Weight regain after gastric bypass

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Gastric bypass is a validated sustained weight loss in patients with a BMI> 35-40kg / m2.Weight regain 18-24 months after gastric bypass surgery poses several problems: i) taking into account the intensity of weight loss (about 66% of the initial excess weight) of some resumption kg should be regarded as a failure questioning other benefits?(Metabolic, reducing mortality and the number of cancers), ii) should be considered as some patients at risk recovery to intervene earlier behavior or assembly surgery?

Method

To assess the reality and the determinants of weight regain we analyzed available data from the cohort of 1000 patients operated in Lille and Angers and extracted data of patients with complete records to 2 years (n=3 8) and applied criteria “medical” weight regain.Indeed weight stability is considered a strategy after non-surgical weight loss, when the eventual recovery of weight does not exceed 5% of weight lost.Weight regain was found between 12 and 24 months.Baseline and weight change early (between 0 and 1 months) and 12 months were compared between patients with stable weight (recovery <5% weight loss at 12 months) and those who regained weight (recovery> 5% weight loss)

Results

On average, 358 patients continued to lose weight between 12 and 24 months (2.6% weight loss at 24 months more than 12 months).Weight loss between 12 and 24 months was not influenced by sex, BMI category starting ( 50 kg / m2), the initial weight loss, or surgical team (Lille or Angers).More weight loss is important between 0 and 12 months, and the weight loss continues between 12 and 24 months (p=0 008).Between 12 and 24 months, 108 patients have taken more than 5% of the weight lost.They do not differ from others by age, sex, weight or BMI starting initial excess weight, or initial weight loss (0-1 months).These patients lost less weight at 12 months (38 ± 13kg) other (42 ± 14kg p=0 001).The 108 patients regained an average of 17.7 ± 17.4% of the weight lost, while another 250 lost 11.3 ± 17.4% higher.

Conclusion

In conclusion, approximately one third of patients with a gastric bypass resume more than 5% weight loss at 12 months.These patients did not differ from those who will continue to lose between 12 and 24 months, except for the fact that their weight loss is a little less intense than 12 months.This suggests that weight loss began to bend soon after surgery and the initial weight loss is not an obstacle to weight loss later.Given the importance of weight loss at 12 months, a recovery of 5% (about 8 kg) of weight lost as a criterion is quite conservative.The translation of this weight regain in “loss of benefits (metabolic …)” must be evaluated.

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