Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan 2.
doi: 10.1007/s11695-025-08444-w. Online ahead of print.

Metabolic and Bariatric Surgery Evolution Over the Past Decades (2009-2024): Insights from the Iranian National Obesity Surgery Database (INOSD)

Shahab Shahabi Shahmiri  1   2 , Abdolreza Pazouki  3   4 , Seyed Amin Setarehdan  3 , Kimia Vakili  5 , Kimia Jazi  6 , Erfan Sheikhbahaei  3 , Fahime Yarigholi  3 , Somayeh Mokhber  3 , Alireza Khalaj  7 , Amir Hossein Davarpanah Jazi  3 , Mohammad Kermansaravi  3   4
Affiliations

Metabolic and Bariatric Surgery Evolution Over the Past Decades (2009-2024): Insights from the Iranian National Obesity Surgery Database (INOSD)

Shahab Shahabi Shahmiri et al. Obes Surg. .

Abstract

Background: Over the past three decades, metabolic and bariatric surgery (MBS) has undergone significant changes in Iran, mirroring global trends and incorporating regional innovations. This study aims to investigate MBS trends in Iran over 15 years (2009-2024), with a focus on demographic patterns and procedural distribution.

Methods: Data from the Iranian National Obesity Surgery Database (INOSD) provided the basis for a retrospective study. The study encompassed all patients with MBS between 2009 and 2024. The demographic traits, body mass index (BMI), obesity-associated medical disease, surgical operation type, and trends over time were analyzed.

Results: In total, 55,936 patients were included, most of whom were female (80%). The majority (62%) were aged 25-45 years. With a declining number of patients with BMI > 50 kg/m² over time, most patients fell in the range of 40-50 kg/m². The most common obesity-associated medical problems were hypertension (15%), severe obstructive sleep apnea (12%), type 2 diabetes mellitus (11%), and dyslipidemia (11%). Rising from 2.6% in 2009 to 56% in 2024, sleeve gastrectomy (SG) surpassed Roux-en-Y gastric bypass (RYGB), which decreased from 92% in 2009 to 13% in 2024. Especially in higher BMI patients, one anastomosis gastric bypass (OAGB) demonstrated a consistent rise. Rates of revisional and conversional surgery rose over time, specifically in OAGB.

Conclusions: With an increasing inclination for SG and OAGB, MBS trends in Iran mirror a worldwide movement toward safer and more effective treatments.

Keywords: Metabolic and bariatric surgery; Obesity; Roux-en-Y gastric bypass; Sleeve gastrectomy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics Approval: This study was approved by the Institutional Review Board and was conducted in accordance with the ethical standards of the Helsinki Declaration and its subsequent amendments. Human Ethics and Consent to Participate: As this was a retrospective analysis of de-identified registry data, formal consent to participate was not required. Competing interests: The authors declare no competing interests.

References

    1. Marin R-C, Radu A-F, Negru PA, Radu A, Negru D, Aron RAC, et al. Integrated insights into metabolic and bariatric surgery: improving life quality and reducing mortality in obesity. Medicina. 2025;61(1):14. - DOI
    1. Lo Menzo E, Szomstein S, Rosenthal RJ. Changing trends in bariatric surgery. Scand J Surg. 2014;104(1):18–23. - DOI - PubMed
    1. Dexter SPL, Deitel M. Historical perspectives of bariatric surgery. In: Agrawal S, editor. Obesity, bariatric and metabolic surgery: A comprehensive guide. Cham: Springer International Publishing; 2023. pp. 85–101. - DOI
    1. Plamper A, Lingohr P, Nadal J, Trebicka J, Brol MJ, Woestemeier A, et al. A Long-Term comparative study between one anastomosis gastric bypass and sleeve gastrectomy. J Gastrointest Surg. 2023;27(1):47–55. - DOI - PubMed
    1. Kermansaravi M, Shahmiri SS, Khalaj A, Jalali SM, Amini M, Alamdari NM, et al. The first Web-Based Iranian National obesity and metabolic surgery database (INOSD). Obes Surg. 2022;32(6):2083–6. - DOI - PubMed

LinkOut - more resources