Abstract
Background
Bariatric surgery (BS) is widely accepted for the treatment of patients with morbid obesity (MO). We aimed to determine presurgical predictors of and surgical technique-related differences in excess weight loss (EWL) 1 year after BS.
Methods
This retrospective study included 407 subjects (F/M 3:1, median age = 44 years) who underwent laparoscopic Roux-en-Y gastric bypass (RYGB, n = 307) or sleeve gastrectomy (SG, n = 100) at our University Hospital and were evaluated 1 year after surgery.
Results
Baseline median (min–max) body mass index (BMI) was 47 kg/m2 (range = 36–71). BMI was higher in the SG than in the RYGB group (53 vs. 46 kg/m2, p < 0.0001). Simple correlation analysis showed negative associations between EWL and age, BMI, waist circumference (WC), fasting glucose, HbA1c, triglycerides (TG), blood pressure, and total cholesterol (all p < 0.01). EWL (mean ± SD) did not differ by gender (p = 0.2), was lower in diabetic than in nondiabetic subjects (71 ± 17% vs. 79 ± 17%, p < 0.0001), and higher in the RYGB vs. SG group (76 ± 18% vs. 68 ± 15%, p < 0.0001). However, SG vs. RYGB differences in EWL disappeared (p = 0.4) after taking into account baseline BMI. Multiple regression and logistic analysis showed that younger individuals with lower BMI but higher WC, and lower HbA1c and TG, had higher EWL and a higher rate of successful (EWL ≥ 60%) weight loss.
Conclusions
Our data indicate that some of the characteristics that would have subjects referred early for BS were associated with higher weight loss. Therefore, the timing of laparoscopic BS might be an important factor for MO individuals in which medical weight loss intervention has failed.
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Acknowledgments
We thank Dr. Assumpta Caixas for critical reading of the manuscript.
Disclosures
Dr. Emilio Ortega, Dr. Rosa Morínigo, Dr. Lilliam Flores, Ms. Violeta Moize, Dr. Martin Rios, Dr. Antonio M. Lacy, and Dr. Josep Vidal have no conflicts of interest or financial ties to disclose.
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Ortega, E., Morínigo, R., Flores, L. et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc 26, 1744–1750 (2012). https://doi.org/10.1007/s00464-011-2104-4
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DOI: https://doi.org/10.1007/s00464-011-2104-4