Lower BMI Pre-Bariatric Surgery Linked to Improved Outcomes

Patients with a body mass index (BMI) below 40 before undergoing bariatric surgery were more likely to achieve a BMI below 30 and benefit from the procedure, according to a recent study.

In the retrospective study, researchers used data from a cohort of 27,320 adults undergoing primary bariatric surgery between June 2006 and May 2015 who were enrolled in the Michigan Bariatric Surgery Collaborative, a clinical data registry. Predictors for achieving a BMI less than 30 one year after surgery was assessed as the primary outcome, and 30-day postoperative complications and 1-year self-reported comorbidity remission were assessed as the secondary outcomes.
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At 1 year post-surgery, 9713 patients achieved a BMI below 30 kg/m². Only 8.5% of patients with a preoperative BMI over 50 kg/m² achieved a BMI of less than 30 kg/m² at 1 year.

A preoperative BMI below 40 kg/m² was a significant predictor for achieving a BMI of less than 30 kg/m² post-surgery. Likewise, patients who had a sleeve gastrectomy, gastric bypass, or duodenal switch were more likely to achieve a BMI below 30 kg/m² compared with those who underwent adjustable gastric banding.

In addition, higher rates of medication discontinuation for hyperlipidemia and diabetes, as well as higher rates of remission for sleep apnea, were reported by patients who achieved a BMI below 30 kg/m². These patients also had higher satisfaction rates compared with those who did not achieve a BMI below 30 kg/m².

“Patients with a preoperative BMI of less than 40 are more likely to achieve a BMI of less than 30 after bariatric surgery and are more likely to experience comorbidity remission,” the researchers concluded. “Policies and practice patterns that delay bariatric surgery until the BMI is 50 or greater can result in significantly inferior outcomes.”

—Melissa Weiss

Reference:

Varban OA, Cassidy RB, Bonham A, et al. Factors associated with achieving a body mass index of less than 30 after bariatric surgery [published online July 26, 2017]. JAMA Surg. doi:10.1001/jamasurg.2017.2348.