A Retrospective Cohort Study on the Impact of Bariatric Surgery on BMI and Comorbidities: Sleeve Gastrectomy versus Gastric Bypass

Document Type : Original Article

Authors

1 MBChB, MSc, PhD in community Medicine- Branch of Clinical Sciences, College of Medicine, University of Suleimani , Iraq

2 MBChB, HDGS, FIBMS, MRCS (glasg.), PDF in HPB - Branch of Clinical Sciences, College of Medicine, University of Suleimani, Iraq

3 4th year medical student, University of Suleimani, College of medicine University of Suleimani, Iraq

4 4th year medical student, University of Suleimani, College of medicineUniversity of Suleimani, Iraq

10.22038/psj.2025.92299.1505

Abstract

Introduction:
Obesity is a many-sided health problem affecting millions of people around the world, which require interventions to minimize its effect on human’s health and health care system. Bariatric surgery has appeared vital assist for copying with obesity and associated complications, but in-depth understanding of its outcomes and patient’s satisfaction has yet to be developed, especially within our community context.
Objective; To compare the short-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass on BMI reduction and resolution of obesity-related comorbidities.
Materials and Methods:
A retrospective cohort study was conducted at Zhyan Private Hospital, Sulaymaniyah, between December 2023 and April 2024. Data from 226 patients who underwent bariatric surgery were analyzed. Pre- and postoperative BMI, hypertension (HT), and type 2 diabetes mellitus (DM) were assessed. Statistical analyses were performed using SPSS v26.0; McNemar’s test was applied for paired categorical outcomes, and Chi-square tests for between-group comparisons.
Results:
 Median BMI reduction was significantly greater in the bypass group (17.49 kg/m²) than in the sleeve group (11.70 kg/m²; p = 0.002). Both procedures produced significant remission of HT (from 40 to 13 cases; p < 0.001) and DM (from 17 to 3 cases; p < 0.001). No significant difference in absolute weight loss was observed between groups (p = 0.15).
Conclusion:
Bariatric surgery, particularly gastric bypass, was associated with marked BMI reduction and comorbidity remission within six months, supporting its role in managing severe obesity and metabolic disease in our population. 

Keywords

Main Subjects


  1. Lim Y, Haq N, Boster J. Obesity and comorbid conditions. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [cited 2024 Jun 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK574535/
  2. Alruwaili BF, Bayyumi DF, Alruwaili OS, Alsadun RS, Alanazi AS, Hadi A, et al. Prevalence and determinants of obesity and overweight among children and adolescents in the Middle East and North African countries: an updated systematic review. Diabetes Metab Syndr Obes 2024;17:2095–103. doi:10. 2147/ DMSO. S458003.
  3. Angrisani L, Ferraro L, Santonicola A, Palma R, Formisano G, Iovino P. Long-term results of laparoscopic Roux-en-Y gastric bypass for morbid obesity: 105 patients with minimum follow-up of 15 years. Surg Obes Relat Dis 2021;17(4):727–36. doi:10.1 016/j.soard. 2020. 11.028.
  4. Fruh SM. Obesity: risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract 2017;29(Suppl 1):S3–14. doi:10.1002/2327-6924. 12510.
  5. Mirghani H, Altedlawi Albalawi I. Metabolic surgery versus usual care effects on diabetes remission: a systematic review and meta-analysis. Diabetol Metab Syndr 2023;15:31. doi:10.1186/s13098-023-01001-4.
  6. Soroceanu RP, Timofte DV, Danila R, Timofeiov S, Livadariu R, Miler AA, et al. The impact of bariatric surgery on quality of life in patients with obesity. J Clin Med 2023;12(13):4225. doi:10.3390/jcm12134225.
  7. Ruban A, Stoenchev K, Ashrafian H, Teare J. Current treatments for obesity. Clin Med (Lond) 2019;19(3):205–12. doi:10.7861/clinmedicine.19-3-205.
  8. Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO Global Registry Report 2018. Obes Surg 2019;29(3):782–95. doi:10. 1007/s11695-018-3593-1.
  9. Versteegden DPA, Van Himbeeck MJJ, Nienhuijs SW. Improvement in quality of life after bariatric surgery: sleeve versus bypass. Surg Obes Relat Dis 2018;14(2):170–4. doi: 10.1016/j. soard.2017.10.008.
  10. Chamarthi VS, Daley SF. Periprocedural care for patients undergoing bariatric device placement and endoscopic procedures. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [cited 2025 Sep 2]. Available from: https:// www. ncbi.nlm.nih .gov/sites/books/NBK513285/
  11. Dietrich A. Biliopancreatic diversion with duodenal switch. In: Ordemann J, Elbelt U, editors. Obesity and metabolic surgery. Berlin, Heidelberg: Springer; 2022. p. 215–28. doi:10.1007/978-3-662-63227-7_13.
  12. Abu Dayyeh BK, Stier C, Alqahtani A, et al. IFSO Bariatric Endoscopy Committee evidence-based review and position statement on endoscopic sleeve gastroplasty for obesity management. Obes Surg 2024;34(10):4318–48. doi:10.1007/s11695-024-07510-z.
  13. Mirghani H, Alamrani SS, Alkonani AA, et al. The impact of bariatric surgery on weight loss and glycemic control in patients with obesity and type 2 diabetes: a systematic review. Cureus 2023;15(11):e49122. doi: 10. 7759/ cureus. 49122.
  14. Sánchez-Pernaute A, Herrera MÁR, Ferré NP, et al. Long-term results of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). Obes Surg 2022;32(3):682–9. doi: 10. 1007/s11695-021-05879-9.
  15. Hatami M, Pazouki A, Hosseini-Baharanchi FS, Kabir A. Bariatric surgeries, from weight loss to weight regain: a retrospective five-years cohort study. Obes Facts 2023;16(6):540–7. doi:10.1159/000533586.
  16. Raj PP, Bhattacharya S, Kumar SS. Comparison of effects of sleeve gastrectomy and gastric bypass on lipid profile parameters in Indian obese: a case matched analysis. Obes Surg 2017;27(10):2606–12. doi:10.1007/s11695-017- 2692-8.
  17. Borgeraas H, Hofsø D, Hertel JK, Hjelmesæth J. Comparison of the effect of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Obes Rev 2020;21(8):e13011. doi:10. 1111/obr. 13011.
  18. Reynolds K, Barton LJ, Basu A, Fischer H, Arterburn DE, Barthold D, et al. Comparative effectiveness of gastric bypass and vertical sleeve gastrectomy for hypertension remission and relapse: the ENGAGE CVD study. Hypertension 2021;78(4):1116–25. doi:10.1161/HYPERTENSIONAHA.120.16934.
  19. Alfadda AA, Al-Naami MY, Masood A, Elawad R, Isnani A, Ahamed SS, et al. Long-term weight outcomes after bariatric surgery: a single center Saudi Arabian cohort experience. J Clin Med 2021;10(21):4922. doi:10.3390/jcm10214922.
  20. Schiavon CA, Cavalcanti AB, Oliveira JD, et al. Randomized trial of effect of bariatric surgery on blood pressure after 5 years. J Am Coll Cardiol 2024;83(6):637–48. doi: 10.1016/j. jacc.2023. 11.032.
  21. van Zeller C, Brown R, Cheng M, Meurling J, McGowan B, Steier J. Peri-operative outcomes of bariatric surgery in obstructive sleep apnoea: a single-centre cohort study. J Thorac Dis 2023;15(2):802–11. doi:10.21037/jtd-22-1501.

22. Wong CKH, Wu T, Wong SKH, Law BTT, Grieve E, Ng EKW, et al. Effects of bariatric surgery on kidney diseases, cardiovascular diseases, mortality and severe hypoglycaemia among patients with type 2 diabetes mellitus. Nephrol Dial Transplant 2021;36(8):1440–51. doi: 10. 1093/ ndt/gfaa075.