Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland
Authors' conclusion
Patients eligible for MBS who proceed with surgery achieve superior weight loss and glycaemic control compared to those who decide not to proceed with surgery. Opting out of surgery may have significant health implications, highlighting the need for alternative interventions such as intensive lifestyle modification, pharmacotherapy, and diabetes education programs for those unable or unwilling to undergo MBS.
Study context
- Population
- Patients with T2D and obesity referred for consideration of metabolic bariatric surgery (MBS), University Hospital Ayr, Ayrshire & Arran, January 2009–December 2020; 63% female, mean age 48.3 years (SD 8.5), mean BMI 47.4 kg/m² (SD 7.9)
- Participants
- 411 patients
- Exposure
- MBS vs no surgery after referral
- Non-surgeryn = 225reference
- Outcome
- Change in %TWL and HbA1c from baseline
- Follow-up
- Five years
Methodological detailssingle-centre, longitudinal, adjusted mixed-effects modelling
- Single-centre
- Longitudinal
- Adjusted mixed-effects modelling
Main finding
As reported in the abstract
| Group | Value | HbA1c change |
|---|---|---|
| Surgery | 22.0% %TWL | decreased by 1.0% (95% CI: −1.31, −0.70) |
| Non-surgery | 8.6% %TWL | increased by 0.4% (95% CI: 0.09, 0.71) |
Value
Surgery22.0% %TWL
Non-surgery8.6% %TWL
HbA1c change
Surgerydecreased by 1.0% (95% CI: −1.31, −0.70)
Non-surgeryincreased by 0.4% (95% CI: 0.09, 0.71)
- Surgery vs Non-surgery: P < 0.001 — %TWL at five years, higher with surgery
Observational data: associations, not effects.
Further findings
| Outcome | Surgery | Non-surgery |
|---|---|---|
| Annual HbA1c change, adjusted mixed-effects model · per yearAdjusted mixed-effects modelling | decreased by 0.13% (95% CI −0.18–-0.07) | increase of 0.11% (95% CI 0.05–0.17) |
| P | p < 0.001 | p < 0.001 |
| Annual %TWL change, adjusted mixed-effects model · per yearAdjusted mixed-effects modelling | decreased by 1.31% (95% CI −1.73–-0.88) | increase of 1.11% (95% CI 0.66–1.55) |
| P | p < 0.001 | p < 0.001 |
Baseline characteristics
- No significant differences between surgery and non-surgery groups in age, BMI or sex
Original publication
Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland. Int J Obes (Lond). Published 19 November 2025. doi:10.
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