Treatment Pathways and Outcomes in Patients with BMI ≥ 50 kg/m2: Conservative Treatment, Immediate Surgery or Stepwise Surgical Approach

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Obesity prevalence has significantly increased globally, with 67% of the US population classified as overweight or obese.
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Bariatric surgery is the most effective long-term treatment for obesity, improving weight loss and co-morbidities.
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Patients with BMI ≥ 50 kg/m2 face unique surgical challenges, often making procedures like RYGB technically difficult.
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Preoperative conservative treatment shows limited efficacy, with studies reporting only 1.7–5.3 kg weight loss after 6 months.
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The study compares outcomes of conservative treatment, immediate surgery, and stepwise surgical approaches in patients with BMI ≥ 50 kg/m2.

Obesity Surgery

by Sara Notz, Rainer Grotelueschen, Julia Pape, Bjoern-Ole Stueben, Louisa Stern, Julia Gerullies, Jonas Wagner, Anne Lautenbach, Jakob Robert Izbicki, Thilo Hackert, Philipp Busch, Anna Dupree, Dieter Weber, Oliver Mann, Gabriel Plitzko
July 18, 2025

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