Gastric bypass is the most common operation performed in the United States for morbid obesity.
However, weight loss is poor in 10% to 15% of patients.
Dr Guilherme Campos and colleagues from California, USA determined independent factors associated with poor weight loss after gastric bypass.
The team examined demographic, operative, and follow-up data by means of multivariate analysis.
Variables investigated were age, sex, race, marital and insurance status, initial weight and body mass index.
Comorbidities, laparoscopic vs open surgery, gastric pouch area, gastrojejunostomy technique, and alimentary limb length were also assessed.
Weight loss at 12 months was categorized as poor, defined as 40% excess weight loss or good, defined as more than 40% excess weight loss.
|Excess weight loss at follow-up was 60%|
|Archives of Surgery|
The researchers obtained follow-up data in 86% of patients undergoing gastric bypass during the study period.
Mean preoperative body mass index was 52.
Mean body mass index and excess weight loss at follow-up were 34% and 60%, respectively.
The research team noted that 12% had poor weight loss.
The team found that 4 variables were associated with poor weight loss in the univariate analysis, including greater initial weight, diabetes, open approach, and larger pouch size.
Of these, only diabetes and larger pouch size remained after the multivariate analysis.
Dr Campos’ team concluded, “Gastric bypass results in substantial weight loss in most patients.”
“Diabetes and larger pouch size are independently associated with poor weight loss after gastric bypass.”