Super obesity (BMI ≥ 50kg/m2) is becoming increasingly prevalent, but there is a dearth of literature on treatments for people with this degree of obesity as they are often excluded from clinical trials. While surgery is the most durable and effective treatment for obesity, there are some concerns over its safety and efficacy for people with super obesity. We aimed to assess the long-term safety and efficacy of bariatric surgery in this group.
This is a longitudinal follow-up study of patients who underwent bariatric surgery as public patients from 2009-2017. Patients were classified as having obesity (BMI 30-49.9 kg/m2) or super obesity (BMI ≥ 50 kg/m2).
The mean pre-operative BMI±SD was 42.7±4.2 kg/m2 in the obese group (n=85) and 58.9±7.5 kg/m2 in the super obese group (n=48). There were no differences in age or sex of these patient groups (53.8±1.2 versus 49.9±1.6 years; and 34.1% versus 31.1% male). The main operation in both groups was sleeve gastrectomy (88% (n=75) versus 90% (n=43)). Substantial weight loss was achieved by patients in both groups at all time points, with no significant difference between groups in weight loss expressed as a per cent of pre-surgical weight. Weight loss % (kg) in patients with obesity versus super obesity was 24% (28.9 kg, n=68) versus 26% (40.9 kg, n=36) at 1 year, 24% (29.2 kg, n=55) versus 29% (46.2 kg, n=30) at 2 years, 23% (27.4 kg, n=32) versus 25% (40.5 kg, n=13) at 3 years, 21% (25.7 kg, n=23) versus 23% (36.0 kg, n=10) at 4 years and 15% (18.4 kg, n=15) versus 18% (29.5 kg, n=8) at 5 years. There were no differences in complication rates between groups.
Bariatric surgery appears to be equally safe and effective in patients with super obesity as in those with less severe obesity.