Does preoperative weight loss predict success following surgery for morbid obesity?

BACKGROUND We analyzed preoperative weight loss as a predictor of postoperative success in patients after bariatric surgery. METHODS Data were obtained from a retrospective chart review of 562 patients in a multidisciplinary obesity clinic. RESULTS One hundred forty-six patients met the inclusion criteria (23 men and 123 women). The mean age was 39.5 years, and the mean body mass index (BMI) was 52.6 kg/m(2). Comorbid disease includes diabetes (15.7%), hypertension (30.8%), mental illness (38.4%), and musculoskeletal disease (56.8%). Procedures performed were 16 vertical band gastroplasties, 43 open gastric bypasses, 52 laparoscopic gastric bypasses, and 35 laparoscopic adjustable gastric bands. Preoperative weight change was as follows: 31 patients gained weight (21.2%), 56 patients lost weight (38.3%), and 59 patients maintained their weight (40.4%). Postoperative weight loss was not influenced by preoperative weight change among women. However, men who gained weight preoperatively had significantly worse outcomes. CONCLUSIONS Patients may achieve satisfactory early postoperative outcomes despite inconsistent or marginal preoperative weight change.