 year. Both groups were compared in terms of excess BMI loss (%EBMIL) and other clinical outcomes. Possible relationship between %EBMIL, age, surgical technique, and presence of comorbidities such as diabetes mellitus, hypertension (HT), and dyslipidemia (DL) was searched.

Results

Three hundred thirty-seven patients (72.5 % female), 196 (50.1 %) younger than 45 years and 141 (49.9 %) with age ≥45 years. There was significant difference between age group and %EBMIL 12 months after surgery (p?<?0.001), showing better results in younger patients. No differences were found in terms of gender, preoperative body mass index (BMI), surgical technique, nor presence of DL. Using multiple regression, we found significant interaction effect between age group (p?<?0.001), presence of HT (p?=?0.001), and %EBMIL at follow-up.

Conclusions

Patients younger than 45 years lose greater amount of excess BMI than older patients after bariatric surgery. This tendency might be useful as a preoperative weight loss predictor in bariatric patients.     

Laparoscopic Greater Curvature Plication (LGCP) for Treatment of Morbid Obesity in a Series of 244 Patients

Background

Laparoscopic greater curvature plication (LGCP) is a new metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report LGCP outcomes in 244 morbidly obese patients.

Methods

Between 2010 and 2011, patients underwent LGCP. Body mass index (BMI, kilogram per square meter) evolution, excess BMI loss (%EBMIL), excess weight loss (%EWL), complications, and type 2 diabetes mellitus (T2DM) changes were recorded. Repeated-measures analysis of variance (ANOVA) was used to assess weight change at 6, 12, and 18?months. Subgroup analyses were conducted to provide benchmark outcomes at 6?months. Logistic regression was used to identify characteristics predictive of suboptimal weight loss.

Results

Mean baseline BMI (±SD) was 41.4?±?5.5 (80.7?% women, mean age 46.1?±?11.0?years, 68 [27.9?%] patients had T2DM). Mean operative time was 70.6?min; mean hospitalization, 36?h (24?C72). Sixty-eight patients (27.9?%) experienced postoperative nausea and/or vomiting that was controlled within 36?h. There was no mortality. Major complication rate was 1.2?% (n?=?3). Repeated-measures ANOVA indicated significant weight loss across time points (p?n?=?105), BMI, %EBMIL, and %EWL were 36.1?±?4.7, 34.8?±?17.3, and 31.8?±?15.9. Preoperative BMI was the only predictor of weight loss. Patients with BMI <40 lost more weight than those ??40, although by 9?months, differences were no longer significant. In patients with preoperative BMI <40, 18-month %EWL approached 50?% and %EBMIL exceeded 50?%. At 6?months, 96.9?% of patients?? T2DM was significantly improved/resolved.

Conclusions

Over the short term, LGCP results in effective weight loss and significant T2DM reduction with a very low rate of complications.     

Reporting Results After Bariatric Surgery: Reproducibility of Predicted Body Mass Index

Background  

There is a controversy about the best way to report results after bariatric surgery. Several indices have been proposed over the years such as percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess body mass index loss (%EBMIL). More recently, it has been suggested to individualize the body mass index (BMI) goal to be achieved by the patients (predicted BMI—PBMI). The objective was to assess the reproducibility of this PBMI in our service.     

Correlation between Postoperative Weight Loss and Diabetes Mellitus Remission: A Meta-Analysis

Objective

This meta-analysis was conducted to determine the effect of percent excess weight loss (%EWL) after bariatric surgery on diabetes remission.

Methods

The Cochrane Library, PubMed, MEDLINE, Embase, and CINAHL were searched. All reports on %EWL involving humans and published in English between 1 January 1992 and 1 September 2013 were included in the analysis.

Results

Eight studies involving 1,247 patients who underwent bariatric surgery were selected. %EWL was positively associated with remission rate (WMD?=?11.15, 95 % CI: 6.73–15.56, p?Conclusions Patients with extensive weight loss were more likely to achieve T2DM remission after bariatric surgery. Further randomized controlled trials (RCTs) with uniform remission criterion should be performed to provide more reliable evidence.     

Predictors of Weight Loss are Different in Men and Women After Sleeve Gastrectomy

Background

Weight loss following bariatric surgery varies according to patient factors before the intervention. However, whether predictors of weight loss differ between men and women is, to our knowledge, unknown. We therefore aimed to investigate baseline predictors for overall weight loss and identify potential sex-specific baseline predictors in bariatric surgery patients.

Methods

In this prospective cohort study, 160 patients (117 women and 43 men) who underwent sleeve gastrectomy were followed up for 2 years. Weight loss was defined as percent excess body mass index loss (%EBMIL). To investigate whether %EBMIL differed between men and women, we included all two-way interactions with sex by incorporating the product term sex and predictors using multiple linear regression analysis.

Results

The overall mean ± standard deviation of %EBMIL after 2 years was 78.3?±?23.5. Predictors for lower %EBMIL in a regression model with no interactions were female sex (P?=?0.003), higher body mass index before surgery (P?=?0.001), and nonsmoking (P?=?0.029). When examining sex-specific predictors for %EBMIL, higher age (P?=?0.027) and not having diabetes (P?=?0.007) predicted lower %EBMIL in men. In women, unemployment (P?=?0.006) and anxiety and/or depression (P?=?0.009) predicted lower %EBMIL.

Conclusions

This study suggests that weight loss and predictors for weight loss 2 years after sleeve gastrectomy are sex-specific. These findings may be useful for the surgical strategy used to treat these patients.     

Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy on Morbidly Obese,Super-Obese,and Super-Super Obese Patients for the Treatment of Morbid Obesity

Backgrounds

The management of super-super obese patients is challenging for bariatric surgeons. Laparoscopic sleeve gastrectomy (LSG) is feasible as two-stage treatment for high-risk patients. However, its efficacy as a stand-alone procedure in super-super obese (SSO) patients is controversial. The study objective was to demonstrate the safety and efficacy of LSG in super-obese (SO) and SSO patients.

Methods

A retrospective analysis was performed of consecutive patients undergoing LSG. The patients were classified into three groups: morbidly obese (MO), SO, and SSO. The patients’ data, including each patient’s characteristics, body mass index (BMI), preoperative comorbidities, postoperative complications, the resolution of comorbidities, percentage of excess weight loss (%EWL), and total weight loss (%TWL) were compared between groups.

Results

Of the 186 patients, 163 (87.6%) were followed up for 41.2?±?7.3 months (range 33–54 months). The mean BMI was 52.6 kg/m². Eighty-three patients (50.9%) were MO, 52 (31.9%) were SO, and 28 (17.2%) were SSO. The groups were similar in terms of preoperative characteristics and postoperative complications. The mean %TWL were lower for the SSO group with no significant difference. The mean %TWL at 12, 24, 36, and 41.2 months postoperatively was 34.7, 34.4, 31.4, and 29.6% in SSO group, respectively. Also, the %EWL for the SSO group was significantly lower (48.3%) at the end of the follow-up period. However, the rate of significant improvement or complete resolution of comorbidities was similar in all groups.

Conclusion

Although %EWL was lower in the SSO group, LSG was a feasible and safe stand-alone bariatric surgical procedure for the resolution of comorbidities in MO, SO, and SSO patients.

     

Emotion Self-Regulation Moderates the Association Between Symptoms of ADHD and Weight Loss After Bariatric Surgery

Background

This study aimed to examine the combined effect of pre-surgical emotion self-regulation (ESR) and symptoms of attention deficit hyperactivity disorder (sADHD, i.e., inattention, impulsivity, and hyperactivity) on weight loss 12 months following bariatric surgery independent of psychological distress and eating pathology.

Methods

Adults with obesity were recruited from a bariatric surgery specialty clinic in Canada. Patients completed measures of psychological distress (i.e., Beck Depression Inventory II and Beck Anxiety Inventory), eating pathology (i.e., Eating Disorder Examination Questionnaire), ESR (i.e., “Managing Own Emotions” subscale of the Schutte Emotional Intelligence Test), and sADHD (i.e., Adult ADHD Self-Report Scale) prior to surgery. Measures of height and weight were obtained and used to calculate percent excess weight loss (%EWL) of body mass index (BMI) pre- and 12 months post-surgery.

Results

Thirty-seven patients were recruited. The final sample consisted of 30 patients (80% female; mean age = 48 years; mean BMI = 49.32). Patients experienced significant weight loss and reported significant improvement in anxiety, depressed mood, and eating pathology from pre- to 12 months post-surgery. A significant sADHD by ESR interaction on %EWL (F(1, 21) = 6.43, p = .019) was observed and accounted for 13% of unique variance after adjusting for relevant covariates. Probing the interaction with the Johnson-Neyman technique indicated that there was a significant inverse association between sADHD and %EWL among individuals who scored ≤ 0.15 SD below the mean on ESR.

Conclusions

ESR moderated the association between sADHD and %EWL, suggesting that sADHD may attenuate weight loss following bariatric surgery among individuals deficient in ESR. This finding has implications for bariatric surgery pre-surgical psychological assessment.

     

The Influence of Health Literacy and Health Numeracy on Weight Loss Outcomes Following Bariatric Surgery

BackgroundAlthough cognitive functioning and health literacy are related to weight loss 1year following bariatric surgery, the influence of health numeracy (i.e., health-related mathematical abilities) is unknown. In addition, further research is needed to examine the impact of all these factors on longer-term weight loss outcomes to determine if they influence the ability to maintain weight loss.SettingSingle bariatric center.MethodsPatients (N = 567) who underwent bariatric surgery from 2014–2017 completed a brief survey including current weight. Retrospective chart reviews were conducted to gather information from the presurgical evaluation including weight, body mass index (BMI), health literacy, health numeracy and score on a cognitive screener.ResultsAmong participants in the weight loss period (< 2 years postsurgery), health literacy, health numeracy and cognitive functioning were not related to change in BMI (ΔBMI), percent total weight loss (%TWL) or percent excess weight loss (%EWL). However, for participants in the weight maintenance period (2–4 years postsurgery), higher health literacy scores were related to greater change in ΔBMI, and higher health numeracy scores were related to greater ΔBMI, %TWL, and %EWL.DiscussionAlthough health literacy and health numeracy did not predict weight loss outcomes for those in the initial weight loss period, they were related to weight outcomes for participants in the weight maintenance period. This suggests that health literacy and health numeracy may play a role in facilitating longer-term weight maintenance among patients who undergo bariatric surgery. Clinicians conducting presurgical psychosocial evaluations should consider routinely screening for health literacy and health numeracy.     

Early Weight Loss as a Predictor of 2-Year Weight Loss and Resolution of Comorbidities After Sleeve Gastrectomy

Background

The objective of this study was to investigate whether early postoperative weight loss predicts weight loss 1 and 2 years after laparoscopic sleeve gastrectomy (LSG) and to determine its effect on the resolution of comorbidities.

Methods

This was a prospective study of patients who underwent LSG at Jordan University Hospital from February 2009 to January 2014.

Results

One hundred ninety patients (mean age 34.0?±?10.8 years; mean preoperative body mass index 46.2?±?7.7 kg/m²) were included in the study. Of these, 146 were followed for 1 year and 73 were followed for 2 years. Thirty patients (20.5 %) had hypertension, 23 (15.8 %) had diabetes, 78 (53.4 %) had hyperlipidemia, 30 (20.5 %) had obstructive sleep apnea, and 50 (34.2 %) had more than one comorbidity. The percentage of excess weight loss (%EWL) was 22.7?±?8.1, 75.1?±?22.8, and 72.6?±?17.5 at 1, 12, and 24 months, respectively. Fifty-five patients (37.7 %) had a 1-year %EWL of ≥80 %, and 29 (39.7 %) had a 2-year %EWL of ≥80 %. Linear regression analysis showed a strong correlation between 1-month %EWL and %EWL at 1 year (r ²?=?0.23, p?<?0.001) and 2 years (r ²?=?0.28, p?<?0.001). Resolution of comorbidities was associated with higher %EWL achieved at 1 year, but early postoperative weight loss did not have a significant effect on comorbidity resolution.

Conclusions

Early postoperative weight loss can be used to identify and target poor responders.

     

Relationship Between Tobacco Use and Weight Loss After Bariatric Surgery

Background

Smoking cessation had been typically associated with weight gain. So far, there are no reports documenting the relationship between weight loss after bariatric surgery and smoking habit. The objective of the study was to establish the relationship between weight loss and smoking habit in patients undergoing bariatric surgery and to analyze weight loss on severe smokers and on those patients who stopped smoking during the postoperative period.

Methods

All patients undergoing laparoscopic sleeve gastrectomy (LSG) with at least 2-year follow-up were included. Patients were divided into three groups: (A) smokers, (B) ex-smokers, and (C) non-smokers. Demographics and weight loss at 6, 12, and 24 months were analyzed. Smokers were subdivided for further analysis into the following: group A1: heavy smokers, group A2: non-heavy smokers, group A3: active smokers after surgery, and group A4: quitters after surgery. Chi-square test was used for statistics.

Results

One hundred eighty-four patients were included; group A: 62 patients, group B: 57 patients, and group C: 65 patients. Mean BMI was 34?±?6, 31?±?6, and 31?±?6 kg/m2; mean %EWL was 63?±?18, 76?±?21, and 74?±?22 % at 6, 12, and 24 months, respectively. The subgroup analysis showed the following composition: group A1: 19 patients, group A2: 43 patients, group A3: 42 patients, and group A4: 20 patients. Weight loss difference among groups and subgroups was statistically non-significant.

Conclusions

Our study shows that weight loss evolution was independent from smoking habit. Neither smoking cessation during the postoperative period nor smoking severity could be related to weight loss after LSG.

     

Long-Term Relationship Between Tobacco Use and Weight Loss after Sleeve Gastrectomy

Background

Smoking cessation had been typically associated with weight gain. We have reported that there is no relationship between tobacco use and weight loss after bariatric surgery in the short term. The objective of this study was to establish the relationship between weight loss and the smoking habit in patients undergoing bariatric surgery and to analyze weight loss on severe smokers and on those patients who stopped smoking during the long-term postoperative period.

Methods

One hundred eighty-four patients included in our previous study were contacted by phone at 7 years after sleeve gastrectomy. They were again divided into three groups: (A) smokers, (B) ex-smokers, and (C) non-smokers. Demographics and weight loss at 6, 12, 24, and 7 years were analyzed. Smokers were subdivided for further analysis into the following: group A1: heavy smokers, group A2: non-heavy smokers, group A3: active smokers after surgery, and group A4: quitters after surgery. Student test was used for statistics.

Results

One hundred two patients were included. The follow-up was 80.74 ±?7.25 month. Group A: 29 patients, group B: 34 patients, and group C: 39 patients. Mean BMI was 34.35?±?8.44 kg/m² and the %EWL was 56.95?±?27. The subgroup analysis showed the following composition: group A1: 6 patients, group A2: 23 patients, group A3: 23 patients, and group A4: 6 patients. Weight loss difference among groups and subgroups was statistically non-significant.

Conclusions

This study reaffirms the hypothesis that weight loss among bariatric patients is independent from smoking habit even at long-term follow-up and regardless from cessation.

     

Association of Adverse Childhood Experiences and Food Addiction to Bariatric Surgery Completion and Weight Loss Outcome

Introduction/Purpose

Adverse childhood experiences (ACEs) are known risk factors for obesity and poor outcomes following weight loss interventions. ACEs are also associated with addictive behaviors and, potentially, food addiction (FA). This study examined the relationship between ACEs and FA, and their association to undergoing bariatric surgery and post-surgical weight loss outcomes.

Materials and Methods

Between June 2013 and January 2016, 1586 bariatric-surgery-seeking patients completed a psychological evaluation. During their evaluation, the patients were administered measures including the ACE questionnaire and the Yale Food Addiction Scale.

Results

19.2% of those seeking bariatric surgery reported being the victim of childhood sexual abuse, and 22.1% reported being the victim of childhood physical abuse. An elevated ACE score corresponded to increased likelihood of screening positive for FA and more severe FA. When the type of ACE was analyzed separately, ACE was not associated with bariatric surgery completion or percent total weight loss (%TWL). Screening positive for FA corresponded to less %TWL 1 year post-surgery as the total number of ACEs increased, yet there was no association with %TWL 2 years post-surgery. The participants were classified into two groups, those positive for an ACE or FA versus those negative for both. Those who screened positive were significantly less likely to undergo bariatric surgery.

Conclusion

Screening positive for experiencing ACEs was related to severity of FA, and screening positive for being the victim of either childhood abuse or FA reduced the likelihood of completing bariatric surgery. More research is needed to determine how these psychosocial factors might influence bariatric surgery outcomes.

     

The Dutch bariatric weight loss chart: A multicenter tool to assess weight outcome up to 7 years after sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Background

Current methods for weight loss assessment after bariatric surgery do not meet the high standards required to accurately judge patient outcome in a fair and evidence-based way.

Calibration of the Gastric Pouch in Laparoscopic Roux-en-Y Gastric Bypass: Does It Matter? The Influence on Weight Loss

Purpose

To determine the effect of an orogastric tube for calibration of the gastric pouch on percentage excess weight loss (%EWL) and percentage total weight loss (%TWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Material and Methods

A retrospective case-matched control study in 132 patients. Group A (a 40 French orogastric tube was used to calibrate the gastric pouch) was compared to group B (no orogastric tube was used). All other surgical steps were identical in both groups. Postoperative %EWL and %TWL were recorded at 3, 6, 9, 12, and 24 months postoperatively.

Results

Baseline characteristics and comorbidities were similar for both groups; a mean age of 43.6 years, 84% of the patients were female and mean initial BMI was 44 kg/m². At 24 months, 9% of the patients were lost to follow-up. At 1-year follow-up, %EWL and %TWL were 80% and 33.3% in group A versus 70% and 28.6% in group B with p?=?0.013 and p?=?0.007 respectively. At 2 years, EWL% and %TWL were 79.5% and 32.8% in group A and 67.18% and 28.1% in group B with a p value of 0.019 and 0.001 respectively. The use of a calibration tube, initial BMI, and age predicted the %TWL best with R squared at 30.7%.

Conclusion

The use of a calibration tube for creating the gastric pouch may lead to a higher %EWL and %TWL at 2-year follow-up. The standardization of the technique for LRYGB is desirable to achieve the maximum success rate in the surgical therapy of morbid obesity.

     

Laparoscopic Sleeve Gastrectomy and Gastric Bypass for The Aging Population

Background

Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most common bariatric surgeries for treating morbid obesity. The purpose of this study is to determine differences in outcomes from RYGB or SG between patients ages?≥?60 years and?<?60 years.

Methods

A retrospective review of patients who underwent RYGB and SG at our institution from 01/2008 to 05/2012 was conducted. Forty patients from each group (≥60 years and?<?60 years) were matched based on gender, body mass index (BMI), co-morbidities, and type of bariatric surgery performed, and their charts were reviewed up to 1 year post-operatively. Primary end points measured were mean length of stay, operative time, incidence of complications, and readmissions in the first post-operative year. A secondary end point measured was percent total weight loss (%TWL) and excess weight loss (%EWL).

Results

There were no significant differences between group?<?60 and group?≥?60 in operative time (210 vs. 229 min; p?=?0.177), in-hospital post-operative complication rates (2.5 vs. 5 %; p?=?1.0), long-term complication rates (2.5 vs. 10 %; p?=?0.359), and 30-day readmission rates (2.5 vs. 12.5 %; p?=?0.2). Patients in group?<?60 had shorter lengths of stay (2.2 vs. 2.7 days; p?=?0.031), but this difference is not clinically significant. Both groups achieved similar %TWL (21.4 vs. 20.5 %; p?=?0.711) and %EWL (50.6 vs. 50.7 %; p?=?0.986).

Conclusions

Advanced age (≥60 years) is not a significant predictor of a worse outcome for SG and RYGB.