Obesity Surgery

, Volume 27, Issue 5, pp 1137–1144 | Cite as

Weight Regain 10 Years After Roux-en-Y Gastric Bypass

  • Daniela Vicinansa Monaco-Ferreira
  • Vânia Aparecida Leandro-Merhi
Original Contributions



This study aims to investigate weight regain and the associated variables 10 years after Roux-en-Y gastric bypass.


This retrospective study recruited patients submitted to Roux-en-Y gastric bypass (N = 166) for a 10-year follow-up. The following variables were investigated: body mass index (BMI), percentage of excess weight loss (%EWL), weight regain (WR), and percentage of weight regain (%WG). The chi-squared test or Fisher’s exact test compared proportions, and the Mann-Whitney test compared numerical measurements between the groups. Analysis of variance (ANOVA) compared the measurements over time. The significance level was set at 5 %.


The sample had a mean age of 39.59 ± 11.69 years, and females prevailed (71.7 %). In the long-term follow-up, 41 % of the patients had weight regain. Seventy-two months after surgery, excess weight, preoperative BMI, gender, age, nutritional monitoring, and iron deficiency did not explain weight regain. Younger patients had regained significantly more weight 96 (p = 0.008) and 120 months (p = 0.004) after surgery than older patients. Patients who regained weight had ferritin <15 μg/dL 96 months after surgery (p = 0.019).


Patients submitted to Roux-en-Y gastric bypass presented weight regain, which increased over time. Age, iron deficiency, and time since surgery were associated with weight regain in the long-term follow-up.


Weight regain Bariatric surgery Gastric bypass 



We thank the Pontifical Catholic University of Campinas, SP, Brazil and the Coordination for the Improvement of Higher Education Personnel for the master’s scholarship provided to the Master’s Program in Health Sciences of PUC-Campinas, SP, Brazil.

Compliance with Ethical Standards

Statement of Authorship

DVMF conceived and designed the study, collected and analyzed the data, and wrote the manuscript. VALM helped to conceive the study, supervised the research, and reviewed the manuscript. The authors read and approved the final version of the article.


This project was not sponsored.

Conflict of Interests

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Does not apply. For this type of study, formal consent is not required.


  1. 1.
    Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011 Aug;378(9793):804–14.CrossRefPubMedGoogle Scholar
  2. 2.
    World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Genebra: WHO; 2013. Available at: 11/09/2016.
  3. 3.
    Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica (ABESO): Diretrizes Brasileiras de Obesidade 2009–2010; 3a ed. p.19–22. Disponivel em: Acess em: 19/03/2016.
  4. 4.
    World Health Organization. Global Health Observatory (GHO): Obesity. WHO; 2016. Disponível em: 11/3/2016.
  5. 5.
    Instituto Brasileiro de Geografia e Estatística-IBGE. Pesquisa Nacional de Saúde: Percepção do Estado de Saúde, Estilos de Vida e Doenças Crônicas 2013. Disponível em: Acess 13/03/2016.
  6. 6.
    Steffen R, Potoczna N, Bieri N, et al. Successful multi-intervention treatment of severe obesity: a 7-year prospective study with 96 % follow-up. Obes Surg. 2009;19(1):3–12.CrossRefPubMedGoogle Scholar
  7. 7.
    Buchwald H, Buchwald JN, McGlennon TW. Systematic review and meta-analysis of medium-term outcomes after banded Roux-en-Y gastric bypass. Obes Surg. 2014;24(9):1536–51.CrossRefPubMedGoogle Scholar
  8. 8.
    Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux en Y—500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10(3):233–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Chakravartty S, Tassinari D, Salerno A, et al. What is the mechanism behind weight loss maintenance with gastric bypass? Curr Obes Rep. 2015;4(2):262–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Umeda LM, Silva EA, Carneiro G, et al. Early improvement in glycemic control after bariatric surgery and its relationships with insulin, GLP-1 and glucagon secretion in type 2 diabetic patients. Obes Surg. 2011;21(7):896–901.CrossRefPubMedGoogle Scholar
  11. 11.
    Faulconbridge LF, Wadden TA, Thomas JG, et al. Changes in depression and quality of life in obese individuals with binge eating disorder: bariatric surgery versus lifestyle modification. Surg Obes Relat Dis. 2013;9(5):790–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Aguera Z, Garcia-Ruiz-de-Gordejuela A, Vilarrasa N, et al. Psychological and personality predictors of weight loss and comorbid metabolic changes after bariatric surgery. Eur Eat Disord Rev. 2015;23(6):509–16.CrossRefPubMedGoogle Scholar
  13. 13.
    Khawali C, Ferraz MB, Zanella MT, et al. Evaluation of quality of life in severely obese patients after bariatric surgery carried out in the public healthcare system. Arquivos Brasileiros de Endocrinologia & Metabologia. 2012;56(1):33–8.CrossRefGoogle Scholar
  14. 14.
    Nicoletti CF, de Oliveira BA, de Pinhel MA, et al. Influence of excess weight loss and weight regain on biochemical indicators during a 4-year follow-up after Roux-en-Y gastric bypass. Obes Surg. 2015;25(2):279–84.CrossRefPubMedGoogle Scholar
  15. 15.
    Christou NV, Look D, Maclean LD. Weight gain after short and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Magro DO, Geloneze B, Delfini R, et al. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51.CrossRefPubMedGoogle Scholar
  17. 17.
    Freire RH, Borges MC, Alvarez-Leite JI, et al. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Barhouch AS, Padoin AV, Casagrande DS, et al. Predictors of excess weight loss in obese patients after gastric bypass: a 60-month follow-up. Obes Surg. 2016;26(6):1178–85.CrossRefPubMedGoogle Scholar
  19. 19.
    Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.CrossRefPubMedGoogle Scholar
  20. 20.
    Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.CrossRefPubMedGoogle Scholar
  21. 21.
    Cooper TC, Simmons EB, Webb K, et al. Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg. 2015;25(8):1474–81.CrossRefPubMedGoogle Scholar
  22. 22.
    Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity. 2014;22(3):888–94.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Higa K, Ho T, Tercero F, et al. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25.CrossRefPubMedGoogle Scholar
  24. 24.
    Puzziferi N, Roshek TB, Mayo HG, et al. Long-term follow-up after bariatric surgery. A systematic review. J Am Med Assoc. 2014;312(9):934–42.CrossRefGoogle Scholar
  25. 25.
    Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13(2):159–60.CrossRefPubMedGoogle Scholar
  26. 26.
    Novais PF, Rasera Junior I, Leite CV, et al. Body weight evolution and classification of body weight in relation to the results of bariatric surgery: Roux-en-Y gastric bypass. Arquivos Brasileiros de Endocrinologia e Metabologia. 2010;54(3):303–10.CrossRefPubMedGoogle Scholar
  27. 27.
    World Health Organization Iron deficiency anaemia: assessment, prevention, and control: a guide for programme managers, Geneva. WHO, 2001. Disponível em: http:/ Acesso em 19/03/2016
  28. 28.
    World Health Organization Serum ferritin concentrations for the assessment of iron status and iron deficiency in populations. Vitamin and mineral nutrition information system. Geneva, WHO, 2011 (WHO/NMH/NHD/MNM/11.2). Disponível em: Acesso em: 18/03/2016.
  29. 29.
    SAS system for Windows (Statistical Analysis System), versão 9.4. SAS Institute Inc, 2002–2012, Cary, NC, USA.Google Scholar
  30. 30.
    Conover WJ. Practical nonparametric statistics. 3ª ed. Nova Iorque: Wiley; 1999.Google Scholar
  31. 31.
    Conover WJ, Iman RL. Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat. 1981;35(3):124–9.Google Scholar
  32. 32.
    Tabachnick BG, Fidell LS. Using multivariate statistics, 4th ed. Boston: Allyn and Bacon; 2001. p. 966.Google Scholar
  33. 33.
    World Health Organization: Physical status: the use and interpretation of anthropometry. Report of a WHO expert committee. Geneva. WHO technical report series; 854, 1995. Disponível em:
  34. 34.
    Berti LV, Campos J, Ramos A, et al. Position of the SBCBM—nomenclature and definition of outcomes of bariatric and metabolic surgery. Arquivos Brasileiros de Cirurgia Digestiva (ABCD). 2015;28(1):2.CrossRefGoogle Scholar
  35. 35.
    Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.CrossRefPubMedGoogle Scholar
  36. 36.
    Sjöström G, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMedGoogle Scholar
  37. 37.
    Cambi MP, Marchesini SD, Baretta GA. Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation. Arquivos Brasileiros de Ciruriga Digestiva (ABCD). 2015;28(1):40–3.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Daniela Vicinansa Monaco-Ferreira
    • 1
  • Vânia Aparecida Leandro-Merhi
    • 1
    • 2
  1. 1.Graduate Program in Health SciencesPuc-CampinasCampinasBrazil
  2. 2.School of NutritionPuc-CampinasCampinasBrazil

Personalised recommendations