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Patterns of Weight Loss Response Following Gastric Bypass and Sleeve Gastrectomy

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Abstract

Background

Despite the health benefits of bariatric surgery (BS) extend beyond WL, better understanding of the WL response may help improve the outcomes of BS. In this context, we aimed to assess patterns within the variability of weight loss (WL) after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

Methods

WL data from 658 subjects that underwent RYGB (n = 464) or SG (n = 194) as first BS were analyzed. Based on excess WL (EWL), subjects were categorized as good WL responders (EWL ≥ 50 % at nadir weight and throughout follow-up), primarily poor WL responders (1-PWL:EWL < 50 % at nadir weight and thereafter), and secondarily poor WL responders (2-PWL:EWL ≥ 50 % at nadir weight, but <50 % at last follow-up visit). Predictors associated with different WL outcomes were ascertained using regression analysis.

Results

Median follow-up was 55.7 months. Nadir EWL ranged 12.4–143.6 %; last follow-up visit EWL ranged −22.1–143.6 % and weight regain (WR) ranged 0–64.1 kg. Good WL was found in 75.7 of the cohort. 1-PWL response (4.7 %) was characterized by lesser WL but similar WR as compared to good WL and was associated with larger BMI and diabetes prior to surgery. 2-PWL response (19.6 %) was characterized by larger WR as compared to the other groups and was more common following SG. Lesser percentage of medical appointments kept was associated with 1-PWL and 2-PWL.

Conclusion

Our data show the high inter-individual variability of the WL response at mid-term after RYGB and SG and that poor WL after BS could be illustrated by two different patterns, characterized either by sustained limited WL (1-PWL), or pronounced weight regain (2-PWL).

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References

  1. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  PubMed  Google Scholar 

  2. 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.

    CAS  PubMed Central  PubMed  Google Scholar 

  3. Vidal J, Jiménez A. Diabetes remission following metabolic surgery: is GLP-1 the culprit? Curr Atheroscler Rep. 2013;15(10):357.

    Article  PubMed  Google Scholar 

  4. Camastra S, Muscelli E, Gastaldelli A, et al. Long-term effects of bariatric surgery on meal disposal and β-cell function in diabetic and nondiabetic patients. Diabetes. 2013;62(11):3709–17.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Sarzynski MA, Jacobson P, Rankinen T, et al. Associations of markers in 11 obesity candidate genes with maximal weight loss and weight regain in the SOS bariatric surgery cases. Int J Obes (Lond). 2011;35(5):676–83.

    Article  CAS  Google Scholar 

  6. Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308(11):1122–31.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.

    Article  PubMed  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(5):734–40.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Endocr Pract. 2008;14 Suppl 1:1–83.

    Article  PubMed  Google Scholar 

  10. Vidal J, Ibarzabal A, Nicolau J, et al. Short-term effects of sleeve gastrectomy on type 2 diabetes mellitus in severely obese subjects. Obes Surg. 2007;17(8):1069–74.

    Article  CAS  PubMed  Google Scholar 

  11. Morínigo R, Vidal J, Lacy AM, et al. Circulating peptide YY, weight loss, and glucose homeostasis after gastric bypass surgery in morbidly obese subjects. Ann Surg. 2008;247(2):270–5.

    Article  PubMed  Google Scholar 

  12. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  13. Edholm D, Svensson F, Näslund I, et al. Long-term results 11 years after primary gastric bypass in 384 patients. Surg Obes Relat Dis. 2013;9(5):708–13.

    Article  PubMed  Google Scholar 

  14. Valezi AC, de Almeida MM, Mali Jr J. Weight loss outcome after Roux-en-Y gastric bypass: 10 years of follow-up. Obes Surg. 2013;23(8):1290–3.

    Article  PubMed  Google Scholar 

  15. Trastulli S, Desiderio J, Guarino S, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis. 2013;9(5):816–29.

    Article  PubMed  Google Scholar 

  16. Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(1):177–83.

    Article  PubMed  Google Scholar 

  17. Prevot F, Verhaeghe P, Pequignot A, et al. Two lessons from a 5-year follow-up study of laparoscopic sleeve gastrectomy: persistent, relevant weight loss and a short surgical learning curve. Surgery. 2014;155(2):292–9.

    Article  PubMed  Google Scholar 

  18. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.

    Article  PubMed  Google Scholar 

  19. van de Laar AW, Acherman YI. Weight loss percentile charts of large representative series: a benchmark defining sufficient weight loss challenging current criteria for success of bariatric surgery. Obes Surg 2013 Nov 14. [Epub ahead of print]

  20. Adams ST, Salhab M, Hussain ZI, et al. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013;89(1053):411–6.

    Article  PubMed  Google Scholar 

  21. Hatoum IJ, Greenawalt DM, Cotsapas C, et al. Weight loss after gastric bypass is associated with a variant at 15q26.1. Am J Hum Genet. 2013;92(5):827–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Ob Surg. 2013;23:1922–33.

    Article  Google Scholar 

  23. Song Z, Reinhardt K, Buzdon M, et al. Association between support group attendance and weight loss after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4:100–3.

    Article  PubMed  Google Scholar 

  24. Pedersen SD. The role of hormonal factors in weight loss and recidivism after bariatric surgery. Gastroenterol Res Pract. 2013;2013:528450.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Neff KJ, Chuah LL, Aasheim ET, et al. Beyond weight loss: evaluating the multiple benefits of bariatric surgery after roux-en-y gastric bypass and adjustable gastric band. Obes Surg. 2014;24(5):684–91.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by a grant from the Residency Fellowship Program from the Hospital Clínic Universitari (Barcelona, Spain).

Authors’ Contributions

A. de H. and J.V. designed the study, analyzed the data, and wrote the manuscript. T.R. and A.J. analyzed the data and reviewed and edited the manuscript. A.L. and L.F. reviewed and edited the manuscript. J.V. is the guarantor of this work and as such, had full access to all the data in the studies, and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Source of Funding

This work was supported by a grant from the Fondo de Investigaciones Sanitarias (PI11/00892), Instituto de Salud Carlos III (Madrid, Spain), and European Funds for Regional Development (FEDER) from the European Union.

Conflict of Interest

The authors have no conflict of interest to report relevant to this article.

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Authors and Affiliations

  1. Obesity Unit, Endocrinology and Nutrition Department, Hospital Clinic Universitari, Villarroel 170, 08036, Barcelona, Spain

    Ana de Hollanda, Amanda Jiménez, Lílliam Flores, Antonio Lacy & Josep Vidal

  2. Department of Nutrition and Food Sciences, University of Barcelona, Barcelona, Spain

    Tania Ruiz

  3. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain

    Amanda Jiménez, Lílliam Flores & Josep Vidal

  4. Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain

    Amanda Jiménez, Lílliam Flores, Antonio Lacy & Josep Vidal

Authors
  1. Ana de Hollanda
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  2. Tania Ruiz
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  3. Amanda Jiménez
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  4. Lílliam Flores
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  5. Antonio Lacy
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  6. Josep Vidal
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Correspondence to Josep Vidal.

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de Hollanda, A., Ruiz, T., Jiménez, A. et al. Patterns of Weight Loss Response Following Gastric Bypass and Sleeve Gastrectomy. OBES SURG 25, 1177–1183 (2015). https://doi.org/10.1007/s11695-014-1512-7

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  • DOI: https://doi.org/10.1007/s11695-014-1512-7

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