title: Obesity-associated disorders before and after weight reduction by vertical banded gastroplasty in morbidly vs super obese individuals.
abstract: BACKGROUND
  The amount of excess weight which must be lost in order to cure or to improve disorders associated with obesity remains unknown. This study was designed to compare super obese and morbidly obese patients in terms of weight reduction following VBG and to investigate the effects of postoperative weight changes to preexisting co-morbidities.
  
  
  METHODS
  125 patients underwent VBG. Group A consisted of 80 morbidly obese patients (64%) and group B consisted of 45 super obese patients (36%). Preoperative examination was planned to identify and determine the severity of any disorders associated with obesity, that the patients may have had. Following VBG, all patients were followed-up at regular time periods, for at least 2 and up to 4 years. The progress of preexisting co-morbidities was evaluated and carefully recorded.
  
  
  RESULTS
  Among the 80 patients of Group A, there were 240 total co-morbidities (3 per patient), and in group B there were 196 co-morbidities (4.35 per patient) preoperatively. Dyspnea during fatigue and arthritis were found at statistically higher incidence in the super obese category. At the end of the second postoperative year, greater weight loss in terms of number kilograms was seen in patients in group B, but these patients did not reach a BMI lower than 35, while patients in group A had mean BMI below 30. In group A, 66% of the co-morbidities completely resolved, 19% significantly diminished and 15% remain unchanged. In group B, the respective percentages were 53%, 27.5% and 19.5%. However, after weight reduction by VBG a significant number of co-morbidities remain in the super obese patients (92 or 2.044 per/patient), and this is believed to be due to the greater remaining excess weight.
  
  
  CONCLUSIONS
  Reduction of body weight by VBG is associated with resolution or improvement of a significant number of the obesity-associated disorders. However, super obese patients remain obese after surgery, and this results in two-fold higher remaining morbidity.
authors.affiliation: Bariatric Unit, Department of Surgical Oncology, University Hospital, Medical School, University of Crete, Heraklion, Crete, Greece. melissas@med.uoc.gr
authors.forename: J
authors.initials: J
authors.lastname: Melissas
authors.forename: M
authors.initials: M
authors.lastname: Christodoulakis
authors.forename: G
authors.initials: G
authors.lastname: Schoretsanitis
authors.forename: E
authors.initials: E
authors.lastname: Sanidas
authors.forename: E
authors.initials: E
authors.lastname: Ganotakis
authors.forename: D
authors.initials: D
authors.lastname: Michaloudis
authors.forename: D D
authors.initials: DD
authors.lastname: Tsiftsis
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001168:Arthritis / Q000209:etiology*; D015992:Body Mass Index; D004417:Dyspnea / Q000209:etiology*; D005221:Fatigue / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000145:classification / Q000150:complications* / Q000601:surgery*; D010996:Pleural Effusion / Q000209:etiology; D011014:Pneumonia / Q000209:etiology; D001261:Pulmonary Atelectasis / Q000209:etiology; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D015431:Weight Loss