Varban OA, et al. - This study was carried out to explore the predictors for achieving a body mass index (BMI) of less than 30 after bariatric surgery. In this study, patients with a preoperative BMI of less than 40 more frequently achieved a BMI of less than 30 after bariatric surgery and more frequently experienced comorbidity remission. Findings thus suggest significantly inferior outcomes with policies and practice patterns that delay bariatric surgery until the BMI is 50 or greater.

Methods

• Researchers performed this retrospective study using data from the Michigan Bariatric Surgery Collaborative, a statewide quality improvement collaborative that uses a prospectively gathered clinical data registry.
• They included a total of 27,320 adults who underwent primary bariatric surgery between June 2006 and May 2015 at teaching and nonteaching hospitals in Michigan.
• They used logistic regression to assess predictors for achieving a BMI of less than 30 at 1 year after surgery.
• They assessed 30-day postoperative complications and 1-year self-reported comorbidity remission as secondary outcome measures.

Results

• At 1 year after bariatric surgery, 9,713 patients (36%; mean [SD] age, 46.9 [11.3] years; 16.6% male) achieved a BMI of less than 30.
• A preoperative BMI of less than 40 was identified as a significant predictor for achieving this goal (odds ratio [OR], 12.88; 95% CI, 11.71-14.16; P < .001).
• Patients who underwent a sleeve gastrectomy, gastric bypass, or duodenal switch more frequently achieved a BMI of less than 30 compared with those who underwent adjustable gastric banding (OR, 8.37 [95% CI, 7.44-9.43]; OR, 21.43 [95% CI, 18.98-24.19]; and OR, 82.93 [95% CI, 59.78-115.03], respectively; P < .001).
• Researchers identified only 8.5% of patients with a BMI greater than 50 who achieved a BMI of less than 30 after bariatric surgery.
• In this study, patients achieving a BMI of less than 30 had markedly higher reported rates of medication discontinuation for hyperlipidemia (60.7% vs 43.2%, P < .001), diabetes (insulin: 67.7% vs 50.0%, P < .001; oral medications: 78.5% vs 64.3%, P < .001), and hypertension (54.7% vs 34.6%, P < .001), as well as a markedly higher rate of sleep apnea remission (72.5% vs 49.3%, P < .001) and higher satisfaction rate (92.8% vs 78.0%, P < .001) compared with patients who did not.