Background

Bariatric surgery is the most effective treatment for obesity. Despite its success, fewer than 1% of eligible U.S. adults and 0.07% of U.S. veterans undergo bariatric surgery annually. Currently, there's limited research on bariatric surgery outcomes in Veterans Affairs (VA) beneficiaries.ObjectiveTo compare Department of Defense (DoD) health care beneficiaries and VA beneficiaries who underwent bariatric surgery at an academic military medical center. We hypothesize the VA beneficiaries will have different preoperative characteristics than the DoD beneficiaries, resulting in different postoperative outcomes.

Methods

Medical records of primary DoD and VA beneficiaries who underwent bariatric surgery at a single military treatment facility from January 2021 to November 2023 were reviewed.

Results

A total of 127 patients - 99 DoD beneficiaries and 28 VA beneficiaries - were included. Although similar in age and race, the DoD cohort had a significantly higher proportion of females. The VA cohort had significantly higher rates of obstructive sleep apnea, osteoarthritis, anxiety, and post-traumatic stress disorder. Perioperative complication rates were similar. Body mass index (BMI) was similar in both cohorts at 3 and 6 months postoperative. The DoD cohort had a significant decrease in BMI compared to the VA cohort at 12 months postoperative (DoD BMI Loss=10.62, VA BMI Loss=8.44, P=0.02). Hemoglobin A1C, creatinine, and glomerular filtration rate values significantly improved at all postoperative timepoints.

Conclusions

ConclusionAlthough DoD beneficiaries have a significant decrease in BMI at 12 months postoperative compared to VA beneficiaries, all other postoperative outcomes are similar. Eligible VA beneficiaries should receive bariatric surgery referral.