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Erschienen in: Obesity Surgery 8/2015

01.08.2015 | Original Contributions

Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery

verfasst von: Timothy C. Cooper, Elizabeth B. Simmons, Kirsten Webb, James L. Burns, Robert F. Kushner

Erschienen in: Obesity Surgery | Ausgabe 8/2015

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Abstract

Background

The primary purpose of this study was to assess weight loss and occurrence of weight regain among patients who underwent Roux-en-Y gastric bypass (RYGB) using categorical analysis.

Methods

Study participants were selected from patients who underwent RYGB from a single institution. Participants (n = 300, mean procedure age = 45.6 ± 9.9) completed surveys for self-reported preoperative weight, current weight, and subsequent weights over postoperative years. Measured weights and confirmed procedure dates were acquired from patient medical records. Mean preoperative weight and BMI were 140.8 kg ± 32.1 and 49.7 ± 9.9, respectively, and mean years since surgery was 6.9 ± 4.9. Study subjects were mostly Caucasian (56.7 %) and female (80.3 %). Participants were stratified a priori into four cohorts based on percent of weight loss at 1 year, <25 % (n = 39), 25–30 % (n = 51), 30–35 % (n = 73), and >35 % (n = 113). General linear model analyses were conducted to assess the effect of year one weight loss on percent weight regain.

Results

The mean weight regain for all patients was 23.4 % of maximum weight loss. Using categorical analysis, mean weight regain in the <25, 25–30, 30–35, and >35 % weight loss cohorts was 29.1, 21.9, 20.9, and 23.8 %, respectively. Excessive weight regain, defined as ≥25 % of total lost weight, occurred in 37 % of patients.

Conclusion

Weight gain is a common complication following RYGB surgery. Despite the percentage of weight loss over the first year, all cohort patient groups regained on average between 21 and 29 % of lost weight. Excessive weight gain was experienced by over one third of patients. Greater initial absolute weight loss leads to more successful long-term weight outcomes.
Literatur
1.
Zurück zum Zitat Puzziferri N, Nakonezny PA, Livingston EH, et al. Variation of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248(2):233–42.PubMedCrossRef Puzziferri N, Nakonezny PA, Livingston EH, et al. Variation of weight loss following gastric bypass and gastric band. Ann Surg. 2008;248(2):233–42.PubMedCrossRef
2.
Zurück zum Zitat Benoit SC, Hunter TD, Francis DM, et al. Use of bariatric outcomes longitudinal database (BOLD) to study variability in patient success after bariatric surgery. Obes Surg. 2014;24:936–43.PubMed Benoit SC, Hunter TD, Francis DM, et al. Use of bariatric outcomes longitudinal database (BOLD) to study variability in patient success after bariatric surgery. Obes Surg. 2014;24:936–43.PubMed
3.
Zurück zum Zitat Courcoulas AP, Christian NJ, Belle SH, Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, 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, Longitudinal Assessment of Bariatric Surgery (LABS) Consortium, 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 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(5):734–40.PubMedCentralPubMedCrossRef 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(5):734–40.PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–31.PubMedCrossRef Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–31.PubMedCrossRef
6.
Zurück zum Zitat Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.PubMedCrossRef
7.
Zurück zum Zitat Karmali S, Brar R, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.PubMedCrossRef Karmali S, Brar R, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.PubMedCrossRef
8.
9.
Zurück zum Zitat Chang SH, Stoll CRT, Song J, et al. The effectiveness and risks of bariatric surgery. An updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149:275–87.PubMedCentralPubMedCrossRef Chang SH, Stoll CRT, Song J, et al. The effectiveness and risks of bariatric surgery. An updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149:275–87.PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Jebb SA, Ahern AL, Olson AD, et al. Caterson ID. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomized controlled trial. Lancet. 2011;378:1485–92.PubMedCentralPubMedCrossRef Jebb SA, Ahern AL, Olson AD, et al. Caterson ID. Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomized controlled trial. Lancet. 2011;378:1485–92.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Wadden TA, Volger S, Sarwer DB, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365:1969–79.PubMedCentralPubMedCrossRef Wadden TA, Volger S, Sarwer DB, et al. A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med. 2011;365:1969–79.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Smith SR, Weissman NJ, Anderson CM, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363:245–56.PubMedCrossRef Smith SR, Weissman NJ, Anderson CM, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363:245–56.PubMedCrossRef
13.
Zurück zum Zitat Gadde KM, Ryan DH, Peterson CA, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomized, placebo-controlled, phase 3 trial. Lancet. 2011;377:1341–52.PubMedCrossRef Gadde KM, Ryan DH, Peterson CA, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomized, placebo-controlled, phase 3 trial. Lancet. 2011;377:1341–52.PubMedCrossRef
14.
Zurück zum Zitat Van de Laar AWJM, Acherman YIZ. Weight loss percentile charts of large representative series: a benchmark defining sufficient weight loss challenging current criteria for success of bariatric surgery. Obes Surg. 2014;24:727–34.PubMedCrossRef Van de Laar AWJM, Acherman YIZ. Weight loss percentile charts of large representative series: a benchmark defining sufficient weight loss challenging current criteria for success of bariatric surgery. Obes Surg. 2014;24:727–34.PubMedCrossRef
15.
Zurück zum Zitat Bray GA, Bouchard C, Church TS, et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17(4):619–21.PubMedCrossRef Bray GA, Bouchard C, Church TS, et al. Is it time to change the way we report and discuss weight loss? Obesity. 2009;17(4):619–21.PubMedCrossRef
16.
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;18:648–51.PubMedCrossRef Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18:648–51.PubMedCrossRef
17.
Zurück zum Zitat Ritz P, Caiazzo R, Becouarn G, et al. Early prediction of failure to lose weight after obesity surgery. Surg Obes Relat Dis. 2013;9:118–22.PubMedCrossRef Ritz P, Caiazzo R, Becouarn G, et al. Early prediction of failure to lose weight after obesity surgery. Surg Obes Relat Dis. 2013;9:118–22.PubMedCrossRef
18.
Zurück zum Zitat Astrup A, Rossner S. Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Obes Rev. 2000;1:17–9.PubMedCrossRef Astrup A, Rossner S. Lessons from obesity management programmes: greater initial weight loss improves long-term maintenance. Obes Rev. 2000;1:17–9.PubMedCrossRef
19.
Zurück zum Zitat Barte JCM, ter Bogt NCW, Bogers RP, et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev. 2010;11:899–906.PubMedCrossRef Barte JCM, ter Bogt NCW, Bogers RP, et al. Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review. Obes Rev. 2010;11:899–906.PubMedCrossRef
20.
Zurück zum Zitat Neiberg RH, Wing RR, Bray GA, et al. Patterns of weight change associated with long-term weight change and cardiovascular disease risk factors in the Look AHEAD study. Obesity. 2012;20(10):2048–56.PubMedCentralPubMedCrossRef Neiberg RH, Wing RR, Bray GA, et al. Patterns of weight change associated with long-term weight change and cardiovascular disease risk factors in the Look AHEAD study. Obesity. 2012;20(10):2048–56.PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Unick JL, Hogan PE, Neiberg RH, et al. Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention. Obesity. 2014;22(7):1608–16.PubMedCentralPubMedCrossRef Unick JL, Hogan PE, Neiberg RH, et al. Evaluation of early weight loss thresholds for identifying nonresponders to an intensive lifestyle intervention. Obesity. 2014;22(7):1608–16.PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Wadden TA, Neiberg RH, Wing RR, et al. Four-year weight losses in the Look AHEAD study: factors associated with long-term success. Obesity. 2011;19(10):1987–98.PubMedCentralPubMedCrossRef Wadden TA, Neiberg RH, Wing RR, et al. Four-year weight losses in the Look AHEAD study: factors associated with long-term success. Obesity. 2011;19(10):1987–98.PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat The Look AHEAD Research Group. Eight-year losses with an intensive lifestyle intervention: the look AHEAD study. Obesity. 2014;22(1):5–13.PubMedCentralCrossRef The Look AHEAD Research Group. Eight-year losses with an intensive lifestyle intervention: the look AHEAD study. Obesity. 2014;22(1):5–13.PubMedCentralCrossRef
24.
Zurück zum Zitat Kofman MD, Lent MR, Swencionis C. Maladpative eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity. 2010;18(10):1938–43.PubMedCrossRef Kofman MD, Lent MR, Swencionis C. Maladpative eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity. 2010;18(10):1938–43.PubMedCrossRef
25.
Zurück zum Zitat Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:349–56.PubMedCrossRef Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20:349–56.PubMedCrossRef
26.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMed Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76(10):1139–42.PubMed
27.
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. Obesity. 2008;16(3):615–22.PubMedCrossRef Colles SL, Dixon JB, O’Brien PE. Grazing and loss of control related to eating: two high risk factors following bariatric surgery. Obesity. 2008;16(3):615–22.PubMedCrossRef
Metadaten
Titel
Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery
verfasst von
Timothy C. Cooper
Elizabeth B. Simmons
Kirsten Webb
James L. Burns
Robert F. Kushner
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/s11695-014-1560-z

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