Patient Behaviors and Characteristics Related to... : Annals of Surgery

A Multicenter Prospective Cohort Study

Wendy C. King∗
Steven H. Belle†
Amanda S. Hinerman∗
James E. Mitchell‡
Kristine J. Steffen§
Anita P. Courcoulas¶

Annals of Surgery

272

(

)

1044

1052

December 2020

| DOI: 10.1097/SLA.0000000000003281

Objective:

To identify patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass surgery (RYGB).

Background:

There is considerable variation in the magnitude of weight regain after RYGB, highlighting the importance of patient-level factors.

Methods:

A prospective cohort study of adults who underwent bariatric surgery in 6 US cities between 2006 and 2009 included presurgery, and 6-month and annual assessments for up to 7 years. Of 1573 eligible participants, 1278 (81%) with adequate follow-up were included (80% female, median age 46 years, median body mass index 46 kg/m2). Percentage of maximum weight lost was calculated each year after weight nadir.

Results:

Weight was measured a median of 8 (25th–75th percentile, 7–8) times over a median of 6.6 (25th–75th percentile, 5.9–7.0) years. β coefficients, that is, the mean weight regain, compared with the reference, and 95% confidence interval, are reported. Postsurgery behaviors independently associated with weight regain were: sedentary time [2.9% (1.2–4.7), for highest vs lowest quartile], eating fast food [0.5% (0.2–0.7) per meal/wk], eating when feeling full [2.9% (1.2–4.5)], eating continuously [1.6% (0.1–3.1)], binge eating and loss-of-control eating [8.0% (5.1–11.0) for binge eating; 1.6 (−0.1 to 3.3) for loss of control, vs neither], and weighing oneself <weekly [4.2% (2.9–5.4)]. Postsurgery characteristics independently associated with greater weight regain included: younger age, venous edema, poorer physical function, and more depressive symptoms.

Conclusion:

Several behaviors and characteristics associated with greater weight regain were identified, which inform integrated healthcare approaches to patient care and identify high-risk patients to improve long-term weight loss maintenance after RYGB.