With the high prevalence of obesity and associated comorbidities, the costs of health services produce a great economic impact. The objective of this work was to evaluate the economic benefits of bariatric surgery and to relate the costs to the impact on the health of the individual. A historic cohort study was conducted, with review of medical charts of 194 patients who fulfilled the inclusion criteria for the study. The costs for medications, professional care, and examinations in the pre- and postoperative periods were analyzed, taking into consideration the comorbidities DM2, SAH, and dyslipidemia. The study demonstrated a reduction in the medical costs in the course of the postoperative period, in relation to expenses for medications, professional care, and examinations in the preoperative period. Comparing the preoperative expenses with different times in the postoperative period, a statistically significant difference was seen at all time evaluated (p < 0.001). The resolution of comorbidities was higher than 95% at 36 months after surgery. No statistically significant difference was seen with respect to the prevalence of comorbidities between the sexes in the pre- and postoperative periods (p > 0.05). With regard to age, younger patients showed lower rates of comorbidities in the pre- and postoperative periods (p < 0.001). The costs of the surgery are high, but the expenditures for medications, professional care, and examinations decrease progressively after the operation, where this is more evident in patients with more associated comorbidities.

After 60 months of follow-up, the most relevant predictors of weight loss after RYGB were lower preoperative BMI and WC, videolaparoscopy as surgical access, and younger age. Further studies must be carried out to elucidate the impact of these factors on RYGB outcomes.

Weight regain did not compromise therapeutic success. Less weight regain was seen in younger patients. Patients with lower intolerance to red meat tended to show less weight regain. Further studies are needed to elucidate the role of protein intake in weight regain in patients submitted to gastric bypass. No association between weight regain and preoperative BMI or gender was observed.

This study demonstrated the concern for nutrient supplementation in the postoperative period of RYGBP. Thus, the routine use of multivitamins is deemed necessary after the first month postoperatively, with its maintenance preferably for the rest of the patient's life, without abandoning periodic clinical and laboratory follow-up.

There is probably a significantly higher prevalence of obesity among children of morbidly obese parents when compared to the general child population. Since the familial aggregation of NCDs was absolute, these results point to the need for careful evaluation when dealing with children. However, further studies with a larger number of individuals are needed to confirm these results.