Abstract: Objective To identify subtypes of benefits from bariatric surgery among the obese population using latent class analysis and to analyze corresponding intervention strategies. Methods A retrospective study was conducted on 234 obese patients admitted to the Second Affiliated Hospital of Anhui Medical University from July 2022 to February 2024. The percentage of excess weight loss (%EWL) was followed up at 1 month (T1), 3 months (T2), 6 months (T3), and 12 months (T4) postoperatively. An unconditional latent class growth model (LCGM) was employed to analyze the trajectory subtypes of surgical benefits, and the influencing factors were investigated. Results The mean %EWL for the 234 patients after laparoscopic sleeve gastrectomy was (40.57±4.76)%, (54.57±6.12)%, (65.17±8.46)%, and (79.76±8.47)% at T1, T2, T3, and T4, respectively, with statistically significant differences across the four time points (P<0.01). Based on latent class analysis, three subtypes of surgical benefits were identified: a high-level benefit group (C1) with 138 cases (58.97%), a low-level benefit group (C2) with 34 cases (14.53%), and a medium-level benefit group (C3) with 62 cases (26.50%). Multivariate logistic regression analysis indicated that preoperative BMI classification (OR=3.970), anxiety/depression (OR=2.268), postoperative protein intake (OR=2.152), postoperative adverse eating behaviors (OR=2.765), and postoperative weekly exercise duration (OR=2.018) were significant factors associated with the surgical benefit trajectories (all P<0.05). Conclusions Bariatric surgery confers benefits to the obese population; however, a subset of patients exhibits low to medium levels of postoperative benefit. This may be associated with preoperative BMI classification, anxiety/depression, low postoperative protein intake, adverse eating behaviors, and weekly exercise duration of less than 150 minutes. Intervention strategies based on these factors should be implemented early to enhance the surgical benefits for this patient population.

Key words: Obesity, Bariatric surgery, Surgical benefit, Percentage of excess weight loss, Latent class analysis