To evaluate the mid-term (≥3 years) efficacy and safety of metabolic and bariatric surgery (MBS) in Asian patients with mild obesity (BMI 27.5-32.5 kg/m²), compared with those with BMI ≥32.5 kg/m².
Key Findings:
Mild obesity group achieved lower %TWL (approximately 20%) compared to higher-BMI group (approximately 26%, P < 0.05).
Composite metabolic endpoint achievement was similar between groups (30.7% vs 27.6%, P = 0.76).
Both groups showed sustained improvements in glycemic control, lipid profile, blood pressure, and insulin resistance.
Significant remission rates for type 2 diabetes, hypertension, hyperuricemia, and metabolic-associated fatty liver disease in both groups (all P < 0.05).
Higher proportion of mild obesity patients achieved normalization of body weight (BMI <24 kg/m²).
Complication rates were low and comparable between groups.
Interpretation:
MBS is safe and provides durable metabolic benefits for Asian patients with mild obesity, despite lower weight loss compared to those with higher BMI, highlighting the need for updated surgical guidelines.
Limitations:
Small sample size for the mild obesity group.
Retrospective design may introduce bias.
Findings are preliminary and require validation through larger, multicenter studies.
Conclusion:
MBS offers significant metabolic improvements for Asian patients with mild obesity, warranting further research to expand surgical indications and validate these findings.
