Bariatric surgery is a transformative intervention for individuals struggling with obesity, offering significant weight loss and improved health outcomes. However, weight loss results can vary greatly based on several factors, including the patient’s gender and the type of surgery performed. A recent study titled “Sex- and Operation-Dependent Effects on 5-Year Weight Loss Results of Bariatric Surgery,” published in Surgery for Obesity and Related Diseases, delves into these variations and provides valuable insights. Here’s a comprehensive look at the findings and their implications.
Understanding the Study
Background and Objectives
The study aimed to explore the sex-specific weight loss outcomes up to five years after two common types of bariatric surgery: laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). The researchers sought to determine whether the differences in weight loss outcomes between men and women were influenced by the type of surgery performed.
Methods
This retrospective, observational cohort study included 7,098 patients who underwent either RYGB or SG at Vanderbilt University Medical Center. Data spanning from January 1999 to June 2022 were analyzed to evaluate the percentage of total weight loss (TWL) over time using generalized linear mixed models.
Key Findings
Sex- and Procedure-Dependent Weight Loss
The study revealed a significant interaction between sex and type of surgery on weight loss outcomes:
- Women: Women who underwent RYGB experienced significantly greater weight loss compared to those who had SG. At the five-year mark, the adjusted difference in weight loss between RYGB and SG was 8%.
- Men: While men also showed greater weight loss with RYGB compared to SG, the difference was smaller and clinically insignificant, with an adjusted difference of 2.9% at five years.
Overall Weight Loss Trends
- Women, on average, achieved greater weight loss than men after both types of surgery.
- RYGB resulted in more substantial weight loss than SG across both sexes.
Impact of Diabetes
The presence of diabetes was associated with reduced weight loss. Diabetic patients lost about 3% less weight over five years compared to non-diabetic patients.
Implications for Surgical Decision-Making
The findings suggest that for women, RYGB may be the preferred surgical option to maximize weight loss. For men, the choice between RYGB and SG may involve other considerations beyond weight loss, such as the patient’s metabolic profile and personal preferences, given the smaller difference in weight loss outcomes.
Conclusion
This study highlights the importance of considering both sex and type of surgery when evaluating long-term weight loss outcomes in bariatric surgery patients. These insights can guide healthcare providers in tailoring surgical interventions to optimize weight loss and improve overall health outcomes for their patients.
Understanding the nuances of how gender and surgery type interact to affect weight loss can enhance patient care and lead to more personalized treatment plans. As the field of bariatric surgery continues to evolve, ongoing research and individualized patient assessments remain crucial.
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References
- Samuels, J. M., Albaugh, V. L., Yu, D., Chen, Y., Williams, D. B., Spann, M. D., Wang, L., Flynn, C. R., & English, W. J. (2024). Sex- and operation-dependent effects on 5-year weight loss results of bariatric surgery. Surgery for Obesity and Related Diseases, 20(2024), 687-694. https://doi.org/10.1016/j.soard.2024.01.013
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