SAT-116 Efficacy of Bariatric Surgery in Improving Obesity in South Asians

Obesity and its complications have become a major public health problem. Health risk conferred by obesity can be reduced by sustained weight loss but this is difficult in a majority. Bariatric surgery (BS) has proven to provide an excellent answer to this problem but there is minimal data in South Asians and especially in Sri Lankans. In this study we aimed to find the effect of BS on improving obesity in Sri Lankans. We did a retrospective analysis of medical records of 170 obese patients who underwent BS at the Colombo South Teaching Hospital, Sri Lanka. Overall 74.1% were females. Laparoscopic sleeve gastrectomy (LSG) was the commonest BS (69.5%) performed, followed by laparoscopic mini gastric bypass (LMGB) (24.1%) and laparoscopic Roux-en-Y gastric bypass (4.9%). Mean age was 38.1 ± 10.4 years. Mean pre-operative body weight and body mass index were 115.0 ± 23.0 kg and 45.1 ± 6.8 kg/m(2) respectively. The baseline waist circumference (WC) and body fat percentage (BFP) in females and males were 119.0 ± 11.0 cm vs 129.0 ± 14.9 cm, p<0.05 and 45.4% ± 4.8% vs 40.6% ± 6.1%, p<0.005 respectively. At 1 month, 3 months, 6 months, 9 months and 12 months after BS, patients lost 11.3 ± 5.0 kg (female: 10.0 ± 3.9 kg, male: 14.8 ± 6.0 kg, p<0.001), 19.3 ± 6.4 kg (female: 17.8 ± 4.4 kg, male: 25.5 ± 9.2 kg, p<0.01), 26.0 ± 8.8 kg (female: 24.7 ± 6.8 kg, male: 30.1 ± 13.2 kg, p=0.15), 28.7 ± 7.8 kg (female: 28.5 ± 7.8 kg, male: 29.6 ± 8.2 kg, p=0.77) and 30.1 ±8.1 kg (female: 30.0 ±8.2 kg, male: 30.8 ±8.4 kg, p=0.83) of body weight respectively. At 1 month, 3 months, 6 months, 9 months and 12 months after BS the reduction in WC from baseline were 6.1 ± 7.4 cm, 13.7 ± 8.4 cm, 19.1 ± 9.0 cm, 20.4 ± 7.8 cm and 21.1 ±8.2 cm respectively. At 1 month, 3 months, 6 months, 9 months and 12 months after BS the reduction in BFP from baseline were 1.6 ± 4.6%, 4.6 ± 6.6%, 7.5 ± 5.6%, 9.3 ± 9.9% and 9.2 ± 6.5% respectively. There was no significant difference in the reduction of WC and BFP among males and females. Patients who underwent LMGB lost more weight as compared to LSG at 3 months (22.5 ± 8.9 kg vs 18.3 ± 5.2 kg, p=0.07), 6 months (32.6 ± 14.7 kg vs 24.7 ± 7.1 kg, p=0.13) and 12 months (34.6 ± 8.4 kg vs 30.0 ± 8.4 kg, p=0.31) although this difference did not reach statistical significance. Thus BS resulted in a sustained and progressive loss of weight, WC and BFP with rapid improvement in the first 6-9 months and the effect plateauing afterwards. Males lost weight more rapidly than females in the first 6 months after BS, but at 12 months there was no difference in weight loss among the two genders. In conclusion BS provides effective, sustained and progressive weight loss in obese patients with males benefiting more in the short term but with equal efficacy among genders in the long-term. Overall LMBG shows a trend towards better efficacy in weight loss as compared to LSG, especially in the first 6 months but further studies are warranted.