Long-term Weight Regain after Gastric Bypass: A 5-year Prospective Study

Springer Science and Business Media LLC - Tập 18 - Trang 648-651 - 2008
Daniéla Oliveira Magro1,2, Bruno Geloneze3, Regis Delfini2, Bruna Contini Pareja2, Francisco Callejas2,4, José Carlos Pareja2,4
1Preventive Medicine Department, University of Campinas (UNICAMP), Campinas, Brazil
2Obesity Surgery Center of Campinas, Campinas, Brazil
3Internal Medicine Department, Division of Endocrinology, University of Campinas (UNICAMP), Campinas, Brazil
4Surgery Department, University of Campinas, UNICAMP, Campinas, Brazil

Tóm tắt

A certain weight gain occurs after obesity surgery compared to the lower weight usually observed between 18 and 24 months postsurgery. The objective of this study was to evaluate weight regain in patients submitted to gastric bypass over a 5-year follow-up period. A longitudinal prospective study was conducted on 782 obese patients of both genders. Only patients with at least 2 years of surgery were included. The percentage of excess body mass index (BMI) loss at 24, 36, 48, and 60 months postsurgery was compared to the measurements obtained at 18 months after surgery. Surgical therapeutic failure was also evaluated. Percent excess BMI loss was significant up to 18 months postsurgery (p < 0.001), with a mean difference in BMI of 1.06 kg/m2 compared to 12 months postsurgery. Percent BMI loss was no longer significant after 24 months, and weight regain became significant within 48 months after surgery (p < 0.01). Among the patients who presented weight regain, a mean 8% increase was observed within 60 months compared to the lowest weight obtained at 18 months after surgery. The percentage of surgical failure was higher in the superobese group at all times studied, reaching 18.8% at 48 months after surgery. Weight regain was observed within 24 months after surgery in approximately 50% of patients. Both weight regain and surgical failure were higher in the superobese group. Studies in regard to metabolic and hormonal mechanisms underlying weight regain might elucidate the causes of this finding.

Tài liệu tham khảo

Hsu LK, Betancourt S, Sullivan SP. Eating disturbances before and after vertical banded gastroplasty: a pilot study. Int J Eat Disord. 1996;19(1):23–34. Spitzer RR, Devleu M, Waish BT et al. Binge eating disorder: a multisite field trial of the diagnostic criteria. Int J Eat Disord. 1992;11:191–203. Malone M, Alger-Mayer S. Binge status and quality of life after gastric bypass surgery: a one-year study. Obesity Res. 2004;12:473–81. Buchwald H, Avidor Y, Braunwald E et al. Bariatric surgery. A systematic review and meta-analysis. JAMA. 2004;13:1724–37. Hsu LK, Benotti PN, Dwyer J, Roberts SB, Saltzman E, Shikora S et al. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med. 1998;60:338–46. Brolin RE, Kenler HA, Gorman JH, Cody RP. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215:387–95. Capella JF, Capella RF. The weight reduction operation of choice: Vertical banded gastroplasty or gastric bypass? Am J Surg. 1996;171:74–9. Fobi MA, Lee H, Igwe D Jr, Felahy B, James E, Stanczyk M et al. Revision of failed gastric bypass to distal Roux-en-Y gastric bypass: a review of 65 cases. Obes Surg. 2001;11:190–5. Biron S, Hould FS, Lebel S, Marceau S, Lescelleur O, Simard S et al. Twenty years of biliopancreatic diversion: What is the goal of the surgery? Obes Surg. 2004;14:160–4. Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007—Editorial. Obes Surg. 2007;565–8. MacLean LD, Rhode BM, Nohr LW. Late outcome of isolated gastric bypass. Ann Surg. 1999;231:524–8. Saunders R. Binge eating in gastric bypass patients before surgery. Obes Surg. 1999;9:72–6. Cook CM, Edwards C. Success habits of long-term gastric bypass patients. Obes Surg. 1999;9:80–2. Signore C. Beyond Change, “Information Regarding Obesity Surgery”. September 2004. JKS Associates 43494 Woodward Avenue, Suite 108 Bloomfield Hills, MI 48302-0567. ISSN 1548-260X. Adami GF, Gandolfo P, Bauer B, Scopinaro N. Binge eating in massively obese patients undergoing bariatric surgery. In J Eat Disord. 1995;17:45–50.