Predictivity of preoperative weight loss on co-morbidity resolution in bariatric patients.

BACKGROUND: Class III obesity presents as a health risk affecting multiple organ systems. OBJECTIVES: This study aims to evaluate if preoperative weight loss affects obesity-related co-morbidity resolution after metabolic and bariatric surgery. SETTING: Academic medical center, United States. METHODS: A retrospective analysis was conducted with a preliminary sample of 788 patients who received metabolic and bariatric surgery for weight loss at an academic medical center from 2016 to 2020. Preoperative percentage of excess weight loss and the diagnosis and resolution of 4 co-morbidities were also examined over 2 years (diabetes, hypertension, hyperlipidemia [HLD], and obstructive sleep apnea). Statistical analyses were completed using Statistical Package for the Social Sciences. RESULTS: Each co-morbidity showed resolution at each timepoint (1 month, 3 months, 6 months, 1 year, and 2 years), with diabetes showing the greatest resolution of 80.0% at 1 year. Other co-morbidities that showed resolution at 1 year were hypertension (61.1%), HLD (53.3%), and obstructive sleep apnea (29.3%). Of these, percentage of excess weight loss before surgery was significantly associated with resolution of diabetes and HLD during the immediate postoperative period (1 month‑6 months) when adjusted for age and gender (P < .05). CONCLUSIONS: Prior studies have indicated that metabolic and bariatric surgery is effective in treating class III obesity and the decline of co-morbidities. Here, we show that the benefits of metabolic and bariatric surgery on diabetes and HLD are enhanced with preoperative weight loss in the immediate postoperative period. Understanding these changes in co-morbidities after surgery will be important in effectively advising patients on preoperative weight loss and helping them manage their health.