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Background/Objectives-Bariatric surgery produces robust weight-loss, however, factors associated with long-term weight-loss maintenance among adolescents undergoing Roux-en-Y gastric bypass surgery (RYGB) are unknown. Subjects/Methods-Fifty adolescents (mean±SD age and BMI = 17.1±1.7yrs and 59±11kg/m 2) underwent RYGB, had follow-up visits at 1-yr and at a visit between 5-12yrs following surgery (FABS-5+ visit; mean±SD 8.1±1.6yrs). A non-surgical comparison group (n=30; mean±SD age and BMI = 15.3±1.7yrs and BMI=52±8kg/m 2) was recruited to compare weight trajectories overtime. Questionnaires (health-related and eating behaviors, health responsibility, impact of weight on quality of life, international physical activity questionnaire (IPAQ), and dietary habits via surgery guidelines) were administered at the FABS-5+ visit. Post-hoc, participants were split into 2 groups: long-term weight loss maintainers (n=23; baseline BMI=58.2kg/m 2 ; 1-yr BMI=35.8kg/m 2 ; FABS-5+ BMI=34.9kg/m 2) and re-gainers (n=27; baseline BMI=59.8kg/m 2 ; 1yr BMI=36.8 kg/m 2 ; FABS-5+ BMI=48.0kg/m 2) to compare factors which might contribute to differences. Data were analyzed using generalized estimating equations adjusted for age, sex, baseline BMI, baseline diabetes status, and length of follow-up. Results-The BMI of the surgical group declined from baseline to 1-yr (−38.5±6.9%), which, despite some regain, was largely maintained until FABS-5+ (−29.6±13.9 % change). The BMI of the comparison group increased from baseline to the FABS-5+ visit (+10.3±20.6%). When the surgical group was split into maintainers and re-gainers, no differences in weight-related and

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