Success of bariatric surgery associated with lower pre-surgery BMI

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People with type 2 diabetes who undergo bariatric surgery are more likely to achieve remission if they are not ‘extremely obese’ before the procedure, research shows.
A study of 27,320 Americans who underwent bariatric surgery from June 2006 to May 2015 concluded that optimum success following the operation depends on a Body Mass Index (BMI) of less than 40.
People with a BMI of less than 40 were “significantly more likely” to achieve a BMI of less than 30 following the operation, and achieve remission from type 2 diabetes one year after the procedure.
Those with a BMI of 50 or higher at the time of the operation were less likely to experience less positive results, but experts say people undergoing the procedure with a BMI of 50 would still benefit from the surgery.
Lead researcher Dr Oliver A Varban, of the Michigan Bariatric Surgery Collaborative, said: “Bariatric surgery is optimal in patients with a BMI of less than 40. Policies and practice patterns that delay bariatric surgery until the BMI is 50 or greater can result in significantly inferior outcomes.”
The study looked examined 38 bariatric surgery centres home to a total of 70 surgeons, and researchers believe the findings could be important in understanding the clinical benefits of weight loss surgery.
Dr Bruce M Wolfe and Dr Elizaveta Walker, from Oregon Health and Science University, Portland, said in an accompanying article: “The authors’ conclusion that bariatric surgery should be more liberally applied to patients with less severe obesity is consistent with multiple reports of improved control of type 2 diabetes, if not remission, among lower-BMI patient populations following [metabolic bariatric surgery].
“However, these reports generally do not refute the importance of weight loss in achieving important clinical benefit among patients with obesity-related comorbid disease.”
The results were published in the journal JAMA Surgery.