Even After Surgery, Most Superobese Patients Remain Morbidly Obese

Superobese gastric bypass surgery patients appear to have improvements in quality of life (QOL) and obesity-related co-existing conditions, but despite losing some weight, still remain obese following surgery, according to a new study.

Researchers at the Hôpital du Chablais (Aigle-Monthey, Switzerland) compared weight loss, body mass index (BMI), comorbidities and quality of life in 492 morbidly obese (MO; having a BMI of 40 to 49) patients and 133 superobese (SO; having a BMI of 50 or higher) patients treated with primary laparoscopic Roux-en-Y gastric bypass between 1999 and 2006. The researchers found that the MO patients lost up to 15 BMI units (34.7% body weight) after 18 months and maintained an average loss of 13 BMI (30.1% body weight) units six years after surgery. The SO patients lost a maximum of 21 BMI units (37.3% body weight) after two and a half years and an average of 17 BMI units (30.7% body weight) after six years. But although the SO patients had a greater weight loss than MO patients, less than 50% of them had a BMI of less than 35 six years after surgery, compared to more than 90% of the MO patients. The authors noted, however, that the improvements in QOL and co-morbidities were impressive and similar in both groups. The study was published in the April 2009 issue of Archives of Surgery.

"Although many superobese patients remain in the severely obese or morbidly obese category, equivalent improvements in quality of life and obesity-related comorbidities indicate that weight loss is not all that matters after bariatric surgery,” concluded lead author Michel Suter, M.D., P.D, and colleagues of the department of surgery. "Only large randomized studies comparing Roux-en-Y gastric bypass with other bariatric procedures and studying all aspects of weight loss surgery, with long-term follow-up, will be able to establish whether one procedure is superior to the others, especially in the superobese patient group.”

Typically, the actual weight of superobese patients exceeds their estimated ideal weight by about 225%. In comparison, the U.S. National Institutes of Health (NIH) advises that an increase in 20% or more above "ideal body weight” is the point at which weight-related health dangers appear. Patients with this condition incur much greater weight-related health risks, including an increased risk of dying --estimated at 5-10 times greater than that of people of normal weight--as well as arthritis, breathing problems, cancer, depression, diabetes, gastro-esophageal reflux disease (GERD), heart disease, hypertension, infertility, loss of bowel and urinary control, menstrual problems, obstructive sleep apnea, swollen legs, and venous disorders.

Related Links:
Hôpital du Chablais