OUTCOME FOLLOWING BARIATRIC SURGERY IN SUPER VERSUS MORBIDLY OBESE PATIENTS - DOES WEIGHT MATTER

Background: Numerous investigators have attempted to identify prognost ic indicators for successful outcome following bariatric surgery. The purpose of this study was to determine whether degree of obesity affec ts outcome in super obese [>225% ideal body weight (IBW)] versus morbi dly obese patients (160-225% IBW) undergoing gastric restrictive/bypas s procedures. Methods: Since 1984, 157 patients underwent either gastr ic bypass or vertical banded gastroplasty. Super obese (78) and morbid ly obese (79) patients were followed prospectively, documenting outcom e and complications. Results: Super obese patients reached maximum wei ght loss 3 years following bariatric surgery, exhibiting a decrease in body mass index (BMI) from 61 to 39 kg/m(2) and an average loss of 42 % excess body weight (EBW). Morbidly obese patients had a decrease in BMI from 44 to 31 kg/m(2) and carried 39% EBW at 1 year. After their r espective nadirs, each group began to regain the lost weight with the super obese exhibiting a current BMI of 45 kg/m(2) (61% EBW) versus 34 kg/m(2) (52% EBW) in the morbidly obese at 72 months cumulative follo w-up. Currently, loss of 50% or more of EBW occurred in 53% of super o bese patients Versus 72% of morbidly obese (P < 0.01). Twenty-six perc ent of super obese patients returned to within 50% of ideal body weigh t (IBW) while 71% of morbidly obese were able to reach this goal (P < 0.01). Co-morbidities and complications related to surgery were simila r in each group. Conclusions: Super obese patients have a greater abso lute weight loss after bariatric surgery than do morbidly obese patien ts. Using commonly utilized measures of success based on weight, morbi dly obese patients tend to have better outcomes following bariatric su rgery.