Background

The obesity associated with Prader-Willi syndrome (PWS) results from a chronic imbalance between energy intake and expenditure due to hyperphagia, decreased physical activity, reduced metabolic rate and an inability to vomit. Obesity control is notoriously difficult; thus, the role of bariatric surgery in PWS remains controversial as long-term data are lacking.We evaluated the outcomes of bariatric surgery in PWS.Between June 2002 and June 2016, three PWS patients with mean age of 32 years underwent Laparoscopic Roux-en-Y Gastric bypass in our unit. There is no lost-to-follow-up in this study. The best mean percentage of total weight loss was achieved at 5 years (48.4 +- 7.1). Successful weight loss has been seen in al three patients in their consecutive consults up to their last follow up. The mean %TWL were 42.7% at 2 years, 47.4% at 5 years, 48.4% at 6 years, 46.8% at 7 years, 44.6% at 8 years, and 41.2% at 9 years. At 10 years the mean %TWL was 38% and the mean %EWL of 59.3 +- 1.3%. The trend of weight changes was similar in all patients. Changes in obesity-related comorbidities were seen in all three patients. Type 2 diabetes mellitus remission in 50%; Obstructive sleep apnoea-syndrime in 33.3%; and complete remission (100%) in hypertension and dyslipidaemia. There was no mortality.Bariatric surgery produced notable and sustainable weight loss and comorbidity resolution in PWS. This study suggests that bariatric surgery can be performed in PWS patients along with multidisciplinary long-term follow up.