Observational Study

. 2025 May;95(5):895-903.

doi: 10.1111/ans.19378. Epub 2025 Jan 9.

Metabolic bariatric surgery generates substantial, sustained weight loss and health improvement in a real-world setting

Wendy A Brown^{1

2

3}, Dianne L Brown¹, Jennifer F Holland¹, Angus Campbell¹, Jenifer Cottrell¹, Susannah Ahern^{1

4}, Jennifer Reilly⁵, Patrick Garduce^{1

4}, James Wetter¹, Jeffrey M Hamdorf^{1

6}, Michael Talbot^{1

7}, Samuel Baker^{1

8}, Andrew D MacCormick^{1

9}, Ian D Caterson^{1

10}

Affiliations

¹ Bariatric Surgery Registry, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
² Monash University Department of Surgery, Central Clinical School, Alfred Health, Melbourne, Victoria, Australia.
³ Oesophago-Gastric and Bariatric Unit, Alfred Health, Melbourne, Victoria, Australia.
⁴ School of Public Health, Monash University, Melbourne, Victoria, Australia.
⁵ Department of Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, Victoria, Australia.
⁶ Discipline of Surgery, Medical School, The University of Western Australia, Perth, Western Australia, Australia.
⁷ Department of Surgery, University of New South Wales St George and Sutherland Clinical School, Sydney, New South Wales, Australia.
⁸ Department of Surgery, Mater Private Hospital, Townsville, Queensland, Australia.
⁹ Department of Surgery, University of Auckland, Auckland, New Zealand.
¹⁰ Boden Initiative, Charles Perkins Centre, University of Sydney, New South Wales, Australia.

PMID: 39785110
PMCID: PMC12105569
DOI: 10.1111/ans.19378

Observational Study

Metabolic bariatric surgery generates substantial, sustained weight loss and health improvement in a real-world setting

Wendy A Brown et al. ANZ J Surg. 2025 May.

. 2025 May;95(5):895-903.

doi: 10.1111/ans.19378. Epub 2025 Jan 9.

Authors

Affiliations

¹ Bariatric Surgery Registry, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
² Monash University Department of Surgery, Central Clinical School, Alfred Health, Melbourne, Victoria, Australia.
³ Oesophago-Gastric and Bariatric Unit, Alfred Health, Melbourne, Victoria, Australia.
⁴ School of Public Health, Monash University, Melbourne, Victoria, Australia.
⁵ Department of Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, Victoria, Australia.
⁶ Discipline of Surgery, Medical School, The University of Western Australia, Perth, Western Australia, Australia.
⁷ Department of Surgery, University of New South Wales St George and Sutherland Clinical School, Sydney, New South Wales, Australia.
⁸ Department of Surgery, Mater Private Hospital, Townsville, Queensland, Australia.
⁹ Department of Surgery, University of Auckland, Auckland, New Zealand.
¹⁰ Boden Initiative, Charles Perkins Centre, University of Sydney, New South Wales, Australia.

PMID: 39785110
PMCID: PMC12105569
DOI: 10.1111/ans.19378

Abstract

Background: To determine if the positive outcomes from clinical trials regarding the safety and efficacy of metabolic bariatric surgery are reproducible at a national level.

Methods: A longitudinal registry-based observation study with data collected from all persons undergoing metabolic bariatric surgery in Australia from 28 February 2012-31 December 2021 including data from 122,567 index patients who underwent 134,625 completed bariatric procedures.

Main outcomes and measures: Defined adverse outcomes at 90-days (unplanned readmission, intensive care admission and re-operation; death), annual change in weight (percent total body weight loss (TBWL)), diabetes treatment and need for re-operation.

Results: 79.0% of participants were female. Mean age on the day of surgery was 44.0 years (SD 11.8; range 12.9-87.9 years) and mean BMI 41.7 kg/m2 (SD 7.6). At 5-years participants who underwent one anastomosis gastric bypass had TBWL 34.88% (SD 8.67%), roux-en-Y gastric bypass 30.73 % (SD 9.47%); sleeve gastrectomy 26.5% (SD 10.5%) and adjustable gastric bands 17.6% (SD 12.1%). At 90-days 3.6% of procedures recorded a defined adverse event. 13,904 (13.6%) primary participants reported being treated for diabetes at baseline. No medication for diabetes was required by 71.6% (follow-up 58%) at 1-year and 61% (follow-up 22%) at 5-years. 13 904 (13.6%) primary participants reported being treated for diabetes at baseline. No medication for diabetes was required by 71.6% (follow-up 58%) at 1-year and 61% (follow-up 22%) at 5-years.

Conclusions: Metabolic bariatric surgery is safe and induces substantial weight loss with reduced need for diabetes medications in the real-world.

Gov id: NCT03441451.

Keywords: metabolic bariatric surgery; outcomes; quality and safety; registry; weight loss.

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Conflict of interest statement

Wendy A. Brown: Grants from Johnson and Johnson, Medtronic, GORE, Applied Medical, Novo Nordisk, NHMRC, Myerton and the Australian Government. Personal fees from GORE, Novo Nordisc, Pfizer, Medtronic and Merck Sharpe and Dohme for lectures and advisory boards. Professor Brown is an Editorial Board member of ANZ Journal of Surgery and a co‐author of this article. To minimize bias, they were excluded from all editorial decision‐making related to the acceptance of this article for publication. Jeffrey M. Hamdorf: Grants from Gore, Baxter Healthcare, Department of Health, Government of Western Australia, National Blood Authority Australia. Personal fees from Johnson and Johnson, Gore. Board Member, Australian and New Zealand Metabolic Obesity Surgery Society. Michael Talbot: Grants from Gore and Medtronic. Personal fees from Medtronic, Johnson and Johnson, Gore, Device Technologies, MSD, Green Surgical. Ian D. Caterson: Grants for clinical trials from Eli Lilly, Boehringer Ingelheim, Sydney Local Health District. Board member of Obesity Australia. Dianne L. Brown, Jennifer F. Holland, Angus Campbell, Jenifer Cottrell, Susannah Ahern, Jennifer Reilly, Patrick Garduce, James Wetter, Samuel Baker and Andrew D. MacCormick have no disclosures.

Figures

**Fig. 1**
Participation in the Australian arm of the Australia and New Zealand Bariatric Surgery Registry.

**Fig. 2**
Weight loss according to metabolic bariatric procedure for adult participants who had not undergone a conversion surgery.

**Fig. 3**
Diabetes treatment before and after bariatric surgery.

See this image and copyright information in PMC

References

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Metabolic bariatric surgery generates substantial, sustained weight loss and health improvement in a real-world setting

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Metabolic bariatric surgery generates substantial, sustained weight loss and health improvement in a real-world setting

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