Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group
There is little robust data on weight regain (WR) after bariatric surgery making it difficult to counsel patients regarding long-term outcomes of different bariatric procedures. The purpose of this study was to see WR in medium and long term after SG, RYGB, and OAGB in Indian population.
In a multicentre study, data on preoperative and postoperative weights over 5 years were collected. Multiple definitions were applied to find the proportion of patients with significant WR increase of 25% of lost weight from nadir (definition 1), weight gain of > 10 kg from nadir (definition 2), and BMI gain of > 5 kg/m2 from nadir (definition 3). The proportion of those with significant WR was compared across sub-groups.
A total of 9617 patients were included. Median WR at 5 years was 14.1% of lost weight, 1.92 kg/m2, and 5 kg. Significant WR using definition 1 was 35.1%, 14.6%, and 3% after sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and mini-one anastomosis gastric bypass (OAGB) respectively. Severe albumin deficiency was highest in OAGB (5.9%) patients followed by SG (2.9%) and RYGB (2.2%) at 5 years(p = 0.023). Haemoglobin levels < 10 g/dL were seen in 8.2%, 9.0%, and 13.9% of SG, RYGB, and OAGB patients respectively (p = 0.041).
In the first comparative study of WR, OAGB had lesser WR in comparison to SG and RYGB but had the most impact on Hb and albumin levels in the long term. Definition selection for reporting WR has a significant impact on the results. There is a need for standardising the reporting of WR in bariatric literature.
KeywordsBariatric surgery Obesity surgery Weight regain Sleeve gastrectomy Gastric sleeve Gastric bypass Roux-en-Y gastric bypass Mini-one anastomosis gastric bypass
We are thankful to Dr. Aparna Govil Bhasker for the help in organising the study as well as guidance in writing the manuscript, Kankona Dey for the help in data compilation, Dr. Laila Baig for organising the consensus meeting, Manjari Agarwal for data compilation, and Mr. Souvik Dutta for statistical analysis.
SJB, KM, and SS conceived the idea for the topic. SJB initiated the research and wrote the manuscript. PP collected most of the data and wrote the manuscript. SJB and PP contributed equally to the manuscript. KM and SS wrote and edited parts of the manuscript. All authors participated in the discussions on the topic. All authors have seen the final version and approve of it.
Compliance with Ethical Standards
Conflict of Interest Statement
The authors declare that they have no conflict of interest.
Statement of Human and Animal Rights
Statement of Informed Consent
For this type of study, formal consent is not required.
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