TOPLINE

Approximately one in four individuals experienced significant weight regain (≥ 25% of maximal weight lost) more than 2 years following bariatric surgery. Inappropriate eating behaviors were strongly associated with weight regain, with patients reporting fewer inappropriate eating behaviors having more than three times higher odds of maintaining optimal weight regain outcomes.

METHODOLOGY

• Although weight regain after bariatric surgery has been widely studied, most research has focused on outcomes within the first 2 years after surgery, and data on long-term weight regain outcomes remain limited.
• Researchers randomly selected 234 adults (mean age, 46.00 years; 70.94% women) from a private medical center database who underwent bariatric surgery more than 2 years earlier to assess long-term weight regain and identify associated factors; an optimal weight regain outcome was defined as regaining less than 25% of the maximal weight lost after bariatric surgery.
• Analysis included demographic characteristics, surgical factors (type of procedure, preoperative BMI, revision surgery history), lifestyle behaviors (physical activity, nutrition habits, smoking status), support variables (family or friends support for surgery and consultations with a dietitian, psychologist, and physician), and quality of life.
• Procedures included restrictive-only surgeries (sleeve gastrectomy and adjustable gastric banding, 51.28%) and procedures with bypass (gastric bypass and one-anastomosis gastric bypass, 48.71%).
• Patients were assessed 2 to 27 years after surgery, with an average of 8.97 years.

TAKEAWAY

• At follow-up, 75.6% of the patients achieved an optimal weight regain outcome.
• In multivariable analyses, male sex was significantly associated with higher odds of achieving an optimal weight regain outcome (odds ratio [OR], 3.45; P = .009).
• Fewer inappropriate eating behaviors (OR, 3.17) and smoking (OR, 9.75) were significantly associated with higher odds of achieving an optimal weight regain outcome. Additionally, receipt of dietitian support was associated with lower odds of weight regain (OR, 0.34; P < .05 for all).
• An exploratory model found similar results and explained about 27% of the variation in weight regain, with eating behaviors making the strongest contribution.

IN PRACTICE

"These findings suggest that long-term clinical response of bariatric surgery may be influenced not only by the surgical procedure itself but also by sociodemographic characteristics, healthy behaviors, and support-related factors," the authors of the study wrote.

SOURCE

The study was led by Lani Ofri, Ariel University, Ariel, Israel. It was published online in Obesity Surgery.

LIMITATIONS

The study population was drawn from a single medical center, which may have limited the generalizability of the findings to broader bariatric surgery populations. The analysis relied on self-reported data, which may have introduced reporting bias. Moreover, the study did not include a formal sample-size calculation, and the small number of smokers may have made the smoking-related findings less reliable.

DISCLOSURES

Funding information for the study was not explicitly reported. The authors disclosed having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.