Background

Sleeve gastrectomy (SG) is an effective bariatric surgery, but its application to all patients may not portend to enough long term weight loss for some based on their initial BMI. It remains unclear if patients of various preoperative BMI’s will benefit equally from SG.

Methods

Ten year review of 1724 patients who underwent SG at Abington Jefferson Health. Data includes demographics, length of stay, perioperative complications, and weight-loss outcomes at 12-24-36 months. We defined BMI goals above the ideal body weight of 30 and 35 Kg/m2 since failing to achieve these would allow for the conversation of the role of subsequent bariatric procedures.

Results

There is strong evidence to support that patients with lower initial-BMI had far greater success in reaching the goal, both <30 and <35. For the goal of achieving a BMI <30, there is no evidence to show an association between initial-BMI and reaching the goal at any interval post-surgery. A longer interval of time post-surgery was not related with higher success. Success as expressed in terms of achieving BMI benchmarks is significantly compromised when the starting BMI requires a goal of dropping more than 10 BMI points.

Conclusions

Starting BMI seems to be a major contributor to long term weight loss after VSG. This procedure is a safe intervention that will allow most patients to drop their starting BMI by 10 points. This will be true at 1, 2 and 3 years after surgery. Second stage procedures may be needed for patients of highest BMI.