TOPLINE:

Among patients with obesity undergoing laparoscopic sleeve gastrectomy, those with lower preoperative BMI and < 25% total body weight loss (TBWL) at 12 months were at higher risk for rapid recurrent weight gain (RRWG) within 2 years after surgery.

METHODOLOGY:

• The specific risk factors contributing to RRWG within 2 years after bariatric surgery remain unclear.
• To identify risk factors for RRWG, researchers conducted a retrospective cohort study of patients with a preoperative BMI ≥ 32.5 who underwent primary laparoscopic sleeve gastrectomy.
• Body weight, blood pressure, and laboratory parameters were assessed before surgery, at scheduled visits through 12 months after surgery, and annually thereafter up to 5 years.
• The primary endpoint was recurrent weight gain within 2 years after sleeve gastrectomy, defined as regaining at least 20% of the weight lost during the first postoperative year.

TAKEAWAY:

• A total of 201 patients (median age, 39.7 years; 50.2% female) were analyzed, including 19 who experienced RRWG and 182 who maintained weight loss.
• At 12 months, weight-loss measures were similar between groups except for lower TBWL in the RRWG group (32.23% vs 34.96%; P = .033). By 24 months, however, the RRWG group had significantly lower excess body weight loss and TBWL than the weight-loss maintenance group (P < .001 for both).
• By years 3 and 4, the RRWG group exhibited significantly higher rates of recurrent weight gain (P < .001 and P = .009, respectively).
• Compared with the weight-loss maintenance group at 24 months, the RRWG group had worse metabolic outcomes, including a higher prevalence of diabetes (26.32% vs 7.14%), more frequent worsening of dyslipidemia from 12 to 24 months (57.89% vs 25.27%), and a lower remission rate of hypertension (46.15% vs 62.50%).
• In a multivariable analysis, preoperative BMI < 37.4 and TBWL < 25% at 12 months independently predicted RRWG within 2 years after surgery (P = .001 and P = .036, respectively).

IN PRACTICE:

“Incorporating multidisciplinary strategies that include psychiatric and bariatric care could be beneficial in reducing the risk of RRWG and improving long-term metabolic health,” the authors of the study wrote.

SOURCE:

The study was led by Wei-Leng Chin, I-Shou University, Kaohsiung City, Taiwan. It was published online in Obesity Surgery.

LIMITATIONS:

The retrospective, single-center design may have introduced selection bias and limited generalizability. The small number of RRWG events limited the precision of adjusted estimates, and residual confounding could not be excluded. Follow-up for metabolic outcomes was limited to 2 years.

DISCLOSURES:

The study received no specific funding from agencies in the public, commercial, or not-for-profit sectors. The authors reported 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.