Long-term effectiveness of bariatric surgery: weight and metabolic outcomes after 10 years of follow-up

Introduction: We evaluated 10-year outcomes of bariatric surgery in a retrospective cohort, focusing on weight loss and the evolution of comorbidities. Methods: this was an observational study involving 96 patients who underwent surgery between 2013 and 2024. We analyzed the percentage of excess weight loss (%EWL) and comorbidity remission. Of the patients, 78.1 % underwent gastric bypass (GB) and 19.8 % vertical sleeve gastrectomy (SG). Results: the %EWL peaked at 57.3 % at 2 years and remained at 43.3 % at 10 years. Preoperative diabetes and hypertension were independent predictors of reduced weight loss. GB showed significant superiority over SG in %EWL at both 5 and 10 years (p < 0.05). Remission rates were high for diabetes, hypertension, dyslipidemia, obstructive sleep apnea (OSA), and hepatic steatosis, with no significant differences between surgical techniques. Mechanical arthropathy did not improve significantly during follow-up (48.9 % vs 50.5 %; p = 0.88). Conclusions: bariatric surgery maintains clinically relevant weight loss at 10 years, with GB proving superior to SG in the long term. Comorbidities improve significantly, except for arthropathy, which persists despite weight loss.