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Factors Related to Weight Loss up to 4 Years after Bariatric Surgery

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Abstract

Background

Gastric bypass is the bariatric surgery most frequently performed in the world. It is responsible for sustainable weight loss, resolution of comorbidities, and improvement of quality of life. However, weight loss is not homogeneous, at times being insufficient in some patients. Our objective was to assess which factors were important in influencing this differentiated weight loss over a period of 4 years after surgery.

Methods

In this retrospective study, we assessed several physical, socioeconomic, behavioral, surgical, and demographic factors in morbidly obese patients submitted to Roux-en-Y gastric bypass that might influence excess weight loss over a period of 4 years after surgery. The same factors were assessed in order to characterize insufficient excess weight loss (<50% EWL).

Results

Review of the medical records of 149 patients showed that type-2 diabetes mellitus and dyslipidemia were the most important factors related to a lower EWL up to the third year. Preoperative weight loss, lower schooling, and lack of adherence to nutritional guidelines were important after 2 and 3 years. The presence of depression and lack of adherence to nutritional guidelines were the factors related to EWL of less than 50%.

Conclusions

Special attention and clarification should be provided to patients with diabetes mellitus type 2 and dyslipidemia and to patients with depression and lower schooling, since these patients tend to lose less excess weight after surgery. Multiprofessional care should also be provided so that the patients will follow nutritional guidelines more rigorously after surgery.

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References

  1. Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  2. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  3. Korenkov M, Sauerland S. Clinical update: bariatric surgery. Lancet. 2007;370:1988–90.

    Article  PubMed  Google Scholar 

  4. Ali MR, Fuller WD, Choi MP, et al. Bariatric surgical outcomes. Surg Clin North Am. 2005;85:835–52.

    Article  PubMed  Google Scholar 

  5. Salem L, Jensen CC, Flum DR. Are bariatric surgical outcomes worth their cost? A systematic review. J Am Coll Surg. 2005;200:270–8.

    Article  PubMed  Google Scholar 

  6. Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234(3):279–91.

    Article  PubMed  CAS  Google Scholar 

  7. Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.

    Article  PubMed  CAS  Google Scholar 

  8. Christou NV, Look D, MacLean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.

    Article  PubMed  Google Scholar 

  9. Elfhag K, Rössner S. Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity reviews. 2005;6:67–85.

    Article  PubMed  CAS  Google Scholar 

  10. Ciovica R, Takata M, Vittinghoff E. The Impact of Roux Limb Length on Weight Loss After Gastric Bypass Obes Surg. 2008;18:5–10.

    Google Scholar 

  11. Campos GM, Rabl C, Mulligan K, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008;143:877–84.

    Article  PubMed  Google Scholar 

  12. Carbonell AM, Wolfe LG, Meador RN, et al. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis. 2008;4:441–4.

    Article  PubMed  Google Scholar 

  13. Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.

    Article  PubMed  CAS  Google Scholar 

  14. Lutfi R, Torquati A, Sekhar N, et al. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20:864–7.

    Article  PubMed  CAS  Google Scholar 

  15. Ray EC, Nickels MW, Sayeed S, et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134:555–63.

    Article  PubMed  Google Scholar 

  16. Perugini RA, Mason R, Czerniach DR, et al. Predictors of complication and suboptimal weight loss after laparoscopic Roux-en-Y gastric bypass. Arch Surg. 2003;138:541–6.

    Article  PubMed  Google Scholar 

  17. Kadera BE, Lum K, Grant J. Remission of type 2 diabetes after Roux-en-Y gastric bypass is associated with greater weight loss. Surg Obes Relat Dis. 2009;5:305–9.

    Article  PubMed  Google Scholar 

  18. Melton GB, Steele KE, Schweitzer MA, et al. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities and insurance status with outcomes. J Gastrointest Surg. 2008;12:250–5.

    Article  PubMed  Google Scholar 

  19. Luis DA, Aller R, Sagrado MG, et al. Influence of Lys656asn polymorphism of leptin receptor gene on surgical results of biliopancreatic diversion. J Gastrointest Surg. 2010;14:899–903.

    Article  PubMed  Google Scholar 

  20. Thonney B, Pataky Z, Badel S, et al. The relationship between weight loss and psychosocial functioning among bariatric surgery patients. Am J Surg. 2010;199:183–8.

    Article  PubMed  Google Scholar 

  21. Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5:713–21.

    Article  PubMed  Google Scholar 

  22. NIH. Gastrointestinal surgery for severe obesity: Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.

    Google Scholar 

  23. Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16:1227–31.

    Article  PubMed  Google Scholar 

  24. Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y – 500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.

    Article  PubMed  CAS  Google Scholar 

  25. Flier J, Maratos-Flier E. Energy homeostasis and body weight. Curr Biol. 2000;10:R215–7.

    Article  PubMed  CAS  Google Scholar 

  26. Kahn BB, Flier JS. Obesity and insulin resistance. J Clin Invest. 2000;106:473–81.

    Article  PubMed  CAS  Google Scholar 

  27. Prospective UK. Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53. published correction appears in Lancet. 1999;354(9178):602.

    Article  Google Scholar 

  28. Roberts K, Duffy A, Kaufman J, et al. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21:1397–402.

    Article  PubMed  CAS  Google Scholar 

  29. Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215:387–95.

    Article  PubMed  CAS  Google Scholar 

  30. Ciovica R, Takata M, Vittinghoff E. The impact of Roux limb length on weight loss after gastric bypass. Obes Surg. 2008;18:5–10.

    Article  PubMed  Google Scholar 

  31. van de Laar A, de Caluwé L, Dillemans B. Relative Outcome Measures for Bariatric Surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg. 2011. doi:10.1007/s11695-010-0347-0.

  32. Scopinaro N, Adami GF, Papadia FS. Effects of biliopancreatic diversion on type 2 diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253(4):699–703.

    Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Wilson Salgado Júnior.

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Júnior, W.S., do Amaral, J.L. & Nonino-Borges, C.B. Factors Related to Weight Loss up to 4 Years after Bariatric Surgery. OBES SURG 21, 1724–1730 (2011). https://doi.org/10.1007/s11695-011-0420-3

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