**5.4 Preoperative BMI**

Greater preoperative BMI was significantly associated with IWL [64]. A metaanalysis found that preoperative BMI and super-obesity were negatively associated with WL, where super-obese patients had 10.1 EWL% decrease [66]. Others observed that at 12 months post RYGB or LAGB, patients with baseline BMI ≥ 50 kg/ m2 were more likely to have significant WR, but those with BMI < 50 kg/m2 were likely to continue losing weight [67]. Similarly, 80–100% of LSG patients with presurgery BMI > 40 kg/m2 had WR to BMI > 30 kg/m2 two years years after surgery; but only 3.6–38% of patients with lower pre-operative BMI (32.1–39.9 kg/m2 ) had BMI > 30 kg/m2 during the same time period [68].
