PD591 - COMPARABLE OUTCOMES OF INTENSIVE MULTIMODAL TREATMENT IN SUPER OBESITY

PD591

COMPARABLE OUTCOMES OF INTENSIVE MULTIMODAL TREATMENT IN SUPER OBESITY

M. Fischer^1,*, N. Oberänder¹, K. Mayer-Carius¹, J. Hösel¹, B. Jansen-Winkeln¹, A. Weimann¹

¹Klinikum St. Georg gGmbH, Leipzig, Germany

Rationale: First line treatment for patients with super obesity (BMI ≥ 50) is bariatric surgery. However, some patients do not feel ready, decline it against medical advice, or first seek alternative treatment. In our clinic an intensive multimodal intervention has been offered to such patients for over 12 years. We evaluated its long-term outcome in comparison to patients with moderate morbid obesity.

Methods: A prospective cohort study of 522 consecutively treated patients with morbid obesity. Treatment comprised of an intensive one-year multimodal intervention and 5 years follow-up care. We compared completion rate, weight loss and later bariatric surgery between groups with BMI ≥50 vs. BMI 35-49.9.

Results: BMI ≥50 was present in 176 (34%) patients. Average BMI was 56.8±6.11 vs. 43.6±3.87. BMI50+ group was younger (43.4 vs. 46.1 years, p<.001) and of lower education (p<.05). Sex ratio was comparable (65-67% female). No differences were found in 12-months completion rate (76.1% vs. 79.2%, p = .434) and weight loss (22.1% vs. 21.0%, p = .281). However, during follow-up care significantly more patients were treated with bariatric surgery (16.5% vs. 8.7%, p < .05). At 6 years, a comparable number of patients, who did not yet undergo surgery attended the final visit (41.9% vs. 44.3%, p = .725) with comparable weight loss (10.5% vs. 9.8%, p = .753). Weight loss of ≥15% was maintained by 24.7% vs. 22.5% (p = .734) of patients.

Conclusion: Intensive multimodal treatment can achieve comparable short- and long-term results in super obese patients. However, after six years, non-surgical results are generally mixed and a higher proportion proceeded to bariatric surgery. These findings support multimodal interventions as a viable bridge for super obese patients delaying surgery, facilitating meaningful weight reduction and adherence without inferior results, though surgery remains key for more profound loss in this high-risk group.

Disclosure of Interest: M. Fischer: None declared, N. Oberänder: None declared, K. Mayer-Carius: None declared, J. Hösel: None declared, B. Jansen-Winkeln: None declared, A. Weimann Grant / Research Support from: has received lecture fees from Abbott, Baxter, B. Braun, Falk Foundation and Fresenius Kabi, consultancy Longevist Life for Science, and research grants from B. Braun, Mucos and Seca