Abstract Journal Bariatric Surgery (original) (raw)
2017, ANZ Journal of Surgery
Substantial weight loss in the setting of obesity has considerable metabolic benefits. Yet some studies have shown improvements in obesity-related comorbidities with more modest weight loss. By closely monitoring patients, we aimed to determine the effects of weight loss on the metabolic syndrome, and determine the target weight loss required for its resolution. Methodology: We performed a prospective observational study of obese participants with metabolic syndrome (ATPIII) who underwent gastric banding. Participants were assessed for all criteria of the metabolic syndrome each month for nine months, then three-monthly until 24 months. Results: There were 89 participants recruited, with baseline BMI 42.4AE6.2kg and age 48.2AE10.7years. Resolution of the metabolic syndrome occurred in 60 of 89 participants (67%) at 12 months and 60 of 75 participants (80%) at 24 months. The mean weight loss when metabolic syndrome resolved was 10.9AE7.7% total body weight loss (TBWL). Median weight loss at which prevalence of disease was halved was 7.0% TBWL for hypertriglyceridemia; 11% TBWL for HDL cholesterol and hyperglycaemia; 20% TBWL for hypertension; 29% TBWL for waist circumference. Achieving 10-12.5% TBWL correlated with a 2.09 (p=0.025) odds of resolution of the metabolic syndrome with increasing probability of resolution with more substantial weight loss. Conclusion: In obese participants, a weight loss target of 10-12.5% TBWL (25-30% EWL) is a reasonable initial goal for metabolic benefits. Further metabolic improvement could be expected with additional weight loss. These findings can help inform weight loss efforts, in counselling patients, determining targets and assessing success of weight loss strategy.
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