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Erschienen in: Obesity Surgery 8/2015

01.08.2015 | Original Contributions

Predictors of Lowest Weight and Long-Term Weight Regain Among Roux-en-Y Gastric Bypass Patients

verfasst von: Brenton R. Yanos, Karen K. Saules, Leslie M. Schuh, Stephanie Sogg

Erschienen in: Obesity Surgery | Ausgabe 8/2015

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Abstract

Background

Weight loss surgery (WLS) outcomes are poorly understood. This study aimed to evaluate the relationship of well-documented (e.g., health, diet, physical activity) and theoretically relevant variables (e.g., substance use and “food addiction”) with both weight nadir and weight regain (WR) following WLS.

Methods

A sample of 97 Roux-en-Y gastric bypass patients (M time since surgery = 8.86 years) were surveyed about pre- and post-WLS weight, health, self-management behaviors, alcohol problems, and clinical symptoms.

Results

Patients lost a mean of 42 % (SD = 10.71 %) of total weight at weight nadir, but 26 % (SD = 19.66 %) of the lost weight was regained by the time of the survey. Correlates of lower weight nadir and WR differed considerably, with minor overlap. Weight nadir was associated with pre-WLS drug use and post-WLS medical comorbidities. WR, on the other hand, was associated with post-WLS adherence to dietary and physical activity modification. Post-WLS nocturnal eating, depression, and problematic alcohol use were also associated with WR. With all associated variables in regression models, number of post-WLS medical comorbidities (β = −.313, p < 0.01) and post-WLS depression (β = 0.325, p < 0.01) accounted for the most variance and remained as significant predictors of weight nadir and WR, respectively.

Conclusions

While weight nadir was associated with relatively few and largely nonmodifiable variables, WR was significantly associated with adherence-related behaviors, mood symptoms, and pathological patterns of food and alcohol use, all of which are potentially modifiable. These findings underscore the importance of long-term behavioral and psychosocial monitoring after surgery.
Literatur
1.
Zurück zum Zitat Aftab H, Risstad H, Sovik T, et al. Five-year outcome after gastric bypass for morbid obesity in a Norwegian cohort. Surg Obes Rel Dis. 2014;10:71–8.CrossRef Aftab H, Risstad H, Sovik T, et al. Five-year outcome after gastric bypass for morbid obesity in a Norwegian cohort. Surg Obes Rel Dis. 2014;10:71–8.CrossRef
3.
Zurück zum Zitat Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedCentralPubMed Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedCentralPubMed
4.
Zurück zum Zitat Cremieux PY, Buchwald H, Shikora S, et al. A study on the economic impact of bariatric surgery. Am J Manag C. 2008;14(9):589–96. Cremieux PY, Buchwald H, Shikora S, et al. A study on the economic impact of bariatric surgery. Am J Manag C. 2008;14(9):589–96.
5.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRef
6.
Zurück zum Zitat Laurino Neto RM, Herbella FA, Tauil RM, et al.. Comorbidities remission after Roux-en-Y gastric bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain. Obes Surg. 2012;22(10):1580–5.PubMedCrossRef Laurino Neto RM, Herbella FA, Tauil RM, et al.. Comorbidities remission after Roux-en-Y gastric bypass for morbid obesity is sustained in a long-term follow-up and correlates with weight regain. Obes Surg. 2012;22(10):1580–5.PubMedCrossRef
7.
Zurück zum Zitat Hatoum IJ, Kaplan LM. Advantages of percent weight loss as a method of reporting weight loss after Roux-en-y gastric bypass. Obes. 2013;21:1519–25.CrossRef Hatoum IJ, Kaplan LM. Advantages of percent weight loss as a method of reporting weight loss after Roux-en-y gastric bypass. Obes. 2013;21:1519–25.CrossRef
8.
Zurück zum Zitat Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obes. 2014;22:888–94.CrossRef Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obes. 2014;22:888–94.CrossRef
9.
Zurück zum Zitat Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.PubMedCrossRef Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.PubMedCrossRef
10.
Zurück zum Zitat Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.CrossRef Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31:1248–61.CrossRef
11.
Zurück zum Zitat Faria SL, Kelly EO, Lins RD, et al. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20:135–9.PubMedCrossRef Faria SL, Kelly EO, Lins RD, et al. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20:135–9.PubMedCrossRef
12.
Zurück zum Zitat Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28:53–8.PubMedCrossRef Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28:53–8.PubMedCrossRef
13.
Zurück zum Zitat Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.PubMedCrossRef Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.PubMedCrossRef
15.
Zurück zum Zitat Franks SF, Kaiser KA. Predictive factors in bariatric surgery outcomes: what is the role of the preoperative psychological evaluation? Primary Psychiatry. 2008;15(8):74–83. Franks SF, Kaiser KA. Predictive factors in bariatric surgery outcomes: what is the role of the preoperative psychological evaluation? Primary Psychiatry. 2008;15(8):74–83.
16.
Zurück zum Zitat Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16(9):1227–31.PubMedCrossRef Ma Y, Pagoto SL, Olendzki BC, et al. Predictors of weight status following laparoscopic gastric bypass. Obes Surg. 2006;16(9):1227–31.PubMedCrossRef
17.
Zurück zum Zitat Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef
18.
Zurück zum Zitat Bond DS, Phelan S, Leahey TM, et al. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2009;33:173–80.CrossRef Bond DS, Phelan S, Leahey TM, et al. Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods. Int J Obes. 2009;33:173–80.CrossRef
19.
Zurück zum Zitat Burgmer R, Grigutsch K, Zipfel S, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg. 2005;15:684–91.PubMedCrossRef Burgmer R, Grigutsch K, Zipfel S, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg. 2005;15:684–91.PubMedCrossRef
20.
Zurück zum Zitat Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obes. 2008;16(3):615–22.CrossRef Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obes. 2008;16(3):615–22.CrossRef
21.
Zurück zum Zitat de Zwaan M. Weight and eating changes after bariatric surgery. In: Mitchell JE, de Zwaan M, editors. Bariatric surgery: a guide for mental health professionals. New York: Routledge; 2005. p. 77–100. de Zwaan M. Weight and eating changes after bariatric surgery. In: Mitchell JE, de Zwaan M, editors. Bariatric surgery: a guide for mental health professionals. New York: Routledge; 2005. p. 77–100.
22.
Zurück zum Zitat de Zwaan M, Enderle J, Wagner S, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Dis. 2011;133(1–2):61–8.PubMedCrossRef de Zwaan M, Enderle J, Wagner S, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Dis. 2011;133(1–2):61–8.PubMedCrossRef
23.
Zurück zum Zitat Hsu LK, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338–46.PubMedCrossRef Hsu LK, Benotti PN, Dwyer J, et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338–46.PubMedCrossRef
24.
Zurück zum Zitat Kinzl JF, Schrattenecker M, Traweger C, et al. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006;16(12):1609–14.PubMedCrossRef Kinzl JF, Schrattenecker M, Traweger C, et al. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006;16(12):1609–14.PubMedCrossRef
25.
Zurück zum Zitat Niego SH, Kofman MD, Weiss JJ, et al. Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Disord. 2007;40(4):349–59.PubMedCrossRef Niego SH, Kofman MD, Weiss JJ, et al. Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Disord. 2007;40(4):349–59.PubMedCrossRef
26.
Zurück zum Zitat Cornicelli M, Noli G, Marinari GM, et al. Dietary habits and body weight at long-term following biliopancreatic diversion. Obes Surg. 2010;20(9):1278–80.PubMedCrossRef Cornicelli M, Noli G, Marinari GM, et al. Dietary habits and body weight at long-term following biliopancreatic diversion. Obes Surg. 2010;20(9):1278–80.PubMedCrossRef
27.
Zurück zum Zitat Latner JD, Wetzler S, Goodman ER, et al. Gastric bypass in a low-income, inner-city population: eating disturbances and weight loss. Obes Res. 2004;12:956–61.PubMedCrossRef Latner JD, Wetzler S, Goodman ER, et al. Gastric bypass in a low-income, inner-city population: eating disturbances and weight loss. Obes Res. 2004;12:956–61.PubMedCrossRef
28.
Zurück zum Zitat Sciamanna CN, Kiernan M, Rolls BJ, et al. Practices associated with weight loss versus weight-loss maintenance. Am J Prev Med. 2011;41(2):159–66.PubMedCrossRef Sciamanna CN, Kiernan M, Rolls BJ, et al. Practices associated with weight loss versus weight-loss maintenance. Am J Prev Med. 2011;41(2):159–66.PubMedCrossRef
29.
Zurück zum Zitat Elkins G, Whitfield P, Marcus J, et al. Noncompliance with behavioral recommendations following bariatric surgery. Obes Surg. 2005;15:546–51.PubMedCrossRef Elkins G, Whitfield P, Marcus J, et al. Noncompliance with behavioral recommendations following bariatric surgery. Obes Surg. 2005;15:546–51.PubMedCrossRef
30.
Zurück zum Zitat Schwartz RW, Strodel WE, Simpson WS, et al. Gastric bypass revision: lessons learned from 920 cases. Surgery. 1988;104:806–12.PubMed Schwartz RW, Strodel WE, Simpson WS, et al. Gastric bypass revision: lessons learned from 920 cases. Surgery. 1988;104:806–12.PubMed
31.
Zurück zum Zitat Maniscalco M, Zedda A, Giardiello C, et al. Effect of bariatric surgery on the six minute walk test in severe uncomplicated obesity. Obes Surg. 2006;16:836–41.PubMedCrossRef Maniscalco M, Zedda A, Giardiello C, et al. Effect of bariatric surgery on the six minute walk test in severe uncomplicated obesity. Obes Surg. 2006;16:836–41.PubMedCrossRef
32.
Zurück zum Zitat Serés L, Lopez-Averbe J, Coll R, et al. Increased exercise capacity after surgically induced weight loss in morbid obesity. Obes. 2006;14:273–9.CrossRef Serés L, Lopez-Averbe J, Coll R, et al. Increased exercise capacity after surgically induced weight loss in morbid obesity. Obes. 2006;14:273–9.CrossRef
33.
Zurück zum Zitat Howard L, Malone M, Michalek A, et al. Gastric bypass and vertical banded gastroplasty: a prospective randomized comparison and 5-year follow-up. Obes Surg. 1995;5(1):55–60.PubMedCrossRef Howard L, Malone M, Michalek A, et al. Gastric bypass and vertical banded gastroplasty: a prospective randomized comparison and 5-year follow-up. Obes Surg. 1995;5(1):55–60.PubMedCrossRef
34.
Zurück zum Zitat Olbers T, Fagevik-Olsen M, Maleckas A, Lonroth H. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity. Brit J Surg. 2005;92(5):557–62.PubMedCrossRef Olbers T, Fagevik-Olsen M, Maleckas A, Lonroth H. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity. Brit J Surg. 2005;92(5):557–62.PubMedCrossRef
35.
Zurück zum Zitat van de Laar A, de Caluwé L, Dillemans B. Relative outcomes 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;21:763–7.PubMedCrossRef van de Laar A, de Caluwé L, Dillemans B. Relative outcomes 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;21:763–7.PubMedCrossRef
36.
Zurück zum Zitat Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.PubMedCentralPubMedCrossRef Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.PubMedCentralPubMedCrossRef
37.
Zurück zum Zitat Babor TF, Higgins-Biddle JC, Saunders JB, et al. The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Geneva: World Health Organization; 2001. Babor TF, Higgins-Biddle JC, Saunders JB, et al. The Alcohol Use Disorders Identification Test: guidelines for use in primary health care. Geneva: World Health Organization; 2001.
38.
Zurück zum Zitat Hays RD, Merz JF, Nicholas R. Response burden, reliability, and validity of the CAGE, Short MAST, and AUDIT alcohol screening measures. Behav Res Meth Instrum Comput. 1995;27:277–80.CrossRef Hays RD, Merz JF, Nicholas R. Response burden, reliability, and validity of the CAGE, Short MAST, and AUDIT alcohol screening measures. Behav Res Meth Instrum Comput. 1995;27:277–80.CrossRef
39.
Zurück zum Zitat Bohn MJ, Babor TF, Kranzler HR. The alcohol use disorders identification test (AUDIT): validation of a screening instrument for use in medical settings. JSAD. 1995;56:423–32. Bohn MJ, Babor TF, Kranzler HR. The alcohol use disorders identification test (AUDIT): validation of a screening instrument for use in medical settings. JSAD. 1995;56:423–32.
40.
Zurück zum Zitat Humeniuk R, Ali R, Babor TF, et al. Validation of the alcohol, smoking and substance involvement screening test (ASSIST). Addiction. 2008;103(6):1039–47.PubMedCrossRef Humeniuk R, Ali R, Babor TF, et al. Validation of the alcohol, smoking and substance involvement screening test (ASSIST). Addiction. 2008;103(6):1039–47.PubMedCrossRef
41.
Zurück zum Zitat Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale food addiction scale. Appetite. 2009;52(2):430–6.PubMedCrossRef Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale food addiction scale. Appetite. 2009;52(2):430–6.PubMedCrossRef
42.
Zurück zum Zitat American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (Text Revision). Washington, DC; 2000. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (Text Revision). Washington, DC; 2000.
43.
Zurück zum Zitat Clark SM, Saules KK. Validation of the Yale food addiction scale among a weight-loss surgery population. Eat Behav. 2013;14(2):216–9. Clark SM, Saules KK. Validation of the Yale food addiction scale among a weight-loss surgery population. Eat Behav. 2013;14(2):216–9.
44.
Zurück zum Zitat Meule A, Heckel D, Kubler A. Factor structure and item analysis of the Yale food addiction scale in obese candidates for bariatric surgery. Eur Eat Disord Rev. 2012;20:419–22. Meule A, Heckel D, Kubler A. Factor structure and item analysis of the Yale food addiction scale in obese candidates for bariatric surgery. Eur Eat Disord Rev. 2012;20:419–22.
46.
Zurück zum Zitat Martin A, Rief W, Klaiberg A, et al. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiat. 2006;28:71–7.CrossRef Martin A, Rief W, Klaiberg A, et al. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiat. 2006;28:71–7.CrossRef
47.
Zurück zum Zitat Welch G, Wesolowski C, Piepul B, et al. Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obes Surg. 2005;18(5):517–24.CrossRef Welch G, Wesolowski C, Piepul B, et al. Physical activity predicts weight loss following gastric bypass surgery: findings from a support group survey. Obes Surg. 2005;18(5):517–24.CrossRef
48.
Zurück zum Zitat Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. MSSE. 2000;32(9):498–504. Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. MSSE. 2000;32(9):498–504.
49.
Zurück zum Zitat de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6:79–87.PubMedCrossRef de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6:79–87.PubMedCrossRef
50.
Zurück zum Zitat Spitzer RL, Yanovski SZ, Marcus MD. Questionnaire on Eating and Weight Patterns Revised. Mclean: Behavioral Measurement and Database Services (Producer); BRS Search Service (Vendor); 1994. Spitzer RL, Yanovski SZ, Marcus MD. Questionnaire on Eating and Weight Patterns Revised. Mclean: Behavioral Measurement and Database Services (Producer); BRS Search Service (Vendor); 1994.
51.
Zurück zum Zitat de Zwaan M, Mitchell JE, Specker SM, et al. Diagnosing binge eating disorder: level of agreement between self-report and expert rating. Int J Eat Disord. 1993;14(3):289–95.PubMedCrossRef de Zwaan M, Mitchell JE, Specker SM, et al. Diagnosing binge eating disorder: level of agreement between self-report and expert rating. Int J Eat Disord. 1993;14(3):289–95.PubMedCrossRef
52.
Zurück zum Zitat Allison KC, Lundgren JD, O’Reardon JP, et al. The night eating questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome. Eat Behav. 2008;9:62–72.PubMedCrossRef Allison KC, Lundgren JD, O’Reardon JP, et al. The night eating questionnaire (NEQ): psychometric properties of a measure of severity of the Night Eating Syndrome. Eat Behav. 2008;9:62–72.PubMedCrossRef
53.
Zurück zum Zitat Armstrong T, Bull F. Development of the world health organization global physical activity questionnaire. J Publ Health. 2006;14:66–70.CrossRef Armstrong T, Bull F. Development of the world health organization global physical activity questionnaire. J Publ Health. 2006;14:66–70.CrossRef
54.
Zurück zum Zitat Bond DS, Thomas JG, Unick JL, et al. Self-reported and objectively measured sedentary behavior in bariatric surgery candidates. Surg Obes Relat Dis. 2013;9:123–8.PubMedCentralPubMedCrossRef Bond DS, Thomas JG, Unick JL, et al. Self-reported and objectively measured sedentary behavior in bariatric surgery candidates. Surg Obes Relat Dis. 2013;9:123–8.PubMedCentralPubMedCrossRef
Metadaten
Titel
Predictors of Lowest Weight and Long-Term Weight Regain Among Roux-en-Y Gastric Bypass Patients
verfasst von
Brenton R. Yanos
Karen K. Saules
Leslie M. Schuh
Stephanie Sogg
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2015
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1536-z

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