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Perioperative Management
Expected Outcomes
Success is multifactorial, influenced by surgical technique, patient
education, adherence to dietary and supplement regimens, physical
activity, and mental health support.
Weight-Loss Outcomes
➤ Expected total weight loss (TWL) at 12–18 months postoperatively
varies by procedure:
• SG: 25% to 30%
• RNYGB: 30% to 35%
• BPD/DS: 35–40%
• SADI-S: 30–40%
• AGB: 15% to 20%
Comorbidity Remission
➤ Remission rates for T2DM vary by procedure and patient-specific
factors, including disease duration and β-cell function. Studies
have shown:
• RNYGB and BPD/DS result in remission of T2DM in 70–80% of patients.
• SG yields remission in approximately 60–65% of patients.
• Metabolic benef its extend to improvement in hypertension,
dyslipidemia, MASLD, obstructive sleep apnea (OSA), and polycystic
ovary syndrome (PCOS).
Mortality and Cardiovascular Risk Reduction
➤ MBS is associated with a 30% to 50% reduction in all-cause mortality,
driven mainly by reductions in cardiovascular death, cancer, and
T2DM-related complications. MBS also leads to a lower incidence of
myocardial infarction, stroke, and heart failure over time.
Psychosocial Outcomes and Quality of Life
➤ Many patients report significant improvements in physical
functioning, depression, anxiety, and social engagement. Long-
term psychosocial follow-up is recommended due to emerging
concerns regarding substance use, body image dissatisfaction,
and disordered eating in a subset of patients.
Durability and Predictors of Outcomes
➤ Success is multifactorial, influenced by surgical technique,
patient education, adherence to dietary and supplement
regimens, physical activity, and mental health support. Predictors
of poor overall surgical outcomes and reduced durability include
younger age, inadequate follow-up, unresolved psychiatric
conditions, and lack of family or social support.
