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Post-Bariatric Body Contouring Improves Weight Loss Compared to Bariatric Surgery Alone at a Safety Net Medical Center in a Major US Metropolitan City
Langley Grace Wallace*1, Jacqueline Stoneburner1, Hooman Nikizad1, Ronald Feinstein2
1Keck School of Medicine of USC, Los Angeles, CA; 2Kaiser Permanente, West Los Angeles, Los Angeles, CA

Background: There is some evidence in the literature demonstrating that patients who undergo body contouring following bariatric surgery (BS) have greater long-term weight loss and reduced comorbidity burden compared to patients who undergo only BS. However, there is a paucity of literature validating these findings in patients with poor access to healthcare, including minorities and those of low socioeconomic status. This study aims to determine the effect of post-bariatric panniculectomy (P) on multiple outcomes at a safety net medical system in a major US metropolitan city.
Methods: An IRB approved-retrospective review of patients who underwent BS+/-P between 2015-2022 was performed. The control group (N=54) underwent BS alone; the test group (N=27) underwent BS+P. Each BS+P patient was matched to two BS patients for age, sex and BMI on the day of BS. The following outcomes were compared between groups: BMI and absolute weight change, change in HbA1c for patients with diabetes mellitus (DM), and change in number of hypertension (HTN) medications. Notably, English was the primary language for 66.7% of the BS+P group, but only 42.6% of the BS group (p=0.04).
Results: The BS+P group demonstrated a significantly greater mean absolute weight change than the BS group (-35.5 kg vs -23.9 kg) (p=0.02). The BS+P group also had greater mean BMI change (-11.8 vs -9.2) (p=0.13). Despite improvements in weight loss and BMI, panniculectomy did not have a significant impact on HbA1c in DM or number of HTN medications.
Conclusion: While prior studies have reported a positive impact of body contouring on post-BS weight loss, this study is the first to illustrate such findings at a safety net medical center. Post-BS panniculectomy improved weight loss compared to BS alone, however no significant difference was noted in comorbidity burden. These findings support providing greater access to body contouring after BS at safety net institutions. Future studies are needed to assess how psychosocial wellbeing intersects with the observed relationships in the present study.
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