Definitions of Long-Term Weight Regain and Their Associations with Clinical Outcomes

Abstract

Introduction The prevalence and clinical significance of weight regain after bariatric surgery remains largely unclear due to the lack of a standardized definition of significant weight regain. The development of a clinically relevant definition of weight regain requires a better understanding of its clinical significance. Objectives To assess rates of weight regain 5 years after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), applying six definitions and investigating their association with clinical outcomes. Methods Patients were followed up until 5 years after surgery and weight regain was calculated. Regression techniques were used to assess the association of weight regain with health-related quality of life (HRQoL) and the presence of comorbidities. Results A total of 868 patients participated in the study, with a mean age of 46.6 (± 10.4) years, of which 79% were female. The average preoperative BMI was 44.8 (± 5.9) kg/m 2 and the total maximum weight loss was 32% (± 8%). Eighty-seven percent experienced any regain. Significant weight regain rates ranged from 16 to 37% depending on the definition. Three weight regain definitions were associated with deterioration in physical HRQoL (p < 0.05), while associations between definitions of weight regain and the presence of comorbidities 5 years after surgery were not significant. Conclusion These results indicate that identifying one single categorical definition of clinically significant weight regain is difficult. Additional research into the clinical significance of weight regain is needed to inform the development of a standardized definition that includes all dimensions of surgery success: weight, HRQoL, and comorbidity remission. Keywords Weight regain. Health-related quality of life. Roux-en-Y gastric bypass. Sleeve gastrectomy. Long-term follow-up * Vera Voorwinde

Long‐term changes in adipose tissue gene expression following bariatric surgery

“…We therefore defined body weight stability during the two to five‐year follow‐up period as a change < 7% ( n = 19) and weight gain as ≥ 7% increase ( n = 18). Six of the weight regain patients had an increase greater than 5 kg m −2 in BMI, a threshold used to classify significant weight regain following surgery [28]. At baseline and 2 years postsurgery, anthropometric measures showed no difference between the weight gain and weight stable groups (Table ).…”

Gastrojejunal Anastomotic Technique. Does It Matter? Weight Loss and Weight Regain 5 Years After Laparoscopic Roux-en-Y Gastric Bypass

“…Approximately 10% of patient's regain significant weight 3 years after LRYGB and 30% on longer term [19,20]. These individuals' insulin resistance, diabetes, depression and other comorbidities re-occur, and their Quality of Life decreases [21,22]. Changes to the structure and diameter of the gastroenterostomy are described as a major factor in weight re-gain, which is influenced by surgical technique.…”

Perceived and Preferred Social Support in Patients Experiencing Weight Regain After Bariatric Surgery—a Qualitative Study

“…One and a half to 2 years post-surgery, most patients have either stabilized their weight, or in some cases regained some weight [2]. The exact prevalence of weight regain is unclear, both due to low follow-up rates [3] and to large variations in how weight regain is defined [4]. Weight regain seems to be especially common after gastric banding, but may occur regardless of surgical method [5].…”