Analysis of Medium-Term Weight Regain 5 Years After Laparoscopic Sleeve Gastrectomy

Obes Surg. 2019 Nov;29(11):3508-3513. doi: 10.1007/s11695-019-04009-w.

Abstract

Objective: Some patients fail to maintain weight loss after bariatric surgery. Weight regain (WR) disturbs the patients due to possible reappearance of obesity-related comorbidities. This study aimed to assess WR 5 years after laparoscopic sleeve gastrectomy (LSG).

Patients and methods: This retrospective study included 100 adults who underwent LGS. The percentage of excess weight loss (%EWL) was recorded. WR was defined as an increase of at least 10% of the lowest postoperative weight. Patients with WR were subjected to CT gastric volumety. Eating behavior was assessed by the Three-Factor Eating Questionnaire-Revised 18-Items (TFEQ-R18).

Results: Preoperative comorbidities improved in 89.5% of the patients. Twenty-five females (32.5%) got pregnant within 3 years after surgery. Age, maximum weight loss, and uncontrolled and emotional eating scales of the TFEQ-R18 were independently affecting %EWL. Also, pregnancy negatively affected %EWL. Fourteen patients regain weight: 11 females and three males. CT volumetry of the 14 patients showed a median stomach volume of 515 mL (range 172-1066 mL). CT estimated gastric volume was negatively correlated with % EWL (r = - 0.674, p = 0.008). Patients who developed WR were significantly older (p = 0.006), with lower maximum weight loss, and having higher scores of uncontrolled and emotional eating scales of TFEQ-R18.

Conclusion: Medium-term postsurgical weight regain and unsuccessful weight loss in patients who had undergone LSG is associated with older age, maladaptive eating behavior, larger residual stomach, and pregnancy.

Keywords: CT volumetry; Sleeve gastrectomy; Weight regain.

MeSH terms

  • Adult
  • Body Mass Index
  • Feeding Behavior / physiology
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / pathology
  • Obesity, Morbid / surgery*
  • Postoperative Period
  • Retrospective Studies
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Weight Gain / physiology*
  • Weight Loss / physiology
  • Young Adult