Efficacy and Metabolic Outcomes of Laparoscopic Bariatric Surgery: A 13-year Retrospective Cohort Study at a Tertiary Care Center in Thailand

Background Bariatric surgery is the most effective treatment for severe obesity and metabolic comorbidities, yet comprehensive long-term data in Southeast Asian populations remain limited. This study aims to evaluate weight loss efficacy and metabolic outcomes of laparoscopic bariatric surgery in a Thai population. Materials and Methods This retrospective cohort study analyzed 797 patients undergoing laparoscopic bariatric surgery from a tertiary care university hospital in Thailand between January 2011 and December 2024. Primary outcomes included percentage total weight loss (%TWL), percentage excess weight loss (%EWL), and remission rates of diabetes, hypertension, and dyslipidemia at 3, 6, 12, and 24 months. Results Among 797 patients (69.4% female, mean age 38.8 ± 10.5 years, mean BMI 42.9 ± 9.2 kg/m²), baseline comorbidities included diabetes (25.8%), hypertension (26.2%), and dyslipidemia (38.5%). Laparoscopic sleeve gastrectomy comprised 94.8% of procedures. At 12 months, mean %TWL was 30.4 ± 9.8% and %EWL was 72.9 ± 28.4%, with surgical success (≥ 50% EWL) achieved in 79.2% at one year and 82.7% at two years. At 24 months, metabolic remission rates were: diabetes 77.7%, hypertension 65.1%, and dyslipidemia improvement 47.6%. Overall complication rate was 0.5% (4/797) with zero mortality. All complications occurred within 72 hours and were successfully managed with complete recovery. Follow-up rates declined from 69.5% at 3 months to 31.9% at 24 months. Conclusions Laparoscopic bariatric surgery demonstrates exceptional efficacy with substantial sustained weight loss and outstanding metabolic outcomes in this Asian population, supporting its role as comprehensive metabolic therapy.