Obesity-associated disorders before and after weight reduction by verticalbanded gastroplasty in morbidly vs super obese individuals

Background: The amount of excess weight which must be lost in order to cure or to improve disorders associated with obesity remains unknown. This stud y was designed to compare super obese and morbidly obese patients in terms of weight reduction following VBG and to investigate the effects of postope rative weight changes to preexisting co-morbidities. Methods: 125 patients underwent VBG. Group A consisted of 80 morbidly obese patients (64%) and group B consisted of 45 super obese patients (36%). Pre operative examination was planned to identify and determine the severity of any disorders associated with obesity, that the patients may have had. Fol lowing VBG, all patients were followed-up at regular time periods, for at l east 2 and up to 4 years. The progress of preexisting co-morbidities was ev aluated and carefully recorded. Results: Among the 80 patients of Group A, there were 240 total co-morbidit ies (3 per patient), and in group B there were 196 co-morbidities (4.35 per patient) preoperatively. Dyspnea during fatigue and arthritis were found a t statistically higher incidence in the super obese category. At the end of the second postoperative year, greater weight loss in terms of number kilo grams was seen in patients in group B, but these patients did not reach a B MI lower than 35, while patients in group A had mean BMI below 30. In group A, 66% of the co-morbidities completely resolved, 19% significantly dimini shed and 15% remain unchanged. In group B, the respective percentages were 53%, 27.5% and 19.5%. However, after weight reduction by VBG a significant number of co-morbidities remain in the super obese patients (92 or 2.044 pe r/patient), and this is believed to be due to the greater remaining excess weight. Conclusion: Reduction of body weight by VBG is associated with resolution o r improvement of a significant number of the obesity-associated disorders. However, super obese patients remain obese after surgery, and this results in two-fold higher remaining morbidity.