Sustained weight loss after gastric bypass surgery

A study published online in JAMA Surgery has evaluated the preoperative factors that are associated with long term weight loss after Roux-en-Y gastric bypass (RYGB). Weight loss trajectories following gastric bypass have been variable from person to person and some patients are not able to maintain weight loss. In this study 726 RYGB patients were followed up 7 to 12 years after surgery, and weight loss and preoperative clinical factors were compared. Factors such as preoperative insulin use, smoking and use of 12 or more medications were associated with a greater long term weight loss. Factors such as preoperative hyperlipidaemia, older age and higher BMI were associated with a poorer outcome.

The authors speculate that these findings may be due to an increased interaction with healthcare professionals or perhaps due to unintentional weight loss from other health conditions. They go on to say that more studies are needed to evaluate these medications separately in relation to long term weight loss. More studies are needed to investigate psychosocial, behavioural and other modifiable factors. As these findings seem to suggest that the sickest patients seem to have the best outcomes – contrary to previous studies – more research is needed to confirm the conclusions.