Funding agencies: This work was supported by funds from Geisinger Clinic, the Weis Center for Research, the Geisinger Obesity Institute, and NIH grants DK072488 (GSG, CDS, GA, and XC), DK088231 (GSG), and DK091601 (GSG) from the NIH.
Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery
Article first published online: 6 FEB 2014
Copyright © 2013 The Obesity Society
Volume 22, Issue 3, pages 888–894, March 2014
How to Cite
Still, C. D., Wood, G. C., Chu, X., Manney, C., Strodel, W., Petrick, A., Gabrielsen, J., Mirshahi, T., Argyropoulos, G., Seiler, J., Yung, M., Benotti, P. and Gerhard, G. S. (2014), Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity, 22: 888–894. doi: 10.1002/oby.20529
Disclosure: Dr. Still receives grant and consulting support from Ethicon-Endosurgery. Dr. Petrick has educational grants from Covidien and Ethicon-Endosurgery.
Author contributions: Drs. Still and Gerhard and Mr. Wood had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Still, Wood, Benotti, Argyropoulos, and Gerhard. Acquisition of data: Wood, Chu, Manney, Strodel, Petrick, Gabrielsen, Still, and Seiler. Statistical analysis and interpretation: Gerhard, Still, Wood, and Benotti. Drafting of the manuscript: Benotti, Gerhard, Argyropoulos, Mirshahi, Still, and Wood. Critical revision of the manuscript for important intellectual content: Benotti, Gerhard, Argyropoulos, Mirshahi, Strodel, Petrick, Gabrielsen, Still. Obtaining funding: Gerhard, Argyropoulos, and Still. Administrative, technical or material support: Yung, Manney, Seiler. Study supervision: Gerhard, Still.
- Issue published online: 5 MAR 2014
- Article first published online: 6 FEB 2014
- Accepted manuscript online: 26 JUN 2013 12:43PM EST
- Manuscript Accepted: 28 MAY 2013
- Manuscript Received: 1 FEB 2013
Gastric bypass surgery is an effective therapy for extreme obesity. However, substantial variability in weight loss outcomes exists that remains largely unexplained. Our objective was to determine whether any commonly collected preoperative clinical variables were associated with weight loss following Roux-en-Y gastric bypass (RYGB) surgery.
The analysis was based on a prospectively recruited observational cohort of 2,365 patients who underwent Roux-en-Y gastric bypass surgery from 2004 to 2009. Weight loss was stratified into three major phases, early (0-6 months), nadir, and long-term (>36 months). Multivariate regression models were constructed using a database of over 350 variables.
A total of 12-14 preoperative variables were independently associated (P < 0.05) with each of the temporal weight loss phases. Preoperative variables associated with poorer nadir and long-term weight loss included higher baseline BMI, higher preoperative weight loss, iron deficiency, use of any diabetes medication, nonuse of bupropion medication, no history of smoking, age >50 years, and the presence of fibrosis on liver biopsy.
Several variables previously associated with poorer weight loss after RYGB surgery including age, baseline BMI, and type 2 diabetes were replicated. Several others suggest possible clinical interventions for postoperative management of RYGB patients to improve weight loss outcomes.