Dietary and psych predictors of weight loss after gastric bypass.
BACKGROUND
Identifying severely obese patients who will succeed after bariatric surgery remains challenging. Although numerous studies have attempted to identify preoperative patient characteristics associated with weight loss, the roles of many dietary and psychological characteristics are unclear. The purpose of this study was to examine preoperative dietary and psychological predictors of successful weight loss after bariatric surgery.


METHODS
This retrospective cohort study included all patients who underwent laparoscopic Roux-en-Y gastric bypass from September 2011-June 2013 at a single institution (n = 124). Patient demographics, comorbidities, dietary and psychological factors, and weight loss outcomes were extracted from the electronic medical record. Bivariate associations between these factors and successful weight loss (≥50% excess body weight) were examined. Factors significant at P ≤ 0.1 were included in a multivariate logistic regression model.


RESULTS
On bivariate analysis, absence of either type 2 diabetes or hypertension, preoperative weight <270 lbs, no intentional past weight loss >50 lbs, no previous purging or family history of obesity, and no soda consumption preoperatively were associated with successful weight loss (P < 0.1). On multivariate analysis, successful weight loss was inversely associated with the presence of type 2 diabetes (odds ratio [OR], 0.22, 95% confidence interval [CI], 0.06-0.73), maximum intentional past weight loss >50 lbs (OR, 0.12 [95% CI, 0.04-0.43]), and decreasing soda consumption by >50% (OR, 0.27 [95% CI, 0.08-0.99]).


CONCLUSIONS
Patients with type 2 diabetes mellitus, significant previous weight loss, and poor soda consumption habits are more likely to experience suboptimal weight loss after bariatric surgery. Additional preoperative counseling and close postoperative follow-up is warranted for these patients.
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Benjamin
B
Fox
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Ellie
E
Chen
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Andrew
A
Suzo
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Sally
S
Jolles
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Jacob A
JA
Greenberg
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Guilherme M
GM
Campos
Center for Health Services Research in Primary Care, Department of Veterans Affairs, Durham, North Carolina; Department of Medicine, Duke University Medical Center, Durham, North Carolina.
Corrine I
CI
Voils
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: funk@surgery.wisc.edu.
Luke M
LM
Funk
D000328:Adult; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods / Q000523:psychology*; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D057234:Preoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
Bariatric surgery; Health services research; Roux-en-Y gastric bypass