To Örebro University

Introduction: Metabolic and bariatric surgery (MBS) is part of routine care for patients with severe obesity (BMI >35 kg/m2). In Sweden, the Scandinavian Obesity Registry (SOReg) collects data on all MBS with follow-up at 1, 2, 5 and 10 years. Long-term results (≥10 years) are scarce, especially in larger cohorts.

Method: Patients who underwent a primary Roux-en-Y gastric bypass (RYGB) in 2007-2012 were studied. SOReg was used for weight, laboratory data, and sleep apnoea, defined as CPAP-treatment (continuous positive airway pressure). Data on metabolic comorbidities, defined as active pharmacological treatment, was obtained from the Prescribed drugs registry. Preoperatively, 14.5% were treated for type 2 diabetes (T2D), 31.3% for hypertension, and 12.3% for dyslipidaemia.

Result: 29,578 patients (BMI 42.7 kg/m2, age 41.0 years, and 75.6% women) were included. Ten years after surgery, we had access to SOReg-data in 9966 (33.7%) patients and current pharmacological treatment in 28,233 (95.4%) patients. Mean total body weight loss was 24.6%, corresponding to an excess body weight loss of 62.4%. The following rates of complete remission was seen: T2D 30.0%, hypertension 15.8%, and dyslipidaemia 8.9%. A similar result was seen in laboratory values. The use of CPAP for sleep apnoea was reduced from 9.8% to 4.1% at 10 years.

Discussion: Despite gradual weight regain, large weight loss and substantial remission in comorbid diseases was seen 10 years after primary gastric bypass. The successive weight regain should be noted and addressed.