Background

The Hispanic population along the southern Texas-Mexico border is 80% overweight or obese, making it the “fattest in America.” The region has a high prevalence of obesity-related morbidity and mortality and experienced one of the nation’s highest COVID-19 mortality rates. Considering a regional increase in bariatric surgery, the aims were to determine the use of pre-operative weight loss in predicting surgical success and evaluate the efficacy of Roux-en-Y gastric bypass (RYGB) versus sleeve gastrectomy (SG).

Methods

Pre-operative weight measurements and data for 7 follow-up visits at various intervals (1, 3, 6, 9, 12, 18, and 24 months) were collected for 281 patients from a single hospital site. Surgical success was defined by weight loss and comorbidity reduction.

Results

Patients who lost any preoperative weight had a significantly higher mean %TBWL and those who lost at least 5% of their weight before surgery had on average 7.06±0.76% higher TBWL (p<0.0001) at 24 months post-surgery compared to those who gained weight. Compared to the SG group, patients who underwent RYGB had significantly higher mean %TBWL and showed significant improvements in total cholesterol, LDL, HDL, triglycerides, HbA1c, and systolic blood pressure during the study period.

Conclusions

In this Hispanic population with traditional lifestyles, patient commitment to modify lifestyle behaviors appears to be an indicator of long-term surgery success. Pre-operative weight loss could be a modifiable target for patients undergoing bariatric surgery. In evaluating the efficacy of RYGB versus SG, in this patient population, the RYGB consistently had better outcomes across all variables.