Maintenance of weight loss after body contouring surgery for massive weight loss.
BACKGROUND
Weight loss can be achieved through gastric bypass surgery or diet. Surgery has been reported to be more effective in achieving long-term weight loss. The authors aimed to determine whether massive weight loss is maintained or improved after body contouring.


METHODS
Seventy patients underwent body contouring surgery after massive weight loss from January of 2001 to January of 2005. Data collected included age; gender; mode of massive weight loss; body mass index before massive weight loss, at contour surgery, and at follow-up; and weight of skin excised.


RESULTS
Weight loss was achieved by open (n = 57) or laparoscopic gastric bypass surgery (n = 7), or by diet (n = 6). Average weight loss at contour surgery was 152 lb for open gastric bypass, 139 lb for laparoscopic gastric bypass, and 140 lb for the diet group. Mean weight of excised skin was 12.8 lb. Gastric bypass patients on average gained 2.3 lb, whereas nonsurgical patients gained 22 lb after body contouring, netting out skin excised. On multivariate analysis, weight loss did not differ between laparoscopic and open gastric bypass (p = 0.9); however, surgery led to a 27-lb greater weight loss compared with diet (p = 0.03). This effect was more remarkable with follow-up less than or equal to 18 months compared with more prolonged follow-up. Every year increase in age was associated with an 0.8-lb weight gain (p = 0.03).


CONCLUSIONS
Gastric bypass surgery patients maintain massive weight loss better than "diet" patients. Weight loss tapers over time for gastric bypass surgery patients, with ultimate weight gain, comparable to that seen in the general population as it ages.
Shermak
Michele A
MA
Baltimore, Md. From the Department of Surgery and Division of Plastic Surgery, The Johns Hopkins Medical Institutions.
Bluebond-Langner
Rachel
R
Chang
David
D
D000222:Adaptation, Physiological; D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss