Capacity for Physical Activity Predicts Weight Loss After Roux‐en‐Y Gastric Bypass

Abstract

Despite its overall excellent outcomes, weight loss after Roux-en-Y gastric bypass (RYGB) is highly variable. We conducted this study to identify clinical predictors of weight loss after RYGB. We reviewed charts from 300 consecutive patients who underwent RYGB from August 1999 to November 2002. Data collected included patient demographics, medical comorbidities, and diet history. Of the 20 variables selected for univariate analysis, 9 with univariate P values ≤ 0.15 were entered into a multivariable regression analysis. Using backward selection, covariates with P < 0.05 were retained. Potential confounders were added back into the model and assessed for effect on all model variables. Complete records were available for 246 of the 300 patients (82%). The patient characteristics were 75% female, 93% white, mean age of 45 years, and mean initial BMI of 52.3 kg/m2. One year after surgery, patients lost an average of 64.8% of their excess weight (s.d. = 20.5%). The multivariable regression analysis revealed that limited physical activity, higher initial BMI, lower educational level, diabetes, and decreased attendance at postoperative appointments had an adverse effect on weight loss after RYGB. A model including these five factors accounts for 41% of the observed variability in weight loss (adjusted r2 = 0.41). In this cohort, higher initial BMI and limited physical activity were the strongest predictors of decreased excess weight loss following RYGB. Limited physical activity may be particularly important because it represents an opportunity for potentially meaningful pre- and postsurgical intervention to maximize weight loss following RYGB.

Evaluation of Clinical Outcomes for Gastric Bypass Surgery: Results from a Comprehensive Follow-up Study

“…We assessed physical activity using both a questionnaire and interview format with similar findings. This result for the association of exercise to improved weight loss is similar to that for our earlier study focused on post-surgical support group patients [21] and those reported in other crosssectional studies [36][37][38]. For example, Hatoum et al found baseline weight and physical activity to be the strongest predictor of %EWL 1 year post-surgery [36].…”

Exploring Perceptions of Barriers, Facilitators, and Motivators to Physical Activity Among Female Bariatric Patients

“…Regular PA has also been positively associated with post-operative weight loss following bariatric surgery, especially among previously inactive patients who begin exercising following surgery (Livhits et al 2010, Jacobi et al 2011. On the other hand, physical inactivity has demonstrated adverse effects on weight loss following gastric bypass surgery (Hatoum et al 2009). Unfortunately, PA monitoring studies report that a majority of bariatric patients fail to increase their PA levels post-surgery (Bond et al 2010).…”

Bariatric Surgery and Cardiovascular Risk Factors

“…185 It appears that severely obese patients who become active after bariatric surgery achieve greater weight losses and quality-of-life improvements than those who remain inactive. 45,186,187 According to 1 report, exercisers lost an average of 6.1 kg more than inactive patients, suffered less depression and anxiety, and had higher scores in general health. 187 Because severely obese individuals are often completely sedentary, 188 they should be strongly encouraged to engage in regular walking so that they can move out of the least fit, least active, "high-risk" cohort.…”