title: Milestone Weight Loss Goals (Weight Normalization and Remission of Obesity) after Gastric Bypass Surgery: Long-Term Results from the University of Michigan.
abstract: Rates of weight normalization and obesity remission after Roux-en-Y gastric bypass (GB) are unknown. This study evaluated weight loss, rates of achieving body mass index (BMI) <25 or 30 kg/m2, recidivism, and predictors of success following GB.
  
  
  
  We retrospectively studied weight and BMI at baseline, 2 and 6 months, and annually at 1-7 years in 219 patients undergoing GB at the University of Michigan from January 2008 to November 2010.
  
  
  
  Follow-up was excellent for a population traditionally associated with high attrition rates with data availability of 157/219, 145/219, 144/219, 134/219, 123/219, 82/161, and 29/64 patients at 1-7 years, respectively. Mean baseline BMI was 47.0 kg/m2. Weight normalization (BMI <25 kg/m2) occurred in 2.3-6.8% of patients. More importantly, 47% of patients achieved remission of obesity (BMI <30 kg/m2) at some time point and 24% (52/219) at the last observed time point. BMI <30 kg/m2was associated with a lower initial BMI and follow-up for more than 2 years.
  
  
  
  Rates of weight normalization are low after GB; however, a large number of patients achieved BMI <30 kg/m2. While the percent total weight loss and excess weight loss are both quite high in the entire cohort and this is likely associated with significant health benefits, our results still underscore the need to address obesity with intensive clinical attention earlier in its course.
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA.
authors.forename: Corey J
authors.initials: CJ
authors.lastname: Lager
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA.
authors.forename: Nazanene H
authors.initials: NH
authors.lastname: Esfandiari
authors.affiliation: Division of Endocrinology, University of Mississippi, 2500 N. State St., Jackson, MS, 39216, USA.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Subauste
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Kraftson
authors.affiliation: Department of Biostatistics, School of Public Health, University of Michigan, M4039 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.affiliation: Division of Minimally Invasive Surgery, Department of General Surgery, University of Michigan, 1500 E Medical Center Dr SPC 5343, Ann Arbor, MI, 48109, USA.
authors.forename: Ruth B
authors.initials: RB
authors.lastname: Cassidy
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA.
authors.forename: Darlene
authors.initials: D
authors.lastname: Bellers
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Lockwood
authors.affiliation: Division of Minimally Invasive Surgery, Department of General Surgery, University of Michigan, 1500 E Medical Center Dr SPC 5343, Ann Arbor, MI, 48109, USA.
authors.forename: Oliver A
authors.initials: OA
authors.lastname: Varban
authors.affiliation: Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan Health Systems, Brehm Center for Diabetes, 1000 Wall Street, Room 5313, Ann Arbor, MI, 48105, USA. eliforal@med.umich.edu.
authors.forename: Elif A
authors.initials: EA
authors.lastname: Oral
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Gastric bypass; Metabolism; Obesity; Weight loss; Weight normalization