Predictors of Weight Regain and Insufficient Weight Loss According to Different Definitions After Sleeve Gastrectomy: a Retrospective Analytical Study

Yarigholi, Fahime; Bahardoust, Mansour; Mosavari, Hesam; Tehrani, Farshid Monshizadeh; Gholizadeh, Hamed; Shahabi, Shahab; Hamid, Rizwan; Oshidari, Bahador; Garakani, Kiana; Eghbali, Foolad

doi:10.1007/s11695-022-06322-3

Cited by 18 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Anatomical failures have different reasons based on the technique, including pouch distension for the LAGB technique, dilation of the gastric sleeve, retained fundus, and choosing the procedure for the wrong patient for the LSG technique. Particularly in the RYGB technique, the dilatation of the gastric pouch (>5 cm or >120 mL) or gastrojejunostomy stoma outlet (≥2 cm), gastrogastric fistula, short-limb bypass, small intestine adaptation, and candy cane are among the common failure reasons ( 34 , 39 , 47 ). There are many similarities between the etiology and possible RFs, which are discussed below.…”

Section: Resultsmentioning

confidence: 99%

What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery

Zefreh,

Amani-Beni,

Sheikhbahaei

et al. 2023

Int J Endocrinol Metab

View full text Add to dashboard Cite

Context: This review study aimed to investigate the definition, etiology, risk factors (RFs), management strategy, and prevention of insufficient weight loss (IWL) and weight regain (WR) following bariatric metabolic surgery (BMS). Evidence Acquisition: Electronic databases were searched to retrieve relevant articles. The inclusion criteria were English articles with adult participants assessing the definition, prevalence, etiology, RFs, management strategy, and prevention of IWL/WR. Results: Definition: The preferred definition for post-BMS IWL/WR are the terms "Lack of maintenance of total weight loss (TWL)>20%" and "weight change in percentage compared to nadir weight or weight loss". Prevalence: The exact prevalence of IWL/WR is still being determined due to the type of BMS and various definitions. Etiology: Several mechanisms, including hormonal/metabolic, dietary non-adherence, physical inactivity, mental health, and anatomic surgical failure, are possible etiologies of post-BMS IWL/WR. RFs: Preoperative body mass index (BMI), male gender, psychiatric conditions, comorbidities, age, poor diet, eating disorders, poor follow-ups, insufficient physical activity, micronutrients, and genetic-epigenetic factors are the most important RFs. Management Strategy: The basis of treatment is lifestyle interventions, including dietary, physical activity, psychological, and behavioral therapy. Pharmacotherapy can be added. In the last treatment line, different techniques of endoscopic surgery and revisional surgery can be used. Prevention: Behavioral and psychotherapeutic interventions, dietary therapy, and physical activity therapy are the essential components of prevention. Conclusions: Many definitions exist for WR, less so for IWL. Etiologies and RFs are complex and multifactorial; therefore, the management and prevention strategy is multidisciplinary. Some knowledge gaps, especially for IWL, exist, and these gaps must be filled to strengthen the evidence used to guide patient counseling, selection, and improved outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery

Zefreh,

Amani-Beni,

Sheikhbahaei

et al. 2023

Int J Endocrinol Metab

View full text Add to dashboard Cite

show abstract

“…Depression and anxiety disorders are predictive of less weight loss, particularly after bariatric surgery compared to non-surgical care [ 31 , 32 ]. There is conflicting evidence on whether common sleep disorders, such as obstructive sleep apnea, predict less weight loss success after bariatric surgery [ 33 , 34 ]. Regular alcohol consumption is associated with less weight loss success with non-surgical care, according to the Look AHEAD trial [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Developing a Decision Aid for Clinical Obesity Services in the Real World: the DACOS Nationwide Pilot Study

Atlantis,

Kormas,

Piya

et al. 2024

OBES SURG

View full text Add to dashboard Cite

Purpose The purpose of this study is to develop a decision aid tool using “real-world” data within the Australian health system to predict weight loss after bariatric surgery and non-surgical care. Materials and Methods We analyzed patient record data (aged 16+years) from initial review between 2015 and 2020 with 6-month (n=219) and 9-/12-month (n=153) follow-ups at eight clinical obesity services. Primary outcome was percentage total weight loss (%TWL) at 6 months and 9/12 months. Predictors were selected by statistical evidence (p<0.20), effect size (±2%), and clinical judgment. Multiple linear regression and bariatric surgery were used to create simple predictive models. Accuracy was measured using percentage of predictions within 5% of the observed value, and sensitivity and specificity for predicting target weight loss of 5% (non-surgical care) and 15% (bariatric surgery). Results Observed %TWL with bariatric surgery vs. non-surgical care was 19% vs. 5% at 6 months and 22% vs. 5% at 9/12 months. Predictors at 6 months with intercept (non-surgical care) of 6% include bariatric surgery (+11%), BMI>60 (–3%), depression (–2%), anxiety (–2%), and eating disorder (–2%). Accuracy, sensitivity, and specificity were 58%, 69%, and 56%. Predictors at 9/12 months with intercept of 5% include bariatric surgery (+15%), type 2 diabetes (+5%), eating disorder (+4%), fatty liver (+2%), atrial fibrillation (–4%), osteoarthritis (–3%), sleep/mental disorders (–2–3%), and ≥10 alcohol drinks/week (–2%). Accuracy, sensitivity, and specificity were 55%, 86%, and 53%. Conclusion Clinicians may use DACOS to discuss potential weight loss predictors with patients after surgery or non-surgical care. Graphical Abstract

show abstract

“…Likewise, one study showed that pre-surgery BMI was sometimes a positive significant predictor and at other times a negative predictor of WR subject to the definition used and its components (WR of "10 kg nadir," "an increase of > 20% of maximum weight loss," or "increase of > 25% EWL from nadir") [23]. A recent study found that a preoperative BMI of > 45 kg/m 2 was associated with WR after LSG, regardless of the definition of WR [44].…”

Section: Discussionmentioning

confidence: 99%

“…While there is no literature to directly compare this finding with, inconsistencies again exist. Some authors found that WR was associated with several comorbidities including obstructive sleep apnea and fatty liver disease [44], while others noted that the presence of T2DM or HTN were both not associated with WR definition [23].…”

Section: Discussionmentioning

confidence: 99%

When Definitions Differ, are Comparisons Meaningful? Definitions of Weight Regain After Bariatric Surgery and Their Associations with Patient Characteristics and Clinical Outcomes - A Need for a Revisit?

Lock

Ansari

2023

OBES SURG

View full text Add to dashboard Cite

Introduction Definitions and prevalence of weight regain (WR) after bariatric surgery remains inconsistent and their clinical significance unclear. Objectives To assess WR five years after sleeve gastrectomy (LSG), employing six definitions; and appraise their association with patient characteristics/clinical outcomes. Methods Consecutive patients (N = 589) who underwent LSG were followed up for 5 years. WR prevalence was calculated yearly employing six definitions. Regression analysis assessed associations between WR at 5 years, and patient characteristics (age, sex, preop BMI, number of follow-up visits, number of comorbidities) and remission of comorbidities (type 2 diabetes, hypertension, and dyslipidemia). Results Sample’s mean age and BMI were 34 ± 11.6 years and 43.13 ± 5.77 kg/m2, and 64% were females. Percentage of patients with WR at 2, 3, 4, and 5 years fluctuated between 2.53% and 94.18%, subject to definition, and time point. The definition “Any WR” generated the highest prevalence of WR (86–94%) across all time points. At 5 years, for patient characteristics, preoperative BMI was associated with three definitions (P 0.49 to < 0.001), sex was associated with two (P < 0.026–0.032), and number of comorbidities was associated with one definition (P = 0.01). In terms of comorbidities, only hypertension was associated with WR (one definition, P = 0.025). No other definitions of WR were associated with any of the variables under examination. Conclusion Weight regain is reasonably expected after BMS. WR definitions were of minor clinical significance due to weak associations with limited comorbidities. Dichotomous definitions might offer some guidance while managing individual patients. However, its utility as a comparator metric across patients/procedures requires refinements. Graphical abstract

show abstract

Predictors of Weight Regain and Insufficient Weight Loss According to Different Definitions After Sleeve Gastrectomy: a Retrospective Analytical Study

Cited by 18 publications

References 27 publications

What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery

What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery

Developing a Decision Aid for Clinical Obesity Services in the Real World: the DACOS Nationwide Pilot Study

When Definitions Differ, are Comparisons Meaningful? Definitions of Weight Regain After Bariatric Surgery and Their Associations with Patient Characteristics and Clinical Outcomes - A Need for a Revisit?

Contact Info

Product

Resources

About