Bariatric Surgery Patients See Big Health Benefits Three Years Post-Op, Courcoulas-Led Study Finds

Researchers from the University of Pittsburgh’s School of Medicine and Graduate School of Public Health, as well as other U.S. clinical centers, have found significant health benefits for severely obese patients who have bariatric surgery.

Most such patients—who underwent gastric bypass or laparoscopic adjustable gastric-banding surgical procedures—experienced substantial weight loss in the three years after surgery, with most of the change occurring during the first year. These two common bariatric surgical procedures aid in weight loss through intestinal bypass, stomach restriction, and possibly gut hormone changes.

The study's results were published online in the Journal of the American Medical Association. The research also found variability in both weight change and in improvements in obesity-related complications, including diabetes, hypertension, and high cholesterol.

Led by Anita Courcoulas, a professor of surgery in Pitt’s School of Medicine, researchers used detailed data from the Longitudinal Assessment of Bariatric Surgery Consortium. The longitudinal assessment, which reviews the safety and efficacy of bariatric surgical procedures performed in the United States, comprises a multicenter observational cohort study involving10 hospitals in six geographically diverse clinical centers as well as a data-coordinating center. The researchers gathered standardized assessments and measures on adult study participants undergoing bariatric surgery procedures and followed them for three years.

At baseline, study participants ranged in age from 18 to 78 years, and 79 percent were women. The median Body Mass Index was 45.9 kg/m²; 1,738 participants underwent gastric bypass surgery, and 601 underwent laparoscopic gastric-banding.

In the three-year follow-up following bariatric surgery, the researchers observed substantial weight loss for both procedures. Participants who underwent gastric bypass surgery or laparoscopic adjustable gastric-banding experienced median weight loss of nearly 32 percent and 16 percent, respectively.

Additionally, of the gastric bypass surgical participants who had specific obesity-related health problems prior to surgery, 67 percent experienced partial remission from diabetes and 38 percent remission from hypertension. High cholesterol resolved in 61 percent of the participants who underwent bypass surgery. For those who underwent laparoscopic adjustable gastric-banding, 28 percent experienced partial remission from diabetes and 17 percent remission from hypertension while high cholesterol was resolved in 27 percent of participants.

“Bariatric surgery is not a ‘one size fits all’ approach to weight loss,” cautioned Courcoulas, who also is a bariatric and general surgeon at Magee-Womens Hospital of UPMC. “Our study findings are the result of data collected from a multicenter patient population and they emphasize the heterogeneity in weight change and health outcomes for both types of bariatric surgery that we report. Longer-term follow-up of this carefully studied cohort will determine the durability of these improvements over time and identify the factors associated with the variability in effect.”