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Patients Who Gain Before Weight Loss Surgery Have Outcomes Similar to Those Who Don’t

June 14, 2007 -- People who gain 10 pounds or more before weight loss surgery do as well as those who lose 10 pounds or more before having the operation, a new study shows.

"At 12 and 24 months after the operations, there was a 60% to 70% reduction in excess weight for both groups," the losers and the gainers, says Eric DeMaria, MD, professor and vice chairman of surgery and director of the Bariatric Surgery Program at Duke University in Durham N.C. He presented the findings this week at the 24th annual meeting of the American Society for Bariatric Surgery in San Diego.

Both groups, the gainers and the losers, also had similar improvements in type 2 diabetes and high blood pressure problems and in discontinuing treatment for sleep apnea, a condition commonly associated with obesity.

Before bariatric surgery, patients are advised and sometimes required to lose weight.

The Back Story

For years, doctors who perform gastric bypass and other weight loss surgeries have advised patients to hold their weight stable before the surgery or to lose weight.

Some insurance companies and some bariatric surgery programs require patients to lose weight or at least engage in weight loss attempts before they get the surgery, DeMaria says, and his study suggests it may not make a difference in terms of long-term weight loss and health improvements.

An estimated 177,000 people in the U.S. had bariatric surgery in 2006, according to the Society.

Study Subjects

DeMaria and his colleagues analyzed the records of 1,629 patients who had undergone the most common type of gastric bypass, called laparoscopic Roux-en-Y gastric bypass, at Duke University between October 2000 and December 2006. From that pool of patients they focused on 115 who had gained 10 pounds or more before having the surgery and 88 who had lost 10 pounds or more before undergoing the operation.

"Ninety percent of patients [in the database] didn’t have significant changes in weight before the operation," counting from four or five months before the surgery, DeMaria says. "We were really just studying 10% of patients.''

The groups were similar in age -- the gainers on average were 41; the losers, 44. The gainers' average preoperative weight was 321 pounds; the losers, 312 pounds. Nearly 30% of each group had diabetes, about half in each group had high blood pressure, and about a third in each group had sleep apnea.

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