Background: The Royal College of Physicians (RCP) called earlier this year for obesity to urgently be recognized as a disease, and warned that until this happens its prevalence is unlikely to be reduced. Obesity is associated with multiple comorbidities, including type 2 diabetes mellitus (T2DM), hypertension (HT), and dyslipidemia. Bariatric surgery (BS) produces dramatic weight loss, with improvement of obesity associated comorbidities and decrease of overall mortality.
Objectives and methods: The aim of this study was to evaluate the impact of weight loss on obesity associated comorbidities 1, 2 and 5 years following BS. 91 severely obese patients (81.3% women, mean age 44.5±10 years, mean BMI 51.6±5.2 kg/m2) underwent laparoscopic adjustable gastric banding (LAGB) between February 2009 and June 2012. Results obtained 1, 2 and 5 years postoperatively were compared to the preoperative values using SPPS software version 20.
Results: A significant drop in BMI was recorded throughout the follow-up period, as well as in HbA1c, with greatest improvement seen 2 years after surgery (51.6±5.2 kg/m2 vs. 40.1±6.5 kg/m2, P<0.05 and 58.7±18.8 mmol/mol vs. 43.3±14.5 mmol/mol, P<0.05). In addition, positive results were noted when analyzing the change in treatment. After 5 years, the percentage of patients using glucose lowering agents declined (47.1% vs. 30.6%, P<0.05), and patients were taking less antihyperlipidemic drugs compared to baseline (41.9% vs. 28%, P<0.05). However, the reduction of antihypertensive medication use, was non-statistically significant (67.4% vs. 57.1%, P=ns).
Conclusions: LAGB is an effective procedure producing significant and durable weight loss, with maximum effect obtained 2 years after surgery. Improvement in obesity related comorbidities following LAGB varies. The effect on hypertension control was minimal while both glycemic and lipid status improved, with less medication use postoperatively. Results were maintained after a longer follow up period.