Abstract

Abstract Introduction Outcomes of long-term (5-10 year) weight loss have not been investigated thoroughly and the role of pre-operative weight loss on long-term weight loss, among other factors, are unknown. Our regional bariatric service introduced a 12-week intensive pre-operative information course (IPIC) to optimise pre-operative weight loss and provide education prior to bariatric surgery. The present study determines the effect of pre-operative weight loss and an intense pre-operative information course (IPIC), on long-term weight outcomes and sustained weight loss post-bariatric surgery. Methods Data were collected prospectively from a bariatric center (2008-2022). Excess weight loss (EWL) ≥50% and ≥70% were considered outcome measures. Survival analysis and logistic regression identified variables associated with overall and sustained EWL≥50% and ≥70%. Results 339 patients (median age, 49 years; median follow-up, 7 years [0.5-11years]; median EWL%, 49.6%.) were evaluated, including 158 gastric sleeve and 161 gastric bypass. During follow-up 273 patients (80.5%) and 196 patients (53.1%) achieved EWL≥50% and ≥70%, respectively. In multivariate survival analyses, pre-operative weight loss through IPIC, both <10.5% and >10.5%EWL, were positively associated with EWL≥50% (HR2.23,p<0.001) and EWL≥70% (HR 3.24,p<0.001), respectively. After a median of 6.5years after achieving EWL50% or EWL70%, 56.8% (154/271) had sustained EWL50% and 50.6% (85/168) sustained EWL70%. Higher pre-operative weight loss through IPIC increased the likelihood of sustained EWL≥50% (OR,2.36;p=0.013) and EWL≥70% (OR,2.03;p=0.011) at the end of follow up. Conclusions IPIC and higher pre-operative weight loss improve weight loss post-bariatric surgery and reduce the likelihood of weight regain during long-term follow-up.

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