Background

Background: Weight loss trajectories in different body mass index (BMI) categories of single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) patients have yet to be studied extensively. Objective: The study aimed to compare peak weight loss and weight-loss failure (WLF) rates between different BMI categories of SADI-S patients. Setting: Single private institute, United States.

Methods

Data from 977 patients who underwent a primary SADI-S by four surgeons from June 2013 through September 2021 were retrospectively analyzed. WLF was defined as excess weight loss less than 50% at the last follow-up beyond 18 months postoperatively. Patients were categorized according to their preoperative BMI (30-35, 35-40, 40-45, 45-50, 50-55, and > 55 kg/m2) (Table. 1). Logistic regression was used to determine variables that are predictive of WLF following surgery.

Results

In total, 977 patients were included. Statistically significant differences were noted between the BMI groupings for age, and preoperative weight and BMI. Peak weight loss in regards to %EWL was highest in the BMI 30-35 category and lowest in the BMI >55 category. The peak %TWL was also significantly different between the BMI groupings. Overall, WLF was noted in 13.4% of patients. (Table.1). Only preoperative BMI was found to be predictive of WLF on logistic regression (p < .001 Odds= 1.071).

Conclusions

SADI-S is a viable surgery for patients with obesity, regardless of preoperative BMI. WLF may occur in patients with BMI >40; however, it is improbable in patients with BMI <40.