BACKGROUND: The Office of Group Benefits, an insurance provider for Louisiana state employees and their families, provided bariatric surgery for 490 of its adult OGB members with severe obesity. We report changes in weight, biomarkers, and quality of life (QOL) and focus on 142 participants who completed in-person follow-up assessment (FU) at least five years post-surgery.
METHODS: A lottery selected 100 surgical participants each year for five years. Participants seeking bariatric surgery and approved by an expert medical/surgical panel received either gastric banding (GB), gastric sleeve (GS), or gastric bypass surgery (GBP). Participants completed extensive medical and behavioral assessments at 6 months, one-year and at least five years (Mean= 7.04 years) post-surgery.
RESULTS: Data collection completed in June 2023. Our FU sample included 142 participants (89.44% female, 63.38% Caucasian, 36.62% African American). Weight loss was significant for all groups (P<0.05). Weight loss was greater in participants receiving GBP (n=30, -32.1 kg, SD 19.2) and GS (n=45.07, -21.9 kg, SD 15.9), compared to GB (n=48, -9.0 kg, SD 16.6) after 5+ years (p<.05). QOL responses (IWQOL-Lite) indicated significant improvements (p<.001) from baseline to year one in physical ability, self-esteem, sexual functioning, anxiety, weight distress in public places, and work performance. Gains in QOL scores were not maintained at FU with self-esteem and sexual functioning returning to baseline levels and work performance to below baseline level. Biomarker results indicated HDL increases were significant (P<.05) for all groups at 1 year and FU. Triglycerides and HbA1c were significantly lower (p<.05) for GBP and GS groups. Blood pressure, total and LDL cholesterol changes were unchanged.
CONCLUSIONS: All groups maintained significant weight loss at FU; GBP and GS were superior to GB. While QOL and several obesity-related biomarkers improved, additional treatment, e.g., weight loss medications, lifestyle change, additional surgery, may help ensure long-term success.