Review articleWeight regain after bariatric surgery: a systematic literature review and comparison across studies using a large reference sample
Section snippets
Methods
The reporting checklist from the Meta-analysis Of Observational Studies in Epidemiology Guidelines was used to ensure reporting of relevant background, methods (including search strategy), results, discussion, and conclusion [15].
Literature search
The literature search yielded 2096 studies, 2023 of which were excluded based on the title or abstract alone (e.g., nonhuman models, surgical procedures other than RYGB or SG). Of 73 reports that were reviewed in full, 58 were excluded because ≥1 criterion (see Appendix 2, supplemental material). The most frequent first identified exclusion criteria were (1) WR was not reported after RYGB alone or SG alone, and (2) sample selected based on weight loss or WR (Fig. 1). Of 15 studies that met
Discussion
The clinical problem of WR after bariatric surgery is poorly and inconsistently assessed and reported. In particular, the lack of a standard measure of WR in the bariatric literature and the variability in timing of assessment has precluded comparisons of the magnitude or extent of WR across studies [1,2,4,5]. This literature review addressed these limitations by making comparisons between each study and a reference sample, that is, the percentage difference in WR in each study versus a large
Conclusions
This literature review suggests the large variation in reported WR across studies is partly, but not entirely, explained by heterogeneity in WR measures and timing of assessment. WR also appears to differ by surgical procedure and study design characteristics. In particular, small samples, low participation or data completeness rates, determination of nadir weight with medical records (of unspecified frequency), and use of binary WR measures appear to contribute to unreliable estimates.
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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The reference data used in this study were collected as part of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study funded by the following grants: this clinical study was a cooperative agreement funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Grant numbers: DCC -U01 DK066557; Columbia - U01-DK66667 (in collaboration with Cornell University Medical Center CTRC, Grant UL1-RR024996); University of Washington - U01-DK66568 (in collaboration with CTRC, Grant M01 RR-00037); Neuropsychiatric Research Institute - U01-DK66471; East Carolina University – U01-DK66526; University of Pittsburgh Medical Center – U01-DK66585 (in collaboration with CTRC, Grant UL1-RR024153); Oregon Health & Science University – U01-DK66555.