Late results of gastric bypass surgery for morbid obesity.

Objective: Morbid obesity (excess body weight of 45.5 kg or 100% over ideal body weight) is associated with > 3-fold increased mortality in men and women and is resistant to dietary intervention. Gastric bypass (GBP) and vertical banded gastroplasty (VBG) are the currently accepted surgical treatments. The purpose of this study was to analyze retrospectively 153 consecutive morbidly obese patients who underwent GBP from 1975-1986 and were followed for a minimum of 5 years.

Methods: Data were analyzed from 1-16 years postoperative comparing preoperative morbidity, operative complications, postoperative morbidity, interval weight loss, maximum weight loss, and weight regain.

Results: At the 1- and 5-year intervals, 129 and 86 patients respectively were available for review. Operative mortality was < 1%. Weight loss at 1 year = 48.5 kg rising to 57 kg at 24 months. Statistically significant weight loss of 37.0 kg (19.2 SD)(p < .001) was achieved at 5 years. The mean percent excess body weight lost was 66.4 and 50.9% at 1 and 5 years, respectively. No obesity-related deaths occurred in the follow-up period. Incidence of hypertension, cardiac disease and diabetes was reduced by 25-50% during follow-up.

Conclusions: GBP is a safe and effective operation which achieves sustained weight loss of > 35 kg at 5 years and reduces the complications of morbid obesity.