Abstract
BackgroundCurrently, bariatric surgery is the most effective treatment for severe obesity and its metabolic complications; however, 15–35% of the patients that undergo bariatric surgery do not reach their goal for weight loss. The aim of this study was to determine the proportion of patients that didn’t reach the goal of an excess weight loss of 50% or more during the first 12 months and determine the factors associated to this failure.MethodsWe obtained the demographic, anthropometric and biochemical information from 130 patients with severe obesity who underwent bariatric surgery in our institution between 2012 and 2017. We used self-reports of physical activity, caloric intake and diet composition. An unsuccessful weight loss was considered when the patient lost < 50% or more of the excess weight 12 months after surgery. We compared the characteristics between the successful and unsuccessful groups in order to find the factors associated with success.ResultsWe included 130 patients (mean age 48 ± 9 years, 81.5% were women). One year after surgery, 26 (20%) had loss < 50% EBW. Unsuccessful surgery was associated with an older age, previous history of hypertension, abdominal surgery or depression/anxiety, also the number of comorbidities and unemployment affected the results. These patients loss enough weight to improve some of their comorbidities, but they are more prone to regain weight 2 years after surgery.ConclusionsA fifth of the patients undergoing bariatric surgery may not lose enough weight to be considered successful by current standards. Some patients may benefit from the surgery in the short term, but they are more likely to regain weight after 2 years. The factors influencing this result are still controversial but may be population-specific. Early detection of the patients that are more likely to fail is imperative to establish additional therapeutic strategies, without denying them the opportunity of surgery or waiting for weight re-gain to occur.
Highlights
Bariatric surgery is the most effective treatment for severe obesity and its metabolic complications; 15–35% of the patients that undergo bariatric surgery do not reach their goal for weight loss
We aimed to determine the proportion of patients that didn’t reach the goal of an excess weight loss of 50% or more during the first 12 months in our center and to determine if there is any baseline clinical or laboratory characteristic that may be used as early predictors of this result
We found a significant inverse correlation between the baseline Body Mass Index (BMI) and the %Excess body weight (EBW) lost at 12 months (R = − 0.356, p < 0.001), meaning that the patients with Grade II obesity were likely to lose most of the EBW, patients in grade 3 obesity had a %EBWL of 63.7% (IQR 52–72%), patients with super obesity lost 63.5% EBW (IQR of 54–66%) while the super super obese patients lost between only 57% of EBW (IQR 36–65%) during the first year
Summary
Bariatric surgery is the most effective treatment for severe obesity and its metabolic complications; 15–35% of the patients that undergo bariatric surgery do not reach their goal for weight loss. The aim of this study was to determine the proportion of patients that didn’t reach the goal of an excess weight loss of 50% or more during the first 12 months and determine the factors associated to this failure. In Mexico, the last National Health and Nutrition Survey (ENSANUT 2016) [1], reported that the prevalence of overweight was 39.2% while obesity was 33.3%, which means that less than one third of the population is currently in a healthy weight. 2.9% of the Obesity is associated with comorbidities that increase morbidity and mortality among the affected population. In patients with severe obesity or those with BMI > 35 kg/m2 and other comorbidities, bariatric A BMI of 30–35 kg/m2 reduces the life expectancy by 2 to 4 years and a BMI of 40–45 reduces it by 8 to 10 years [2].
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