Bariatric surgery is a safe and effective procedure that leads to significant weight loss while reducing the need for diabetes medications, according to an Australian study led by Monash University and the University of Sydney.
Published in the ANZ Journal of Surgery, the study analyzed data from individuals who underwent bariatric surgery in Australia between February 28, 2012, and December 31, 2021. A total of 122,567 patients underwent 134,625 bariatric procedures, demonstrating the large-scale impact of weight-loss surgery in the general population.
Sustained Weight Loss Across Different Procedures
Five years post-surgery, patients experienced notable weight reduction, depending on the type of procedure performed:
- One-anastomosis gastric bypass: 34.88% total body weight loss
- Roux-en-Y gastric bypass: 30.73% total body weight loss
- Sleeve gastrectomy: 26.5% total body weight loss
- Adjustable gastric bands: 17.6% total body weight loss
These findings confirm the long-term efficacy of bariatric surgery in helping individuals achieve substantial and sustained weight loss.
Impact on Diabetes Treatment
Among the study participants, 13.6% were receiving treatment for diabetes before undergoing surgery. The results showed a significant reduction in the need for diabetes medications:
After 12 months, 71.6% of the 58% of patients followed up required no diabetes medication.
After five years, 61% of the 22% of patients followed up remained off diabetes medication.
This underscores the potential of bariatric surgery to improve diabetes management, reducing reliance on medication and enhancing overall health outcomes.
Safety and Risk Assessment
The study found that only 3.6% of patients experienced adverse events within 90 days of surgery, including unplanned readmissions, intensive care unit admissions, re-operations, or, in rare cases, death. These rates are comparable to other minimally invasive surgeries, such as gallbladder removal, reinforcing the procedure’s safety.
Professor Wendy Brown, Chair of Monash University’s Department of Surgery at Alfred Health and the study’s first author, emphasized that this is the first large-scale community-level data confirming the safety and effectiveness of bariatric surgery.
“This study provides reassurance to patients, their families, and healthcare funders that bariatric surgery is not only safe but also delivers significant health improvements,” said Professor Brown. “It allows for more informed patient consent by offering realistic expectations of the benefits and risks associated with the procedure.”
A Transformative Impact on Public Health
The ability for 61% of diabetes patients to discontinue all medications five years post-surgery highlights a major public health benefit, potentially reducing long-term healthcare costs associated with obesity-related diseases.
Professor Brown noted that while obesity is often considered a risk factor for surgical complications, the study’s low adverse event rate is “extraordinary,” demonstrating that bariatric surgery can be a viable and safe option for long-term weight management.
Future Research and Next Steps
The research team aims to further explore revisional surgeries, patterns of care, and outcomes in patients managing both obesity and diabetes. Additionally, starting in 2025, patient-reported outcomes will be integrated into the Australia and New Zealand Bariatric Surgery Registry (BSR), enhancing the quality of future findings.
About the Australia and New Zealand Bariatric Surgery Registry (BSR)
The BSR is a longitudinal, community-level national registry that collects data on metabolic and bariatric procedures performed in Australia and New Zealand. The registry, which began as a pilot study in 2012 before expanding nationwide in 2014 (Australia) and 2018 (New Zealand), tracks weight-loss outcomes, safety measures, and health improvements.
Among primary procedures, sleeve gastrectomy remains the most common (80%), while Roux-en-Y gastric bypass is the leading revisional conversion procedure (21.8%).
By continuously analyzing long-term outcomes, the registry aims to refine best practices and support healthcare providers in delivering effective weight-loss solutions.
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