Background: Long-term outcomes from bariatric surgery in the public healthcare setting are limited.
Aims: We aimed to assess the weight and comorbidity outcomes following bariatric surgery at a publicly funded tertiary obesity service.
Methods: A retrospective cohort of 183 participants who underwent bariatric surgery between 1 October 2009 and 1 June 2022 was identified. Postoperative weight change and comorbidity status were assessed from 1 to 10 years post-bariatric surgery. Major obesity related comorbidities included were type 2 diabetes mellitus (T2DM), dyslipidaemia, hypertension, obstructive sleep apnoea (OSA), arthritis/arthralgia and depression and anxiety.
Results: At baseline the cohort had a mean age of 50.6 years (SD, 10.8 years), mean weight of 134.0 kg (SD, 30.4 kg) and mean BMI of 49.0 kg/m2 (SD, 9.4 kg/m2). At baseline, 60.7% of the cohort had three or more comorbidities of the six assessed. Maximal weight loss occurred at 18-months post-surgery with a mean weight reduction of 26.8% (SD, 9.9%). Data was available for 45% (n=14) of the eligible cohort at 10 years with maintenance of 21.4% weight loss (SD 9.6%, p<0.001) when compared to baseline. At 5 years 46% of the cohort had three or more of six comorbidities. Compared to baseline, at 5 years there was a significant reduction in the proportion of the cohort with T2DM (-14.7%, p<0.001), OSA (-13.2%, p<0.05), hypertension (-7.2%, p<0.05) and dyslipidaemia (-13.8%, p<0.05) but there was no change in the proportion with anxiety, depression or arthritis and arthralgia.
Conclusions: In a cohort with complicated obesity, bariatric surgery in a publicly funded service has long term efficacy, with weight loss maintained to 10 years follow up. There was a reduction in the incidence of four major obesity related comorbidities at five years follow up.