Predictors for weight loss after Roux-en-Y gastric bypass: the trend and associated factors for weight loss

BMC Surg. 2022 Aug 11;22(1):310. doi: 10.1186/s12893-022-01760-3.

Abstract

Background: Historically, Roux-en-Y gastric bypass (RYGB) has been considered the gold standard of bariatric surgery (BS). This procedure acts as a mixed restrictive and malabsorptive operation.

Methods: This retrospective cohort study included 410 morbidly obese patients (BMI > 40 kg/m2 or BMI > 35 kg/m2 along with at least one major comorbidity) who underwent primary laparoscopic RYGB surgery from 2009 to 2015 by a single surgery team. The patients were 18 years and older with at least 12 months of follow-up. Total weight loss (%TWL) and comorbidity resolution were compared in short-term (12 months) and mid-term (12-60 months) follow-ups. The primary and secondary outcomes were evaluating the effect of Roux-en-Y on weight loss and control of comorbidities, respectively.

Results: The mean ± SD age, weight, and BMI at surgery were 40.1 ± 10.58 years, 123.32 ± 19.88 kg, and 45.78 ± 5.54 kg/m2, respectively, and 329 (80%) were female, and 62 (15%) had T2DM. %TWL was significantly higher in T2DM patients 9 months postoperatively and after that. Patients with lower BMI (< 50 kg/m2) at surgery and non-diabetic patients had a significantly lower %TWL over a short- and long-term follow-up (P < 0.001).

Conclusions: BS remains the most efficacious and durable weight loss treatment. However, a proportion of patients will experience insufficient weight loss following BS.

Keywords: Bariatric surgery; Roux-en-Y gastric bypass; Weight loss.

MeSH terms

  • Adult
  • Body Mass Index
  • Diabetes Mellitus, Type 2* / complications
  • Female
  • Gastric Bypass* / methods
  • Humans
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Obesity, Morbid* / complications
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss