Early Post-operative Weight Change After Roux-en-Y Gastric Bypass Predicts Weight Loss at 12-Month Follow-up
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ORIGINAL CONTRIBUTIONS
Early Post-operative Weight Change After Roux-en-Y Gastric Bypass Predicts Weight Loss at 12-Month Follow-up Flavia Carvalho Silveira 1 & Neil Gerard Docherty 2 & Paulo Clemente Sallet 3,4 & Marcos Moraes 4 & Thomaz Monclaro 4 & Margaretth Arruda e Silva 4 & Carlos Eduardo Pizani 4 & José Afonso Sallet 5 & Carel Wynand le Roux 2 Received: 14 January 2020 / Revised: 17 August 2020 / Accepted: 18 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Sub-optimal weight loss following Roux-en-Y gastric bypass (RYGB) represents an important clinical challenge in a significant number of patients. Early identification of such patients would be advantageous, as it could aid in the selective implementation of targeted adjunct interventions during the first post-operative year. Methods Clinical audit data from 1137 patients undergoing RYGB between 2013 and 2016 at the Instituto Sallet in Brazil were prospectively registered in an online database (BOLD) and analyzed. Results Forty-eight percent of patients achieving less than 5% total weight loss after the first post-operative month achieved a 20% total weight loss at 1 year (n = 626; OR = 0.6 CI = 95%). Eighty-three percent of patients losing between 5 and 10% at 1 month and 95% of patients losing greater than 10% at 1 month had lost at least 20% of total body weight after the first postoperative year. Forty-four percent of patients achieving less than 10% total weight loss after the third post-operative month achieved 20% total weight loss at 1 year (n = 494; OR = 0.3 CI = 95%). Conclusion Total bodyweight reduction after RYGB of < 5% at 1 month and < 10% at 3 months is associated with suboptimal weight loss at 1 year. These results reinforce findings from other studies reporting that patients tend to follow a common weight loss trajectory. Identifying the patients with weight trajectory requiring adjunct therapies early on is crucial so appropriate adjustments can be made to post-operative care. Keywords Obesity . Bariatric surgery . Roux-en-Y gastric bypass . % weight loss . BMI
José Afonso Sallet and Carel le Roux contributed equally to this work. * Flavia Carvalho Silveira [email protected]
José Afonso Sallet [email protected] Carel Wynand le Roux [email protected]
Neil Gerard Docherty [email protected] Paulo Clemente Sallet [email protected] Marcos Moraes [email protected] Thomaz Monclaro [email protected] Margaretth Arruda e Silva [email protected] Carlos Eduardo Pizani [email protected]
1
NYU Langone Weight Management Program, NYU Langone Medical Center, 530 1st Avenue, Suite 10S, New York, NY 10016, USA
2
Diabetes Complications Research Centre Conway Institute, School of Medicine, University College Dublin, Dublin 4, Ireland
3
Department of Psychiatry Faculty of Medicine, University of São Paulo, São Paulo, Brazil
4
Instituto de Medicina Sallet, São Paulo, Brazil
5
Bariatric and Metabolic Surgery (SRC), Instituto de Medicina Sallet, São
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