TOPLINE:
Among patients with obesity and type 2 diabetes (T2D), those who underwent metabolic bariatric surgery experienced greater weight loss and reductions in A1c levels than patients who did not undergo surgery.
METHODOLOGY:
- Researchers conducted a retrospective cohort study using data of 411 adults with T2D and obesity (mean age, 48.3 years; 63.3% women; mean BMI, 47.4) who were referred for bariatric surgery to a hospital in the West of Scotland between 2009 and 2020, to examine long-term changes in weight and A1c levels.
- Participants either underwent surgery (n = 186) or did not (n = 225).
- The percentage total weight loss and the probability of achieving at least 20% total weight loss were used to assess changes in weight; changes in glycaemic control were evaluated using A1c levels with clinical cutoffs of < 6.0% vs ≥ 6.0% and < 6.5% vs ≥ 6.5% from baseline to 5 years.
TAKEAWAY:
- At 5 years, 86 of 229 (37.6%) patients achieved ≥ 20% total weight loss. Among them, 87.2% had undergone bariatric surgery, whereas 12.8% did not (P < .05).
- Patients who underwent bariatric surgery were more likely to achieve ≥ 20% total weight loss (prevalence ratio, 5.49; P < .001).
- The surgery group lost weight at an average rate of 1.31% per year (95% CI, -1.73% to -0.88%), whereas the non-surgery group gained weight at an average rate of 1.11% per year (95% CI, 0.66%-1.55%).
- Among patients with data on A1c levels, 42.5% in the surgery group vs 7.8% in the non-surgery group had A1c levels < 6.0% at 5 years, and 55.2% vs 13.9% had A1c levels < 6.5% at 5 years (P < .001 for both comparisons).
IN PRACTICE:
“These results support current clinical guidelines that recommend metabolic bariatric surgery for individuals with severe obesity or obesity-related complications who do not achieve adequate results through more conservative treatments,” the authors of the study wrote.
SOURCE:
This study was led by Beatrice Leyaro, University of the West of Scotland, Paisley, Scotland. It was published online on November 19, 2025, in the International Journal of Obesity.
LIMITATIONS:
This study was limited by the absence of data on weight and A1c outcomes, and the lack of detailed information about post-referral care particularly for patients in the non-surgery group. Additionally, data on important factors known to influence bariatric surgery outcomes, such as dietary habits, physical activity, and adherence, were not available in the electronic databases.
DISCLOSURES:
One author reported receiving a PhD studentship grant from the University of the West of Scotland. The authors declared having no competing interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.