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Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass

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Abstract

Background

Strategies to address weight recidivism following Roux-en-Y gastric bypass (RYGB) could be developed if patients at risk were identified in advance. This study aimed to determine factors that predict weight regain.

Methods

Retrospective review was performed of patients who underwent laparoscopic RYGB at a single institution over 10 years. Group-based modeling was used to estimate trajectories of weight regain after nadir and stratify patients based on percent weight change (%WC).

Results

Three trajectories were identified from 586 patients: 121 had ongoing weight loss, 343 were weight stable, and 122 regained weight. Male sex (p = 0.020) and white race (p < 0.001) were associated with stable weight or weight regain. Being from a neighborhood of socioeconomic advantage (p = 0.035) was associated with weight regain. Patients with weight regain experienced improved percent weight loss (%WL) at nadir (p < 0.001) and ΔBMI (p = 0.002), yet they had higher weight and BMI and lower %WL and ΔBMI than the other two groups during long-term follow-up. On multivariate analyses, those who regained weight were more likely from socioeconomically advantaged neighborhoods (OR 1.82, CI 1.18–2.79).

Conclusions

Several patient-related characteristics predicted an increased likelihood of weight regain. Further studies are needed to elucidate how these factors contribute to weight recidivism following bariatric surgery.

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Authors and Affiliations

  1. Department of Surgery, University of Alabama at Birmingham, 1720 2nd Ave South, KB 401, Birmingham, AL, 35294, USA

    Charles J. Keith Jr., Allison A. Gullick, Katey Feng, Joshua Richman, Richard Stahl & Jayleen Grams

  2. Center for Surgical, Medical Acute Care Research, and Transitions, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA

    Joshua Richman

  3. Department of Surgery, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA

    Jayleen Grams

Authors
  1. Charles J. Keith Jr.
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  2. Allison A. Gullick
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  3. Katey Feng
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  4. Joshua Richman
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Correspondence to Jayleen Grams.

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Disclosures

Drs. Keith, Richman, Stahl, and Grams, Ms. Gullick and Feng have no conflicts of interest or financial ties to disclose.

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Keith, C.J., Gullick, A.A., Feng, K. et al. Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass. Surg Endosc 32, 2232–2238 (2018). https://doi.org/10.1007/s00464-017-5913-2

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  • DOI: https://doi.org/10.1007/s00464-017-5913-2

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