Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Morbid obesity is a complex, chronic condition that leads to substantial morbidity, mortality, and impaired quality of life. Surgical intervention is the most successful long-term therapy for weight loss and resolution of obesity-related comorbidities while Aim was To evaluate the effectiveness of LSG and LRYGB in terms of weight loss, resolution of obesity-related comorbidities and complications in patients with morbid obesity over 24 months of follow-up so This was a prospective comparative study of 140 patients with morbid obesity (Body Mass Index [BMI] ≥ 40 kg/m² or ≥ 35 kg/m² with obesity-related comorbidities) who were operated on between January 2024 and December 2025 where They were divided into two groups: Group A (LSG, n = 72) and Group B (LRYGB, n = 68). The primary outcomes were percentage of Excess Weight Loss (%EWL), percentage of Total Weight Loss (%TWL), and BMI at 3, 6, 12, and 24 months and finding were There were no significant differences in baseline characteristics (p > 0.05). At 24 months, LRYGB demonstrated significantly greater %EWL (72.4 ± 9.8% vs 64.2 ± 11.3%, p = 0.001) and %TWL (32.6 ± 5.7% vs 28.1 ± 6.2%, p = 0.002) compared to LSG. Mean BMI reduction was greater in LRYGB (from 46.8 ± 4.2 to 30.9 ± 3.6 kg/m²) than LSG (from 45.9 ± 4.6 to 33.2 ± 4.1 kg/m²) (p = 0.003). T2DM remission was higher in LRYGB (85.3%) than in LSG (68.2%) (p = 0.042). Logistic regression identified procedure type (LRYGB: OR = 2.41, 95% CI: 1.28–4.54, p = 0.007), age < 45 years (OR = 1.87, 95% CI: 1.02–3.42, p = 0.041), and baseline BMI < 50 (OR = 2.15, 95% CI: 1.14–4.05, p = 0.018) as independent predictors of successful weight loss (≥ 50% EWL). LSG had shorter operative time (78.4 ± 14.2 vs 124.6 ± 18.5 min, p < 0.001) and fewer early complications (8.3% vs 14.7%, p = 0.234). Finally, we concluded that LSG and LRYGB both result in significant weight loss in morbidly obese patients. LRYGB has greater weight loss and higher resolution of type 2 diabetes at 24 months, but LSG has a shorter operative time and a trend towards fewer complications.