肥満と減量療法のジャーナル

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Factors Influencing Weight Loss after Bariatric Surgery: A Multivariate Analysis

Rawan ElAbd, Dana Al-Tarrah, Sulaiman Almazeedi, Khaled Alyaqout, Evangelos Efthimiou, Salman Al-Sabah

Introduction: Obesity is a major public health concern due to its association with the development of obesityrelated comorbidities. The aim of this study is to identify the potential relationship between pre-operative patient-related factors with weight loss at 1 and 3 years following Laparoscopic Roux-en-Y gastric bypass (LRYGB), Laparoscopic Sleeve Gastrectomy (LSG) or laparoscopic Adjustable Gastric Banding (LAGB).

Methods: A retrospective cohort study was carried out on 1,210 patients with obesity who underwent primary bariatric surgery at Chelsea and Westminster Hospital NHS Trust between September 1999 and May 2017.

Results: The study sample included 1210 participants. The mean age was 45.3 ± 11.3 years. Females represented 78.3% (n=948) of the sample. The mean BMI at initial assessment was 47.6 ± 7.47 kg/m². LRYGB was found to be the most effective followed by LSG then LAGB at 1 and 3 years as evidenced by higher number of patients having %EWL>50 (P<0.001). After adjusting for confounders, older age, higher initial BMI, black ethnicity, diabetes, and Obstructive Sleep Apnea (OSA) were associated with suboptimal weight loss. The presence of hypertension, smoking, and gender were not associated with %EWL or TBWL% at any time point.

Conclusion: Patient age, race, type of surgery, pre-operative BMI, and co-morbidity status influence weight loss after bariatric surgery, with older age, black ethnicity, LAGB, higher initial BMI, diabetes, and OSA predicting a lower weight loss in the short and medium term. Hypertension, smoking, and gender did not seem to influence weight loss in our study. The study findings could alert the surgeon to take more aggressive measures towards patients with risk factors, in part, by choosing a more effective bariatric procedure.