Impact of the COVID-19 Lockdown on Primary Bariatric Surgery: A Comparative Study of Weight Loss Trajectories and Perioperative Outcomes

<b><i>Background:</i></b> The COVID-19 pandemic and subsequent lockdowns led to substantial changes in health-related behaviors and deferred elective surgeries. This study aimed to evaluate the impact of the COVID-19 lockdown on weight loss trajectories (WLT) and perioperative outcomes in primary bariatric surgery at a single tertiary referral center. <b><i>Methods:</i></b> Patients who underwent primary bariatric surgery immediately prior to the enforced lockdown (During-Lockdown Group, DLG) were compared with historical controls who underwent surgery before the lockdown (Before-Lockdown Group, BLG). WLT were estimated using a random intercept mixed-effects model with repeated measures. Cross-sectional group differences at 3- and 6-months post-surgery were examined. Perioperative outcomes were also analyzed. <b><i>Results:</i></b> A total of 273 patients were included (133 BLG, 140 DLG). The adjusted average weight decreased in both groups over time at different levels. The expected difference in weight between BLG and DLG at 3-months was 1.06 kg (<i>P</i> = .013) and at 6-months was .04 kg (<i>P</i> = .920), respectively. There were no statistically significant differences in postoperative complications, emergency department visits, re-admission rates, re-operation rates, or mortality. <b><i>Conclusions:</i></b> This study suggests that bariatric procedures performed before the COVID-19 lockdown were effective and safe. Despite a statistically significant difference in weight between groups at 3- and 6-months post-surgery, the difference was small and unlikely to be clinically significant. Short-term outcomes were comparable between the two groups. Further investigation is warranted to assess the impact of lifestyle changes during the lockdown on long-term bariatric surgery outcomes.