Safety and efficacy of sleeve gastrectomy in non-diabetic individuals with class I vs. class II obesity: a matched controlled experiment from Tehran Obesity Treatment Study (TOTS)

Background

This study aimed to evaluate the 3-year outcomes of sleeve gastrectomy in non-diabetic individuals with class I obesity.

Methods

A total of 78 participants with class I obesity and 78 participants with class II obesity, matched in terms of age, sex (93.6% female), and the rates of dyslipidemia and hypertension, were included in this prospective cohort study. Follow-up data, including metabolic features, body composition, nutritional characteristics, and surgery complications, were gathered at the baseline and 6, 12, 24, and 36 months post-bariatric surgery. Micronutrient deficiencies and comorbidities (hypertension and dyslipidemia) were evaluated in both groups using conditional logistic regression analysis, and Clavien–Dindo classification was used to compare surgical complications.

Results

Baseline characteristics of the participants in both groups were similar (n = 78, mean age: 36.4 ± 8.5). The two groups were also comparable in terms of weight loss, cardiovascular risk factors, and remission of obesity-related comorbidities 3 years following sleeve gastrectomy. Overall values of Δ total weight loss (TWL)%, Δ excess weight loss (EWL)%, and β (95% CI) were − 1.86 (1.19), and − 2.56 (4.5) with a P value of 0.118 and 0.568, respectively. The occurrence of surgical complications and undesirable outcomes were also similar between the two study groups.

Conclusion

Bariatric surgery is an effective and safe method to achieve weight loss and alleviate cardiovascular risk factors and obesity-related comorbidities in non-diabetic individuals with class I and class II obesity.