Predictors for weight loss after Roux-en-Y gastric bypass: the trend and associated factors for weight loss

Abstract

Background Historically, Roux-en-Y gastric bypass (RYGB) has been considered the gold standard of bariatric surgery (BS). This procedure acts as a mixed restrictive and malabsorptive operation. Methods This retrospective cohort study included 410 morbidly obese patients (BMI > 40 kg/m2 or BMI > 35 kg/m2 along with at least one major comorbidity) who underwent primary laparoscopic RYGB surgery from 2009 to 2015 by a single surgery team. The patients were 18 years and older with at least 12 months of follow-up. Total weight loss (%TWL) and comorbidity resolution were compared in short-term (12 months) and mid-term (12–60 months) follow-ups. The primary and secondary outcomes were evaluating the effect of Roux-en-Y on weight loss and control of comorbidities, respectively. Results The mean ± SD age, weight, and BMI at surgery were 40.1 ± 10.58 years, 123.32 ± 19.88 kg, and 45.78 ± 5.54 kg/m2, respectively, and 329 (80%) were female, and 62 (15%) had T2DM. %TWL was significantly higher in T2DM patients 9 months postoperatively and after that. Patients with lower BMI (< 50 kg/m2) at surgery and non-diabetic patients had a significantly lower %TWL over a short- and long-term follow-up (P < 0.001). Conclusions BS remains the most efficacious and durable weight loss treatment. However, a proportion of patients will experience insufficient weight loss following BS.

Determination of weight loss effectiveness evaluation indexes and establishment of a nomogram for forecasting the probability of effectiveness of weight loss in bariatric surgery: a retrospective cohort

“…On the downside, even though various factors have been identified as affecting the effectiveness of weight loss, the majority of the literature has limited these factors to patients’ anthropometric indicators or inspection indicators 18 , 41 , 42 . In addition, most recent studies only employed multivariate regression analysis to make predictions 43 – 45 , which were not sufficiently visual to be clinically applicable.…”

Influence of Bariatric Surgery on Gut Microbiota Composition and Its Implication on Brain and Peripheral Targets

“…This gastrojejunal anastomosis bypasses the proximal small intestine, a major nutrient digestion and absorption site, further contributing to weight loss in addition to mechanical restriction through the reduction in the overall size of the proximal stomach [32]. The RYGB procedure typically results in a loss of about 70% of excess body weight, or approximately 30% to 35% of total body weight [33]. Due to the bimodal restrictive and malabsorptive effects, RYGB has been shown to promote increased weight loss of up to 20% more than SG at 24 months, although it is considered a more difficult procedure [34].…”

Weight Loss Prediction after Metabolic and Bariatric Surgery

“…Many studies have shown that type 2 diabetes is a prognostic factor for poor weight loss after MBS. 19,[26][27][28] Campos et al 26 found that diabetes was independently associated with poor weight…”

“…Many studies have shown that type 2 diabetes is a prognostic factor for poor weight loss after MBS. 19 , 26 - 28 Campos et al 26 found that diabetes was independently associated with poor weight loss (%EWL <40%) 1 year after RYGB, particularly in those using insulin before surgery. Still et al 19 confirmed that diabetes was independently associated with weight loss outcomes for up to 36 months after RYGB.…”

“…Still et al 19 confirmed that diabetes was independently associated with weight loss outcomes for up to 36 months after RYGB. Eghbali et al 28 recently reported that the mean %TWL was 11.9% (95% confidence interval [CI], 6.84 to 16.9) higher for non-diabetic patients than for those with diabetes in mid-term results (36 to 60 months) following RYGB after adjusting for other clinical factors. Preoperative insulin use was associated with weight gain, and its anabolic effect might hamper weight loss after MBS.…”