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Clinical factors associated with weight loss outcomes after Roux‐en‐Y gastric bypass surgery
Author(s) -
Still Christopher D.,
Wood G. Craig,
Chu Xin,
Manney Christina,
Strodel William,
Petrick Anthony,
Gabrielsen Jon,
Mirshahi Tooraj,
Argyropoulos George,
Seiler Jamie,
Yung Marco,
Benotti Peter,
Gerhard Glenn S.
Publication year - 2014
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20529
Subject(s) - medicine , weight loss , roux en y anastomosis , surgery , gastric bypass surgery , gastric bypass , type 2 diabetes , obesity , diabetes mellitus , endocrinology
Objective Gastric bypass surgery is an effective therapy for extreme obesity. However, substantial variability in weight loss outcomes exists that remains largely unexplained. Our objective was to determine whether any commonly collected preoperative clinical variables were associated with weight loss following Roux‐en‐Y gastric bypass (RYGB) surgery. Methods The analysis was based on a prospectively recruited observational cohort of 2,365 patients who underwent Roux‐en‐Y gastric bypass surgery from 2004 to 2009. Weight loss was stratified into three major phases, early (0‐6 months), nadir, and long‐term (>36 months). Multivariate regression models were constructed using a database of over 350 variables. Results A total of 12‐14 preoperative variables were independently associated ( P < 0.05) with each of the temporal weight loss phases. Preoperative variables associated with poorer nadir and long‐term weight loss included higher baseline BMI, higher preoperative weight loss, iron deficiency, use of any diabetes medication, nonuse of bupropion medication, no history of smoking, age >50 years, and the presence of fibrosis on liver biopsy. Conclusions Several variables previously associated with poorer weight loss after RYGB surgery including age, baseline BMI, and type 2 diabetes were replicated. Several others suggest possible clinical interventions for postoperative management of RYGB patients to improve weight loss outcomes.