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

Oct 19, 2022Obesity surgery

Factors linked to weight regain and poor weight loss after sleeve gastrectomy using different definitions

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Abstract

A preoperative BMI of > 45 kg/m is associated with an increased risk of weight regain and insufficient weight loss after sleeve gastrectomy.

Obstructive sleep apnea is linked to both weight regain and insufficient weight loss following surgery.
Metformin consumption may reduce the likelihood of weight regain and insufficient weight loss after sleeve gastrectomy.
Grades 2 and 3 fatty liver disease are associated with poorer outcomes in terms of weight management post-surgery.
The incidence of weight regain or insufficient weight loss varied from 0% to 19.3%, depending on the criteria used.

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BACKGROUND: Weight regain (WR) and insufficient weight loss (IWL) after sleeve gastrectomy (SG) are challenging issues. This study aimed to evaluate the predictors of WR and IWL after SG.

METHODS: In this retrospective analytical study, 568 patients who underwent SG at Hazrat-e Rasool General Hospital, Tehran, Iran, between January 2015 and April 2022 were evaluated. A total of 333 patients were included. WR and IWL were evaluated by multiple criteria such as a BMI of > 35 kg/m, an increase in BMI of > 5 kg/mabove nadir, an increase in weight of > 10 kg above nadir, percentage of excess weight loss (%EWL) < 50% at 18 months, an increase in weight of > 25% of EWL from nadir at 36 months, and percentage of total weight loss (%TWL) < 20% at 36 months. All participants were followed up for 36 months. 2 2

RESULT: The univariate analysis showed that preoperative BMI, obstructive sleep apnea, metformin consumption, and grades 2 and 3 fatty liver disease were associated with WR and IWL (P < 0.05). WR or IWL incidence varied (0-19.3%) based on different definitions. The multivariate analysis showed that a preoperative BMI of > 45 kg/m[odds ratio(OR) 1.77, 95% CI: 1.12-4.11, P = 0.038] and metformin consumption [OR: 0.48, 95% CI: 0.19-0.78, P = 0.001] were associated with WR and IWL after SG, regardless of the definition of WR or IWL. 2Adjusted Adj Adj

CONCLUSION: This study showed that preoperative BMI of > 45 kg/m, obstructive sleep apnea, metformin consumption, and grades 2 and 3 of fatty liver disease were associated with WR or IWL. 2

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

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