title: Predictability of first-year weight loss in laparoscopic sleeve gastrectomy.
abstract: Bariatric surgery is a significant investment for the patient and weight loss team. In some cases, this includes a requirement for pre-operative weight loss despite the lack of evidence for a correlation with successful outcomes. We sought to determine whether weight loss on a short, immediate pre-operative diet, as well as across the medical weight loss program, would correlate with 1-year outcomes of patients undergoing laparoscopic sleeve gastrectomy (LSG).
  
  
  
  All patients having a LSG between March 2013 and March 2016 were reviewed. Demographics and biometrics [weight, body mass index (BMI)] were collected at initial, day of surgery and follow-up (2 weeks, 6 weeks, 4 months, and 1 year). Pre-operative weight loss was determined both cumulative (initial to day of surgery) and for the pre-operative diet (2 weeks). Weight loss and percent excess weight loss (%EWL) were calculated and correlated at all time points.
  
  
  
  A total of 127 patients were reviewed for this study. The mean %EWL at 1-year follow-up was 47 ± 18%. Weight loss achieved on a 2-week pre-operative diet did not correlate with weight outcomes at 1-year follow-up (r = 0.134, p = 0.40); however, cumulative pre-operative weight loss had a modest correlation (r = 0.443, p < 0.01). Post-operative %EWL at 4 months had the best correlation with longer term weight loss (r = 0.730, p < 0.01).
  
  
  
  Pre-operative performance is not a good predictor for 1-year outcomes in LSG. Better correlation was observed in %EWL at post-surgery visits. Following the patient's trajectory post-operatively may provide a window for intervention to improve weight loss.
authors.affiliation: Department of Surgery, Mount Sinai Hospital, 1500 South Fairfield Avenue, Chicago, IL, USA. amcnickle@medicine.nevada.edu.|Department of Surgery, University of Nevada School of Medicine, 1701 West Charleston Blvd, Suite 400, Las Vegas, NV, 89102, USA. amcnickle@medicine.nevada.edu.
authors.forename: Allison G
authors.initials: AG
authors.lastname: McNickle
authors.affiliation: Division of Minimally Invasive Surgery, Department of Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Bonomo
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D004038:Diet, Reducing; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy / Q000601:surgery*; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Laparoscopic sleeve gastrectomy; Pre-operative weight loss; Prediction of weight loss