Obesity Surgery Outcomes Weighed
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
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.
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
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