For a study, researchers sought to compare the results of obese and nonobese patients with ulcerative colitis who underwent colon removal surgery. The study was a retrospective study that looked at data from 1990-2018. The study was conducted at a center treating people with inflammatory bowel disease. Patients who had surgery to remove their colon (an IPAA) were included in the study. Obesity was defined as having a BMI of 30 or more. The primary measures included 30-day complications, long-term anastomotic leak, and pouch failure rate (excision, permanent diversion, revision). Of 3,300 patients, 631 (19.1%) were obese (median BMI=32.4 kg/m2). On univariate analysis, obese patients were more likely to be less than 50 years old (32.5% vs. 22.7%, P<0.001), ASA class 3 (41.7% vs. 27.7%, P< 0.001), have diabetes (8.1% vs. 3.3%, P<0.001), and have had surgery in the biologic era (72.4% vs. 66.2%, P=0.003); they were less likely to have received preoperative steroids (31.2% vs. 37.4%, P=0.004). After a median follow-up of 7 years, 66.7% had completed at least 1 quality-of-life survey. Pouch survival in the matched sample was 99.2% (99.8% nonobese vs. 95.4% obese, P=0.002). After matching and controlling for confounding variables, worse clinical outcomes associated with obesity included global quality of life (relative risk, –0.71; P=0.002) and long-term pouch failure (HR, 4.24; P=0.007). Obesity was also independently associated with an additional 27 minutes of operating time (P<0.001). There was no association of obesity with the likelihood of developing a postoperative complication, length of stay, or pouch leak.