A research team from the Geisinger Clinic in Danville, Pennsylvania, has found that certain preoperative factors are associated with long-term weight loss after gastric bypass surgery.
The research findings, published in the journal JAMA Surgery, show the importance of taking into consideration certain preoperative clinical factors to predict weight loss after a popular bariatric surgery procedure called Roux-en-Y gastric bypass (RYGB).
Most bariatric surgery patients are expected to lose 30 to 40 percent of their body weight and up to 67 percent of excess body weight, depending on the type of surgery they undergo.
However, weight loss trajectories after bariatric surgery vary from one patient to the other and some people do not achieve or are unable to maintain expected weight losses.
Until now, scientists did not fully understand why, nor were they able to determine with precision the factors which result in better outcomes.
In this study, lead investigator, Michelle R. Lent, and her colleagues have discovered what help improve a patient’s chances of achieving optimal long-term weight loss.
The researchers followed 726 RYGB patients before surgery up to 7 to 12 years after surgery. They looked at their weight loss percentage and examined more than 200 preoperative clinical factors extracted from the electronic medical record, including medications, comorbidities, laboratory test results and demographics.
Among the study participants, 83 percent were female and 97 percent were Caucasia, with an average preoperative body mass index (BMI) of 47.5. Post-operatio, the average weight loss percentage of patients was 22.5 percent.
The results revealed greater long-term weight loss with preoperative insulin use (+7 percent), history of smoking (+3 percent), and taking 12 or more specific medications (+3 percent).
Hyperlipidemia (-3 percent), older age (-9 percent) and high body mass index (-4 percent) prior to surgery were, however, associated with poorer long-term weight loss.
Although further studies are needed to replicate these findings, as well as considering potential preoperative psychosocial and behavioural factors, researchers hope these preliminary results can help to guide clinical care prior to bariatric surgery.

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