Assessing the real-world effect of laparoscopic bariatric surgery on the management of obesity-related comorbidities: A retrospective matched cohort study using a US Claims Database.

AIMS To evaluate the real world effect of laparoscopic bariatric surgery—adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and laparoscopic sleeve gastrectomy (LSG)—on the management of obesity-related comorbidities. METHODS Patients who underwent laparoscopic bariatric surgeries between 2006 and 2013 were identified from the Optum Clinformatics administrative claims database. Those surgical patients were matched to medically-managed patients (controls) on selected patient characteristics. Comorbidity management was assessed every 6 months up to 5 years after the surgery or an assigned index date for controls (follow-up), by evaluating the number of medication classes used to treat type 2 diabetes, hypertension, and dyslipidemia, as well as by evaluating the percentages of patients free of medications for these comorbidities. RESULTS Patients who underwent LAGB (N = 4,208, mean age = 46.3 years), LRYGB (N = 4,308, mean age = 46.4 years), and LSG (N = 545, mean age = 45.1 years) and patients in the control cohort (N = 9,061, mean age = 46.4 years) were similar in age and the majority of patients in each study cohort were female (69.4%-75.8%). Compared to controls, patients who had laparoscopic bariatric surgery had significantly lower medication usage for obesity-related comorbidities, a trend which was evident at 6 months and continued for up to 5 years of follow-up. Sub-analyses of changes in selected laboratory test values over follow-up corroborated the primary analyses. CONCLUSIONS Patients who had laparoscopic bariatric surgery used fewer medications for type 2 diabetes, hypertension, and dyslipidemia and had significant improvement in cardiometabolic risk factors for up to 5 years of follow-up compared to matched controls.