Long-Term Weight Loss after Bariatric Surgery in Patients Visited at Home Outside the Study Environment

Background: Bariatric surgery results in sustained weight loss in the majority of patients. The controlled setting of a trial, however, does not necessarily reflect the everyday routine practice. Therefore, to investigate the results of bariatric surgery in a more natural setting, patients were visited at home, outside a study and hospital environment. Methods: Patients who underwent a vertical banded gastroplasty or a gastric bypass between 1980 and 1997 were eligible. Body weight and height were measured. Patients filled out general and health status questionnaires (Nottingham Health Profile (NHP)). Results: Responses were obtained from 236/313 subjects (75%) with a mean ± SD age of 42.9 ± 10.2 years and a mean current body weight of 100.3 ± 20.7 kg. A maximum weight loss of 48.2 ± 18.4 kg or 70.8 ± 22.4% excess weight loss was obtained after 17 ± 15 months, of which 32.1 ± 22.6 kg or 45.2 ± 29.3%, respectively, was maintained at 8.2 ± 4.5 years after the intervention. Males and females did not differ in weight loss. The type of operation had no influence. Age >50 years and a BMI >50 kg/m2 were not related to a poor outcome, but a time lapse of >5 years since the operation resulted in a less well sustained weight loss. The subjective health status improved considerably, but less so with a smaller weight loss and longer lapse of time since the operation. Especially in females, the NHP still deviated substantially from Dutch norm values. Conclusions: Surgically obtained weight loss is satisfactory in patients outside a strictly controlled study setting. Health benefits are substantial, but are adversely affected by weight gain and time elapsed since the operation.