Original article Resectional gastric bypass outcomes in active duty soldiers: a retrospective review Lionel R. Brounts, M.D.*, Kelly Lesperance, M.D., Ryan Lehmann, D.O., Preston Carter, M.D., Alec Beekley, M.D., Matthew Martin, M.D., Robert Rush, M.D., James Sebesta, M.D. Department of Surgery, Madigan Army Medical Center, Tacoma, Washington Received February 1, 2009; revised March 31, 2009; accepted May 23, 2009 Abstract Background: As in civilian life, some active duty service members have developed severe obesity that is refractory to diet alteration and exercise. In addition to controlling obesity, surgical weight control measures in an active duty population must consider the effect of the postbariatric state on a service member’s ability to continue to be deployable to a war zone or other austere military assignment. We report our experience with such patients undergoing open resectional gastric bypass. Methods: We retrospectively reviewed the perioperative and long-term outcomes of 33 active duty service members who had undergone open gastric bypass by the same surgical team at a single institution during a 30-month period. Data were collected by chart review and questionnaires. Descriptive and inferential analyses were performed using Statistical Package for Social Sciences, version 14.0. Results: The questionnaires were returned by 27 patients (13 women and 14 men). The mean age at surgery was 34.2 years (range 24 –51). The mean follow-up was 218 weeks (range 162–369). The mean preoperative body mass index was 40.6 kg/m 2 (range 34.0 – 49.4). The mean postoperative BMI was 25.6 kg/m 2 (range 19 –34.7). Using the Bariatric Analysis and Reporting Outcome System outcome criteria for these 27 patients, the results were fair for 4 patients (15%), good for 9 (33%), very good for 12 (44%), and excellent for 2 (7%). No patients had treatment failure according to the Bariatric Analysis and Reporting Outcome System criteria. Also, 5 patients who had previously been nonpromotable because of their weight were reclassified as promotable after the results of the bariatric intervention. Of the 27 patients, all but 3 maintained or achieved deployable status after surgical recovery. Conclusion: As in civilian populations, bariatric surgery improves the quality of life of active duty service members who have failed nonoperative means of obesity control. Most service members who undergo bariatric intervention are able to successfully deploy to war zones without adverse effects on their military performance and retain or improve their competitiveness for career promotion. (Surg Obes Relat Dis 2009;5:657– 661.) © 2009 American Society for Metabolic and Bariatric Surgery. All rights reserved. Keywords: Obesity; Obesity surgery; Gastric bypass; Active duty soldiers; Quality of life Obesity prevalence has been steadily increasing, with approximately 64% of adults overweight or obese and 5% extremely obese in the United States [1]. The economic costs have exceeded $100 billion annually and 300,000 deaths annually have been linked to obesity [2,3]. Obesity has been shown to be associated with many co-morbidities, including hypertension, coronary artery disease, stroke, di- abetes mellitus, hyperlipidemia, and poor quality of life [4,5]. The obesity epidemic is not limited to civilians. A 2005 survey showed that 60% of active duty service personnel Presented at the 30th Gary P. Wratten Symposium, May 2008, Wash- ington DC, and at the Washington American Cancer Society Meeting, June 2008, Stevenson, Washington *Correspondence to: lionel.brounts@amedd.army.mil Surgery for Obesity and Related Diseases 5 (2009) 657– 661 1550-7289/09/$ – see front matter © 2009 American Society for Metabolic and Bariatric Surgery. All rights reserved. doi:10.1016/j.soard.2009.05.012