title: Beyond weight loss: evaluating the multiple benefits of bariatric surgery after Roux-en-Y gastric bypass and adjustable gastric band.
abstract: BACKGROUND
  Despite the evidence for benefits beyond weight loss following bariatric surgery, assessments of surgical outcomes are often limited to changes in weight and remission of type 2 diabetes mellitus. To address this shortfall in assessment, the King's Obesity Staging System was developed. This system evaluates the individual in severity stages of physical, psychological, socio-economic and functional disease. These are categorised into disease domains arranged so as to allow an alphabetic mnemonic as Airways, Body Mass Index (BMI), Cardiovascular, Diabetes, Economic, Functional, Gonadal, Health Status (perceived) and (body) Image.
  
  
  METHODS
  In this cohort study, patients were assessed before and 12 months after surgery using the modified King's Obesity Staging Score. We studied 217 consecutive patients undergoing Roux-en-Y gastric bypass (RYGB; N = 148) and laparoscopic adjustable gastric band (LAGB; N = 69) using the modified King's Obesity Staging System to determine health benefits after bariatric surgery.
  
  
  RESULTS
  Preoperatively, the groups had similar BMI, but the RYGB group had worse Airways, Cardiovascular, and Diabetes scores (p < 0.05). After surgery, RYGB and LAGB produced improvements in all scores. In a subgroup paired analysis matched for preoperative Airways, BMI, Cardiovascular, and Diabetes scores, both procedures showed similar improvements in all scores, except for BMI where RYGB had a greater reduction than LAGB (p < 0.05).
  
  
  CONCLUSIONS
  Both RYGB and LAGB deliver multiple benefits to patients as evaluated by the modified King's Obesity Staging System beyond BMI and glycaemic markers. A validated staging score such as the modified King's Obesity Staging System can be used to quantify these benefits.
authors.affiliation: Diabetes Complication Research Centre, UCD Conway Institute, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland, karl.neff@ucd.ie.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Neff
authors.forename: Ling Ling
authors.initials: LL
authors.lastname: Chuah
authors.forename: Erlend T
authors.initials: ET
authors.lastname: Aasheim
authors.forename: Sabrina
authors.initials: S
authors.lastname: Jackson
authors.forename: Sukhpreet S
authors.initials: SS
authors.lastname: Dubb
authors.forename: Shiva T
authors.initials: ST
authors.lastname: Radhakrishnan
authors.forename: Arvinder S
authors.initials: AS
authors.lastname: Sood
authors.forename: Torsten
authors.initials: T
authors.lastname: Olbers
authors.forename: Ian F
authors.initials: IF
authors.lastname: Godsland
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Miras
authors.forename: Carel W
authors.initials: CW
authors.lastname: le Roux
mesh_terms: D000328:Adult; D001786:Blood Glucose; D001828:Body Image; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D015391:Gastroplasty; D006304:Health Status; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012074:Remission Induction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose