# Differences in Weight Loss Postsleeve Gastrectomy Among Patients With Various Types of Obesity Based on Waist-To-Hip Ratio Classification

## TL;DR

This study examines how weight loss differs after sleeve gastrectomy in patients with central versus noncentral obesity, finding early differences in outcomes for women but not for men.

## Contribution

The study identifies sex-specific differences in early postoperative weight loss outcomes based on preoperative waist-to-hip ratio classification.

## Key findings

- Women with central obesity showed greater weight loss in the first and third months after surgery compared to noncentral obesity women.
- No significant weight loss differences were observed between central and noncentral obesity men at any follow-up time.
- Central obesity was associated with higher BMI and white blood cell counts in women and altered metabolic markers in men.

## Abstract

Background: In recent years, laparoscopic sleeve gastrectomy (LSG) has become the main surgical procedure for weight loss, and most clinical studies have focused on the postoperative complications and treatment of metabolic syndrome after LSG. However, it is not clear whether there is a difference in the postoperative weight loss effect between patients with central and noncentral obesity after LSG.

Purpose: To investigate the effect of LSG on weight loss in patients with central obesity and relationship between preoperative waist–hip ratio and weight loss effect.

Methods: We conducted a retrospective study comprising 360 patients who underwent LSG at the Qianfoshan Hospital, Jinan, Shandong Province, China, between 2019 and 2024. Based on the preoperative waist-to-hip ratio (WHR), the participants were divided into central and noncentral obesity groups, and various quantitative and preoperative biochemical indices were measured. Most patients were followed up for at least 6 months.

Results: There were significant differences in weight loss outcomes between women in the central and noncentral obesity groups in the first and third months after surgery; however, no significant differences were observed in the sixth and twelfth months. No significant differences were observed in weight loss outcomes between men in the central and noncentral obesity groups. There were significant differences in the development of central obesity between the two sexes and between those with and without type 2 diabetes. There were significant differences in body mass index (BMI) and white blood cell counts between women in the central and noncentral obesity groups, with patients with central obesity having higher BMI values and white blood cell counts before surgery. There were significant differences in the platelet count (PLT), gamma-glutamyl transferase (GGT), glycosylated hemoglobin A1c (HbA1c), and fasting plasma glucose (FPG) levels between men in the central and noncentral obesity groups, with patients with central obesity having lower PLT, higher GGT, HbA1c, and FPG levels. There was a significant correlation between WHR and early weight loss outcomes after surgery.