Are there really any predictive factors for a successful weight loss after bariatric surgery?

Objectives: The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. Methods: Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s t test and ANOVA and McNemar’s test were applied. Results: Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (n = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (p = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. Conclusion: Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.

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Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery

Surgical Endoscopy ◽

10.1007/s00464-011-2104-4 ◽

2012 ◽

Vol 26 (6) ◽

pp. 1744-1750 ◽

Cited By ~ 82

Author(s):

Emilio Ortega ◽

Rosa Morínigo ◽

Lilliam Flores ◽

Violeta Moize ◽

Martin Rios ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Body Weight ◽

Predictive Factors ◽

Body Weight Loss ◽

Excess Body Weight ◽

Laparoscopic Bariatric Surgery

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Weight Regain after Bariatric Surgery

10.1093/med/9780190608347.003.0025 ◽

2018 ◽

Author(s):

Bartolome Burguera ◽

Amani Mohamed Hag ◽

Leslie J. Heinberg

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Weight Regain ◽

Scientific Evidence ◽

Treatment Options ◽

Behavioral Factors ◽

Number Of Patients ◽

Medical Therapies ◽

Successful Weight Loss ◽

Definition Of

Bariatric surgery is the most effective therapy for morbid obesity. Unfortunately, a significant number of patients experience significant postoperative weight regain, which undermines the metabolic and cardiovascular benefits of weight loss associated with surgery. When revisional procedures are not indicated and/or when behavioral factors are present (e.g., nonadherence, eating pathology), bariatric programs currently do not have any empirically evaluated treatment options to offer those burdened with less favorable outcomes. This chapter reviews the definition of successful weight loss after bariatric surgery, as well as some biologic and behavioral factors that could be implicated in weight regain after surgery. Finally, we outline the scientific evidence supporting the use of behavioral and medical therapies to prevent weight regain after surgery. Bariatric programs need to determine from clinical experience, as well as through clinical trials, what behavioral/medical therapies are the most effective for managing weight gain after bariatric surgery.

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Use of Pharmacotherapy in Obesity Management

The Singapore Family Physician ◽

10.33591/sfp.47.5.u6 ◽

2021 ◽

Vol 47 (5) ◽

Author(s):

Kwang Wei Tham

Keyword(s):

Bariatric Surgery ◽

Body Mass Index ◽

Weight Loss ◽

Weight Regain ◽

Energy Homeostasis ◽

Weight Maintenance ◽

High Body Mass Index ◽

Obesity Management ◽

Behavioural Modification ◽

Successful Weight Loss

Obesity is a chronic disease which is often relapsing and progressive due in part to the physiology of energy homeostasis in people with obesity, rendering them with the challenge of attaining adequate weight loss and weight maintenance after successful weight loss. Depending on the presence, types and severity of the obesity-related comorbidities (ORCs), some patients will require an amount of weight loss beyond what lifestyle and behavioural modification can achieve. Even after bariatric surgery, patients may not lose the expected amount of weight or experience weight regain. Anti-obesity medications may be required to support them further. Hence, the use of pharmacotherapy in obesity management remains an important adjunct to lifestyle and behavioural modifications and even to bariatric surgery, particularly in those with more severe ORCs and with a high body mass index. This article discusses the general approach to the use of pharmacotherapy in obesity management and the various anti-obesity medications currently approved.

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Patient Characteristics Associated with a Successful Weight Loss after Bariatric Surgery

Bariatric Nursing and Surgical Patient Care ◽

10.1089/bar.2010.9994 ◽

2010 ◽

Vol 5 (4) ◽

pp. 313-319 ◽

Cited By ~ 12

Author(s):

Bente Nelbom ◽

Lars Naver ◽

Steen Ladelund ◽

Nete Hornnes

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Patient Characteristics ◽

Successful Weight Loss

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Skin manifestations after bariatric surgery

BMC Dermatology ◽

10.1186/s12895-020-00120-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yada Itthipanichpong ◽

Wilawan Damkerngsuntorn ◽

Natsinee Tangkijngamvong ◽

Suthep Udomsawaengsup ◽

Patchaya Boonchayaanant ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Body Weight Loss ◽

High Density Lipoproteins ◽

Post Surgery ◽

Excessive Body Weight ◽

Successful Group ◽

Successful Weight Loss ◽

Clinical Trials Registry ◽

Post Bariatric Surgery

Abstract Background Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited. Methods Seventy post-BaS patients were examined for cutaneous abnormalities. The patients were divided into those with successful weight loss (% excessive body weight loss (EBWL) of at least 50%) and a non-successful group (%EBWL < 50%). Results Forty-six patients with successful weight loss demonstrated a significantly lower prevalence of acanthosis nigricans on the neck, axillae and inguinal areas, keratosis pilaris (KP) and pebble fingers. However, a higher prevalence of alopecia was observed. After adjustment with patients’ factors, KP (adjusted odds ratio (aOR) = 0.21, 95%CI 0.06–0.74, p = 0.02) and pebble fingers (aOR = 0.09, 95%CI 0.01–0.89, p = 0.04) remained significantly less likely in patients with successful weight loss. Laboratory results comparing pre- and post-surgery values revealed significant decreases in fasting plasma glucose, hemoglobin A1c, and triglyceride and an increase of high-density lipoproteins in both groups. However, significant decreases of liver aminotransferases (AST and ALT) were observed only in the successful group (p = 0.04, 0.003). Nonetheless, a decrease in vitamin B12 (p = 0.01) was observed in the successful group. Conclusion Weight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary. Trial registration Thai Clinical Trials Registry TCTR20171003002. Registered October 3. 2017, retrospectively registered.

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Deterioration of mental health in bariatric surgery after 10 years despite successful weight loss

European Journal of Clinical Nutrition ◽

10.1038/ejcn.2015.112 ◽

2015 ◽

Vol 70 (1) ◽

pp. 17-22 ◽

Cited By ~ 25

Author(s):

L Canetti ◽

E Bachar ◽

O Bonne

Keyword(s):

Mental Health ◽

Bariatric Surgery ◽

Weight Loss ◽

Successful Weight Loss

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Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

Obesity Surgery ◽

10.1007/s11695-021-05388-9 ◽

2021 ◽

Author(s):

Marleen M. Romeijn ◽

Marlies Bongers ◽

Daniëlle D.B. Holthuijsen ◽

Loes Janssen ◽

François M.H. van Dielen ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Employment Status ◽

Weight Regain ◽

Weight Loss Outcomes ◽

Working Status ◽

Successful Weight Loss ◽

Patients Experience ◽

The Impact

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract

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