Researchers Propose Bariatric Surgery Outcome Score to Measure Weight Loss Effectiveness

To counter balance concerns about bariatric surgery side effects, researchers seek to standardize the reporting of weight loss surgery outcomes, so doctors can better decide which treatments to recommend.

The findings of a new study may give doctors a tool to help them better determine which patients are most likely to benefit from weight loss surgery and which type they should have.

In an analysis published this month in the medical journal JAMA Network Open, researchers indicate they may have developed an accurate method to define and measure how effective metabolic bariatric surgeries (MBS) are in treating obesity. Researchers say the tool could set new standards for reporting patient outcomes after undergoing weight loss surgery, which may improve treatments and future obesity research.

Bariatric surgery is often recommended for severe obesity, to help with weight loss, treat metabolic diseases and reduce the risk of diseases caused by carrying extra weight. The procedures are normally used when diet and exercise have not worked, or when complications from other health issues have prevented weight loss.

There are two major types of weight loss surgery. The first is gastric sleeve gastrectomy procedures, which remove approximately 80% of the stomach, reducing it to the size and shape of a banana. The other procedures include gastric bypass surgery, also known as Roux-en-Y Gastric Bypass (RYGB), in which the stomach is divided to create a new, smaller one, which is then rerouted to the lower portion of the small intestine.

Weight Loss Surgery Health Risks

While the procedures have been successful in treating obesity, concerns have been raised over the side effects of bariatric surgery, and long-term health complications they can cause. Prior research has shown that gastric bypass and sleeve surgeries have been linked to higher risks of gastrointestinal (GI) complications, nutritional disorders, bowel obstructions, and even alcohol dependency.

A study conducted in Sweden found that 40% of those who underwent gastric banding surgery required a revision surgery to convert to a gastric bypass procedure, correct problems of the band placement, or reverse the process entirely.

Additional concerns about the weight loss procedures were raised after another study showed that women who underwent an MBS had a higher risk of giving birth to premature or low birth weight infants. The study also found that 23.5% of the participants had a pregnancy about five to seven days shorter than those who did not have surgery.

As a result of the side effects, doctors have increasingly turned to new pharmaceutical options, including Ozempic, Wegovy, Mounjaro and Zepbound, which are part of a new class of medications originally intended to treat diabetes, which have proven effective in promoting weight loss by delaying gastric emptying. However, concerns have emerged about potential gastroparesis side effects from Ozempic and the other drugs, where users develop a painful paralyzed stomach, often requiring emergency treatment and leaving them with long-term stomach problems.

Drug makers now face a growing number of Ozempic lawsuits, Wegovy lawsuits and Mounjaro lawsuits, alleging that they failed to fully disclose the potential long-term side effects when promoting their weight loss drugs.

Evaluating Benefits of Weight Loss Surgery

To help patients and the medical community better understand the benefits and long-term outcomes associated with surgical weight loss options in this new study, researchers from Switzerland and Finland analyzed the data fromvtwo randomized clinical trials, including the Swiss Multicenter Bypass or Sleeve Study (Swiss SM-BOSS) conducted from January 2007 to November 2011, and the Finnish Laparoscopic Gastric Bypass Vs Sleeve Gastrectomy to Treat Morbid Obesity (SLEEVEPASS) study conducted from March 2008 until June 2010.

The trials compared the weight loss outcomes of laparoscopic sleeve gastrectomy procedures to laparoscopic Roux-en-Y gastric bypass surgeries after five years. The analysis included data on 457 patients from the two clinical trials, which included 323 females and 134 males.

The clinical trials evaluated how successful the surgeries were using the Bariatric Analysis and Reporting Outcome System, which used the patient’s total percentage of weight lost, any changes in long-term health conditions, as well as their overall quality of life after weight loss. However, researchers proposed that there may be a better method to calculate the long-term outcomes of patients who had these procedures, since they did not consider surgical complications.

The results showed notable differences in patient health outcomes at one and five years after surgery. Those who had gastric bypass surgery had higher weight loss outcome scores compared to those who underwent gastric sleeve surgery.

However, researchers suggest the findings can be used to create a simpler way to describe patient success after weight loss surgery, which can standardize patient outcome reporting for clinical or research purposes. Having such a standardized system would help researchers correlate data to discover which patients tend to benefit the most.

“A standardized definition and reporting of metabolic bariatric surgery (MBS) outcomes is not available for actual clinical practice and science.” the researchers noted. “These findings indicate that this metabolic bariatric surgery outcome score is a simple, relevant, and feasible composite tool to define and measure MBS outcomes, enabling standardized reporting.”