Early prediction of failure to lose weight after obesity surgery.
BACKGROUND
After Roux-en-Y gastric bypass (RYGB), failing to lose enough weight or regaining weight is a concern for both patients and healthcare professionals. Our objective was to report the criteria for an early prediction of the failure to lose enough weight in the setting of a private practice and an academic center of obesity surgery.


METHODS
A retrospective analysis of the 2-year weight loss profiles of patients after RYGB was performed using nonlinear mixed models. A total of 375 morbidly obese adult patients, with a body mass index of 49.3 ± 7.7 kg/m(2), were included. Weight loss success was determined 2 years after surgery using the percentage of excess weight loss criteria. The surgical treatment and the main outcome measurement was standardized RYGB and the percentage of excess weight loss time profiles.


RESULTS
The patients who failed, succeeded, or had intermediate results at 2 years after surgery had different percentage of excess weight loss profiles during this period. At 6 months, 71% of those who had lost <30% of their initial excess weight had not lost ≥50% at 24 months. In contrast, those who had lost >45% were unlikely to have lost <50% of their excess weight.


CONCLUSIONS
An early (month 6) prediction of failure to lose significant weight after RYGB can be made, with the threshold at 30% of the initial excess weight loss. Patients who have lost <30% of their initial excess weight are unlikely to have lost ≥50% at 24 months.
Department of Cardiovascular and Metabolic Diseases, CHU Toulouse, Toulouse, France. ritz.p@chu-toulouse.fr
Patrick
P
Ritz
Robert
R
Caiazzo
Guillaume
G
Becouarn
Laurent
L
Arnalsteen
Sandrine
S
Andrieu
Philippe
P
Topart
François
F
Pattou
D000328:Adult; D005260:Female; D005544:Forecasting; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors; D017211:Treatment Failure; D015431:Weight Loss / Q000502:physiology*