Background. There is limited literature assessing the outcomes of bariatric surgery in a publically funded, North American, multidisciplinary bariatric program. Our objective was to assess outcomes of roux-en-Y gastric bypass (RYGB) in a publically funded bariatric program through a retrospective review of patient records. Methods. 293 patients spent a median of 13 months attending a multidisciplinary obesity clinic prior to undergoing laparoscopic RYGB surgery. The hospital was a Canadian, publically funded, level 2 trauma center with university teaching services. Results. 79% of the patients were female and the average BMI at first visit to clinic was 55.3 kg/m2. The average decrease in BMI was ？kg/m2. This was an average absolute weight loss of 56.1 kg or 35.5% of initial weight. The average excess weight loss was %. Improvement or resolution of obesity related comorbidities occurred in 65.9% of type 2 diabetics and in 50% of hypertensive patients. Conclusion. Despite this being an unconventional setting of a publically funded program in a large Canadian teaching hospital, early outcomes following RYGB were appropriate in severely obese patients. Ongoing work will identify areas of improvement for enhanced efficiencies within this system. 1. Introduction Globally, the body mass index (BMI) has been increasing over the last 30 years [1]. Currently, more than 20% of the world population is overweight and approximately 10% are obese [2]. In particular, the World Health Organization estimates that over 1.5 billion individuals are overweight and 500 million are obese [3]. In Canada, an estimated 60% of the population was classified as overweight and 24% as clinically obese [4–7]. Currently, bariatric surgery is the only evidence-based approach shown to be effective at achieving marked and sustained weight loss in obese individuals [8]. In addition, resolution of comorbidities, such as type 2 diabetes mellitus (T2DM) and hypertension commonly, occurs following bariatric surgery [9]. Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgical procedure in North America. Weight loss was thought to occur by malabsorption; however, this may not be the primary mechanism of action. Recently, there has been a suggestion that rapid nutrient delivery to the jejunum and ileum may trigger a hormonal response (involving GLP1 and PYY) that alters satiety and hunger [10, 11]. A number of studies have shown significant and sustained weight loss following RYGB in severely obese individuals [8]. However, to date, there have only been a small number of
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