Weight regain after gastric bypass: etiology and treatment options.
Roux-en-Y gastric bypass (RYGB) is one of the most common operations performed for the patients with morbid obesity. Weight regain (WR) is a complication that may decrease efficiency of the surgical treatment and demand further interventions. Different factors including lifestyle, mental health, hormonal/metabolic and surgical plays role in WR after RYGB. Various treatment options have been proposed for WR. Conservative treatment is less effective than surgery. Endoscopic refashioning of gastric pouch/stoma fails to achieve sustainable weight loss. Surgical reduction of pouch has acceptable short-term results, but WR after 3 years is substantial. Banded gastric bypass achieves good short-term results, but long-term follow-up data are needed. Distalization of RYGB has a high risk of protein calorie malnutrition (PCM) and conversion to BP diversion (BPD)/duodenal switch (DS) is a technically demanding procedure. Both procedures achieve sustainable long-term weight loss. More studies are needed to explore long-term results of various surgical interventions for WR after RYGB.
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania;; Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Almantas
A
Maleckas
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Rita
R
Gudaitytė
Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Rūta
R
Petereit
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Linas
L
Venclauskas
Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Džilda
D
Veličkienė
Bariatric surgery; gastric bypass; review; weight regain etiology; weight regain treatment