Obesity Subtypes and Short Term Weight Loss After Vertical Sleeve Gastrectomy: A Retrospective Cohort Study

AIM: Vertical sleeve gastrectomy has become the most common surgical intervention for medically-complicated obesity. This study examines the hypothesis that a clinical subtype of obesity (psychosocial factors, genetic risk, or early life endocrine disruptors termed obesogens) can identify the best candidates for vertical sleeve gastrectomy. MATERIALS AND METHODS: This is a retrospective cohort study of 225 consecutive new individuals with medically-complicated obesity seen preoperatively in outpatient bariatric clinic in an urban community teaching hospital. Eighty-four individuals underwent sleeve gastrectomy with a minimum of 6 months of follow up. RESULTS: Among 3 subtypes, early life obesogen exposure has been identified in 14.5% of individuals, genetic risk in 24.5% of individuals, and psychosocial factors in 61% of individuals. Percent excess weight loss (mean+/-SD) at 6 months is different among the three groups (pANOVA = 0.024). Individuals with genetic risk (38%+/-14) have significantly less weight loss (p = 0.029) than individuals with psychosocial factors (47%+/-15), while there is no difference compared to the obesogen subtype (41%+/-8.9). CONCLUSION: The most common clinical subtype of obesity is psychosocial factors, and there is significantly higher short term weight loss after sleeve gastrectomy in individuals with psychosocial factors. Weight loss may be limited by an individual’s genetic risk and early life obesogen exposure. A prospective study is required to confirm these findings.