Weight Loss After Bariatric Surgery Affected by Baseline Diabetes Status

For patients who undergo bariatric surgery, having diabetes may diminish the amount of weight ultimately lost after the procedure, according to study results intended to be presented at the annual meeting of the Endocrine Society (ENDO 2020).

These results, along with other research accepted for presentation at ENDO 2020, will be published in a supplemental issue of the Journal of the Endocrine Society.

In the study, researchers at the University of Michigan examined the effects of diabetes on multiple measures of weight loss after bariatric surgery. Adult patients in the Michigan Bariatric Surgery Cohort who underwent sleeve gastrectomy (n=334; 77.5% women) or gastric bypass (n=380; 80.3% women) for obesity (body mass index [BMI] >40 kg/m² or 35-39.9 kg/m² with comorbidities) were examined for outcomes including total weight loss, total weight loss percent, and excess weight loss percent over 5 years. Approximately two-thirds of the cohort were retained for the full follow-up period.

In the sleeve gastrectomy group, the mean patient age was 45.3 years and 108 patients (32.3%) had diabetes at baseline. Mean age was similar in the gastric bypass group (43.6 years), in which 149 patients (39.2%) had baseline diabetes. Presence of diabetes at baseline did not affect the probability of achieving a BMI <30 kg/m² after surgery.

Diabetes did, however, affect several other weight outcomes. Compared with patients with baseline diabetes, patients without diabetes were significantly more likely to achieve an excess body weight loss of ≥50% (odds ratio, 1.56; P =.0021) and lost more BMI points regardless of surgery type, with presence of diabetes at baseline linked to approximately 10% to 15% fewer BMI points lost (mean, 1.2 fewer BMI points).

Moreover, in linear mixed models adjusted for surgery type, age, sex, and baseline weight, individuals with diabetes had lower absolute weight loss, percentage of total weight loss, and percentage of excess weight loss after surgery compared with individuals without diabetes.

The study’s investigators discussed how these findings may affect the counseling of patients who are candidates for bariatric surgery in a virtual news conference held by the Endocrine Society on March 30, 2020. They suggested that the results support undergoing surgery earlier rather than later given that diabetes diminished the ultimate weight loss benefits, but acknowledged that these data are still preliminary and more studies are needed to confirm the findings. In addition, more research is needed to elucidate the mechanisms through which diabetes affects outcomes of surgical weight loss.

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References

1. Luo Y, Eldin AWJ, Haddad R, et al. Presence of diabetes diminishes the ultimate weight loss after bariatric surgery. J Endocr Soc. 2020;4(suppl 1).

2. Luo Y. Presence of diabetes diminishes the ultimate weight loss after bariatric surgery. ENDO 2020 Virtual News Conference – Diabetes. March 30, 2020. Accessed March 30, 2020.