Background Scarce evidence exists in the literature about the factors influencing the long-term quality of life (QoL) and weight regain (WR) after Roux-en-Y gastric bypass (RYGB). The aim of the present study was to investigate factors associated with WR and QoL, measured by obesity specific Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQ II), 12 years after RYGB. Methods This prospective longitudinal cohort study included 74 patients with obesity who had RYGB at the Lithuanian University of Health Sciences hospital Surgery department in 2005. Gastrointestinal and dumping symptoms, hypoglycemia, depression and anxiety disorders, hunger, satiety after meals, portion size, and grazing were assessed in the patients who agreed to participate in the study. General linear models were constructed to estimate the effect of variables on the WR and QoL. Results 12-year follow-up data were available for 50 patients (38 female, median body mass index (BMI) before surgery 42.4). The mean % excess BMI loss (%EBMIL) after 12 years was 63.1 (24.6) and the average %WR was 32.2 (19.4). The mean M-A QoLQ II score was 1.44 (1.3). Majority of the patients (76.6%) reported good or very good QoL. In multivariable analysis, only grazing (17.41% 95% CI 7.61-27.21; P = 0.001) was found to be a significant independent factor associated with WR. Factors independently associated with worse QoL were grazing (− 0.97 95% CI − 1.72, − 0.22; P = 0.013) and frequency of abdominal pain once or more per month (− 1.82 95% CI − 2.79, − 0.85; P = 0.001). Conclusion 12 years after RYGB majority of the patients report good or very good QoL and despite some WR have achieved and maintained significant weight loss. Grazing was associated with both WR and worse QoL, while the frequency of abdominal pain once or more per month was associated with only decreased QoL.

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