title: Resectional gastric bypass outcomes in active duty soldiers: a retrospective review.
abstract: BACKGROUND
  As in civilian life, some active duty service members have developed severe obesity that is refractory to diet alteration and exercise. In addition to controlling obesity, surgical weight control measures in an active duty population must consider the effect of the postbariatric state on a service member's ability to continue to be deployable to a war zone or other austere military assignment. We report our experience with such patients undergoing open resectional gastric bypass.
  
  
  METHODS
  We retrospectively reviewed the perioperative and long-term outcomes of 33 active duty service members who had undergone open gastric bypass by the same surgical team at a single institution during a 30-month period. Data were collected by chart review and questionnaires. Descriptive and inferential analyses were performed using Statistical Package for Social Sciences, version 14.0.
  
  
  RESULTS
  The questionnaires were returned by 27 patients (13 women and 14 men). The mean age at surgery was 34.2 years (range 24-51). The mean follow-up was 218 weeks (range 162-369). The mean preoperative body mass index was 40.6 kg/m(2) (range 34.0-49.4). The mean postoperative BMI was 25.6 kg/m(2) (range 19-34.7). Using the Bariatric Analysis and Reporting Outcome System outcome criteria for these 27 patients, the results were fair for 4 patients (15%), good for 9 (33%), very good for 12 (44%), and excellent for 2 (7%). No patients had treatment failure according to the Bariatric Analysis and Reporting Outcome System criteria. Also, 5 patients who had previously been nonpromotable because of their weight were reclassified as promotable after the results of the bariatric intervention. Of the 27 patients, all but 3 maintained or achieved deployable status after surgical recovery.
  
  
  CONCLUSIONS
  As in civilian populations, bariatric surgery improves the quality of life of active duty service members who have failed nonoperative means of obesity control. Most service members who undergo bariatric intervention are able to successfully deploy to war zones without adverse effects on their military performance and retain or improve their competitiveness for career promotion.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, Washington, USA. lionel.brounts@amedd.army.mil
authors.forename: Lionel R
authors.initials: LR
authors.lastname: Brounts
authors.forename: Kelly
authors.initials: K
authors.lastname: Lesperance
authors.forename: Ryan
authors.initials: R
authors.lastname: Lehmann
authors.forename: Preston
authors.initials: P
authors.lastname: Carter
authors.forename: Alec
authors.initials: A
authors.lastname: Beekley
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.forename: Robert
authors.initials: R
authors.lastname: Rush
authors.forename: James
authors.initials: J
authors.lastname: Sebesta
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009767:Obesity, Morbid / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult