Researchers at Rabin Medical Center in Israel recently published in the journal JAMA Surgery that obese patients who underwent sleeve gastrectomy — one type of bariatric surgery — may regain weight and develop obesity-related comorbidities in the long-term. The study is entitled “Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy.”
Obesity is a serious public health problem worldwide having long been recognized by the World Health Organization as a global epidemic. It causes a systemic inflammatory state in the body being associated with several chronic diseases such as diabetes, hypertension, cardiovascular diseases, and cancer.
Laparoscopic sleeve gastrectomy (LSG) is a common, safe, effective bariatric procedure where a substantial part of the stomach is removed in order to limit food intake. LSG has becoming increasingly popular in the Western world; however, there is a lack of data concerning its long-term effects on obesity-related disorders.
In the study, researchers investigated the long-term impact of LSG on weight loss and in the development of medical conditions like diabetes and hypertension. Data from patients submitted to LSG between April 2006 and February 2013 at the university hospital were collected.
Researchers found a total of 443 LSGs that resulted in a percentage of excess weight loss of 77% at 1-year follow-up, 70% at 3-year follow-up and 56% at 5-year follow-up. Concerning diabetes, complete remission was maintained in 51% of the patients 1 year after the surgery, 38% after 3 years, and 20% after 5 years. Hypertension remission was found to be maintained in 46%, 48% and 46% of the patients at 1, 3 and 5 years follow-up, respectively.
The research team concluded that LSG induced weight loss and substantial improvements in obesity-related comorbidities, namely diabetes and hypertension. Over time, however, the team reports that individuals may experience a significant weight regain and a decrease in the remission rate of diabetes.
“The longer follow-up data revealed weight regain and a decrease in remission rates for type 2 diabetes mellitus and other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient,” concluded the research team according to a news release.
These new insights are important for those considering the procedure, as sleeve gastrectomy causes permanent changes to the digestive system through removal of the majority of the stomach. Other bariatric surgical procedures, such as gastric banding surgery, are completely reversible. If long-term results of sleeve gastrectomy show the procedure to be ineffective for weight loss and controlling diabetes, obese patients may instead choose to opt for a non-permanent procedure instead.
