title: Low Educational Status and Childhood Obesity Associated with Insufficient Mid-Term Weight Loss After Sleeve Gastrectomy: a Retrospective Observational Cohort Study.
abstract: Successful weight loss after bariatric surgery has been associated with a variety of factors. The aim of this study was to determine the effects of educational status on surgical weight loss for patients undergoing sleeve gastrectomy (SG).
  
  
  
  This retrospective cohort study was carried out on patients undergoing SG between September 2013 and July 2015. Six months after surgery, the patients were classified into two groups according to their success in the percentage of excess weight loss (%EWL). Group 1: <%50EWL (insufficient WL) and group 2: ≥%50EWL (successful WL) in the sixth month. The independent predictors for insufficient weight loss six months after SG were analyzed.
  
  
  
  In the sixth post-operative month, their mean %EWL and percentage of excess body mass index loss (%EBMIL) were 50 ± 15.4 and 58.2 ± 19.3, respectively. In univariate analysis, group 1 patients were found to be significantly older when compared to group 2 patients while the education level of group 2 patients was significantly higher when compared to group 1. A tertiary educational level at a university or higher was associated with a nearly fourfold increased success in weight loss (AOR 3.772, p = 0.03) 6 months after SG. Multivariate analysis showed that patients with a history of childhood obesity were more likely to have insufficient weight loss (AOR 0.390, p = 0.045).
  
  
  
  Childhood obesity and a lower level of education are associated with insufficient weight loss 6 months after SG. However, prospective external validation is warranted, with a long-term follow-up of a large bariatric surgery population.
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey. edilektasli@gmail.com.
authors.forename: Evren
authors.initials: E
authors.lastname: Dilektasli
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Erol
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Haci Murat
authors.initials: HM
authors.lastname: Cayci
authors.affiliation: Department of Biostatistics, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Guven
authors.initials: G
authors.lastname: Ozkaya
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Mehmet Emrah
authors.initials: ME
authors.lastname: Bayam
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Duman
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Necdet D
authors.initials: ND
authors.lastname: Tihan
authors.affiliation: Department of General Surgery, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Erdogdu
authors.affiliation: Department of Endocrinology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.
authors.forename: Gurcan
authors.initials: G
authors.lastname: Kisakol
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004522:Educational Status; D005260:Female; D005743:Gastrectomy / Q000534:rehabilitation / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000601:surgery*; D010353:Patient Education as Topic; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
keywords: Childhood obesity; Education level; Failure; Sleeve gastrectomy; Success; Weight loss