Low Educational Status and Childhood Obesity Associated with Insufficient Mid-Term Weight Loss After Sleeve Gastrectomy: a Retrospective Observational Cohort Study.

Abstract

Successful weight loss after bariatric surgery has been associated with a variety of factors. The aim of this study was to determine the effects of educational status on surgical weight loss for patients undergoing sleeve gastrectomy (SG). This retrospective cohort study was carried out on patients undergoing SG between September 2013 and July 2015. Sixmonths after surgery, the patients were classified into two groups according to their success in the percentage of excess weight loss (%EWL). Group 1: <%50EWL (insufficient WL) and group 2: ≥%50EWL (successful WL) in the sixth month. The independent predictors for insufficient weight loss six months after SG were analyzed. In the sixth post-operative month, their mean %EWL and percentage of excess body mass index loss (%EBMIL) were 50 ± 15.4 and 58.2 ± 19.3, respectively. In univariate analysis, group 1 patients were found to be significantly older when compared to group 2 patients while the education level of group 2 patients was significantly higher when compared to group 1. A tertiary educational level at a university or higher was associated with a nearly fourfold increased success in weight loss (AOR 3.772, p = 0.03) 6months after SG. Multivariate analysis showed that patients with a history of childhood obesity were more likely to have insufficient weight loss (AOR 0.390, p = 0.045). Childhood obesity and a lower level of education are associated with insufficient weight loss 6months after SG. However, prospective external validation is warranted, with a long-term follow-up of a large bariatric surgery population.