An Australian perspective on SADI-S/OADS: Excess weight loss and comorbidity improvement

Background: The single anastomosis duodenal-ileal bypass with sleeve gastrectomy or one anastomosis duodenal switch (SADI-S/OADS) has been utilised as a treatment for obesity in Australia since 2016; however, the impact of SADI-S/OADS on health-related outcomes has not been reported in the Australian population. Objectives: To determine the effect of SADI-S/OADS on excess weight loss (EWL) and comorbidities in obese Australian adults. Methods: Retrospective cohort study. Adults were eligible if they attended SADI-S/OADS, with a minimum of 3-months follow-up. Results: 85 patients underwent SADI-S/OADS. Eligible patients were 44.7 (S.D. 10.9) years of age, 64.7% female, with an average follow-up of 10.7 months. At baseline the mean BMI was 47.0 (S.D. 9.1) and 30.3% had type II diabetes mellitus. At follow-up, EWL was 60.4%, where 58.8% achieved >50% EWL and 32% achieved >75% EWL. 80% of patients with type II diabetes achieved resolution. Total cholesterol to high density lipoprotein ratio improved from 4.5 (S.D. 1.1) mmol/L to 4.0 (S.D. 0.8) mmol/L (p=0.063). Conclusion: In Australia, initial results suggest that by an average of 10 months post-surgery, SADI-S/OADS is an effective treatment for obesity and results in a high rate of type II diabetes resolution with improvements to the lipid profile. Long-term follow-up will strengthen confidence in the efficacy of SADI-S/OADS for treating obesity in Australia.