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Preoperative Weight Loss as a Predictor of Long-term Success Following Roux-en-Y Gastric Bypass

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Abstract

Background

All patients undergoing gastric bypass surgery at this institution are recommended to achieve a goal of 10% total body weight (TBW) loss prior to surgery. The objective of this study was to determine whether preoperative TBW correlated with 3- and 4-year weight loss outcome.

Methods

This study was conducted prospectively at a large teaching hospital. All adult patients with 3- and 4-year follow-up data since the start of the study in 1998 to September 2007 were included. All data are expressed as mean ± SD. Pairwise correlation and ordinary least squares regression analysis was used to determine the strength of association between preoperative TBW loss and weight loss at 3 and 4 years.

Results

One hundred fifty patients (120 females), age 45.3 ± 8.9 years, were included. Their body mass indexes (BMIs), preoperatively and after 3 years, were 52.2 ± 9.8 and 35.4 ± 8.2 kg/m2, respectively. There was a significant correlation between preoperative and 3-year TBW lost (9.5 ± 6.8% vs 31.9 ± 11.7%, r = 0.302, p = 0.0002) and between excess body weight (EBW) lost preoperatively and after 3 years (16.1 ± 11.3% vs 55.1 ± 20.2%, r = 0.225, p = 0.006). Ninety five patients had follow-up data available at 4 years. Their mean preoperative BMI was 52.6 ± 9.7 kg/m2 and decreased to 37.5 ± 9.0 kg/m2. The TBW loss prior to and after surgery (10.0 ± 6.5% vs 29.4 ± 11.5%) was significantly correlated (r = 0.247, p = 0.015). The EBW loss preoperatively and after 4 years correlated positively (17.1 ± 11.1% vs 50.8 ± 19.8%, r = 0.205, p = 0.046).

Conclusion

There is a significant correlation between weight loss attained preoperatively and sustained weight loss at 3 and 4 years.

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References

  1. Anderson JW, Conley SB, Nicholas AS. One hundred pound weight losses with an intensive behavioral program: changes in risk factors in 118 patients with long-term follow-up. Am J Clin Nutr. 2007;86(2):301–7.

    PubMed  Google Scholar 

  2. Hill JO. Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev. 2006;27(7):750–61.

    PubMed  Google Scholar 

  3. Hill JO, Wyatt HR. Role of physical activity in preventing and treating obesity. J Appl Physiol. 2005;99(2):765–70.

    Article  PubMed  Google Scholar 

  4. Evans RK, Bond DS, Wolfe LG, et al. Participation in 150 min/week of moderate or higher intensity physical activity yields greater weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2007;3(5):526–30.

    Article  PubMed  Google Scholar 

  5. Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl J Med. 1995;332(10):621–8.

    Article  PubMed  CAS  Google Scholar 

  6. Badman MK, Flier JS. The gut and energy balance: visceral allies in the obesity wars. Science. 2005;305(5717):1909–14.

    Article  Google Scholar 

  7. Morinigo R, Moize V, Musri M, et al. Glucagon-like peptide 1, peptide YY, hunger and satiety after gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab. 2006;91(5):1735–40.

    Article  PubMed  CAS  Google Scholar 

  8. Chan JL, Mon EC, Stoyneva V, et al. Peptide YY levels are elevated after gastric bypass surgery. Obesity. 2006;14(2):194–8.

    Article  PubMed  CAS  Google Scholar 

  9. Korner J, Bessler M, Cirilo LJ, et al. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY and insulin. J Clin Endocrinol Metab. 2005;90(1):359–65.

    Article  PubMed  CAS  Google Scholar 

  10. Korner J, Inabnet W, Conwell IM, et al. Differential effects of gastric bypass and banding on circulating gut hormone and leptin levels. Obesity. 2006;14(9):1553–6

    Article  PubMed  CAS  Google Scholar 

  11. Alvarado R, Alami RS, Hsu G, Safadi BY, Sanchez BR, Morton JM, et al. The impact of preoperative weight loss undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1282–6.

    Article  PubMed  CAS  Google Scholar 

  12. Alami RS, Morton JM, Schuster R, Lie J, Sanchez BR, Peters A, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Disord. 2007;3:141–6.

    Article  Google Scholar 

  13. Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, et al. Outcomes of preoperative weight loss in high risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142(10):994–8.

    Article  PubMed  Google Scholar 

  14. Buchwald H. Bariatric surgery for morbid obesity: health implications for patients, health professionals, and third party payers. J Am Coll Surg. 2005;200:593–604.

    Article  PubMed  Google Scholar 

  15. Jakicic JM, Wing RR, Winters-Hart C. Relationship of physical activity to eating behaviors and weight loss in women. Med Sci Sports Exerc. 2002;34(10):1653–9.

    Article  PubMed  CAS  Google Scholar 

  16. Blumenthal JA, Babyak MA, Moore KA, et al. Effects of exercise training on older patients with major depression. Arch Intern Med. 1999;159(19):2349–56.

    Article  PubMed  CAS  Google Scholar 

  17. Liu RC, Sabnis AA, Forsyth C, Chand B. The effects of acute preoperative weight loss on laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2005;15:1396–402.

    Article  PubMed  Google Scholar 

  18. Buchwald H, Avidor Y, Braunwald E. Bariatric surgery: a systematic review and meta analysis. JAMA. 2004;292(14):1724–37.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

The authors thank Dr. Lyn Howard, MD, Professor, Division of Clinical Nutrition, Albany Medical College, Albany, NY, for her assistance in the recruitment and clinical care of the gastric bypass patients and Dr. Carl Rosati, MD, Associate Professor, Division of Trauma Surgery, Albany Medical College, Albany, NY, for his thoughtful review of this manuscript.

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Authors and Affiliations

  1. Department of Medicine, Division of Gastroenterology and Nutrition, Albany Medical College, MC-23, 47 New Scotland Ave., Albany, NY, 12208, USA

    Sharon Alger-Mayer

  2. Department of Pharmacy Practice, Albany College of Pharmacy, 106, New Scotland Ave., Albany, NY, 12208, USA

    John M. Polimeni & Margaret Malone

Authors
  1. Sharon Alger-Mayer
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  2. John M. Polimeni
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  3. Margaret Malone
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Correspondence to Sharon Alger-Mayer.

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Alger-Mayer, S., Polimeni, J.M. & Malone, M. Preoperative Weight Loss as a Predictor of Long-term Success Following Roux-en-Y Gastric Bypass. OBES SURG 18, 772–775 (2008). https://doi.org/10.1007/s11695-008-9482-2

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  • DOI: https://doi.org/10.1007/s11695-008-9482-2

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