EFFECTS OF GASTROPLASTY ON BODY-WEIGHT AND RELATED BIOLOGICAL ABNORMALITIES IN MORBID-OBESITY

Obesity is a prevalent metabolic disorder associated with high morbidi ty and mortality rates. Medical treatment rarely succeeds, and bariatr ic surgery has been proposed as an alternative therapy. The purpose of this non-controlled retrospective study was to evaluate time-course c hanges in body weight in severely obese patients who underwent vertica l ring gastroplasty or adjustable silicone gastric banding, and to ass ess the prevalence and potential reversibility of several of the biolo gical abnormalities associated with morbid obesity. From an initial co hort comprising 658 patients, regular body weight measurements and bio logical data were obtained in 505 patients [419 females, 86 males; age 36 +/- 11 years; body mass index 42.7 +/- 6.9 kg/m(2); (mean +/- SD)] with a mean follow-up of 26 +/- 14 months. Mean weight loss was 32 +/ - 16 kg. Most weight reduction occurred within the first 6 months, fol lowed by near-stabilisation or even slight weight regain. Most biologi cal parameters were obtained before surgery and after at least 6 month s of follow-up. The high prevalence and severity of metabolic disturba nces associated with the insulin resistance syndrome (hyperglycaemia, hyperinsulinaemia, decreased HDL cholesterol, hypertriglyceridaemia, e levated fibrinogen levels and hyperuricaemia) before gastroplasty were significantly decreased after weight loss. No major biological defici encies were observed following gastroplasty, except low iron serum lev els. It is concluded that marked weight loss associated with gastropla sty involved a remarkable reduction in the prevalence and severity of several biological abnormalities classically considered as cardiovascu lar risk factors.