Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass

Surg Endosc. 2018 May;32(5):2232-2238. doi: 10.1007/s00464-017-5913-2. Epub 2017 Oct 24.

Abstract

Background: Strategies to address weight recidivism following Roux-en-Y gastric bypass (RYGB) could be developed if patients at risk were identified in advance. This study aimed to determine factors that predict weight regain.

Methods: Retrospective review was performed of patients who underwent laparoscopic RYGB at a single institution over 10 years. Group-based modeling was used to estimate trajectories of weight regain after nadir and stratify patients based on percent weight change (%WC).

Results: Three trajectories were identified from 586 patients: 121 had ongoing weight loss, 343 were weight stable, and 122 regained weight. Male sex (p = 0.020) and white race (p < 0.001) were associated with stable weight or weight regain. Being from a neighborhood of socioeconomic advantage (p = 0.035) was associated with weight regain. Patients with weight regain experienced improved percent weight loss (%WL) at nadir (p < 0.001) and ΔBMI (p = 0.002), yet they had higher weight and BMI and lower %WL and ΔBMI than the other two groups during long-term follow-up. On multivariate analyses, those who regained weight were more likely from socioeconomically advantaged neighborhoods (OR 1.82, CI 1.18-2.79).

Conclusions: Several patient-related characteristics predicted an increased likelihood of weight regain. Further studies are needed to elucidate how these factors contribute to weight recidivism following bariatric surgery.

Keywords: Bariatric surgery; RYGB; Recidivism; Weight regain.

MeSH terms

  • Adult
  • Female
  • Gastric Bypass*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Predictive Value of Tests
  • Retrospective Studies
  • Weight Gain*