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Long-Term Effect of Gastric Bypass and Sleeve Gastrectomy on Severe Obesity: Do Preoperative Weight Loss and Binge Eating Behavior Predict the Outcome of Bariatric Surgery?

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Abstract

Background

Few studies have examined weight loss sustainability after sleeve gastrectomy (SG). The purpose of this study was to determine long-term outcome after SG and gastric bypass (GBP) and learn whether preoperative weight loss and binge eating behavior can be used to predict outcome.

Materials and Methods

Together, 257 patients (64 % women) were operated, 163 by GBP and 94 by SG. Binge eating was assessed by binge eating scale (BES) and preoperative weight loss was advised to all, including very low-calorie diet for 5 weeks. Postoperative visits took place at 1 and 2 years, and long-term outcome was at median 5 years (range 2.29–6.85). Multivariate linear regression analysis was used to predict outcome at 2-year and long-term control.

Results

Median age was 48 years, weight 141.1 kg, and BMI 48.2 kg/m2. Preoperative weight loss was median 4.9 % before GBP and 3.8 % before SG, P = 0.04. Total weight loss at year one was 24.1 % in GBP and 23.7 % in SG (P = 0.40), at year two 24.4 and 23.4 % (P = 0.26), and at long-term control 23.0 and 20.2 % (P = 0.006), respectively. Weight was analyzed in 93, 88, and 89 % of those alive, respectively. BES did not predict weight outcome, but larger preoperative weight loss predicted less postoperative weight loss at 2 years.

Conclusion

On long term, weight loss was better maintained after GBP compared with SG. Binge eating behavior was not a significant predictor, but larger preoperative weight loss predicted less postoperative weight loss for the next 2 years.

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Authors and Affiliations

  1. Abdominal Center, Peijas Hospital, Helsinki University Hospital, P.O. Box 900, FIN-00029 HUS, Vantaa, Finland

    Tuula Pekkarinen, Nabil Jaser, Anne Juuti & Marja Leivonen

  2. University of Helsinki and Helsinki University Hospital, P.O. Box 440, FIN-00029 HUS, Helsinki, Finland

    Harri Mustonen

  3. Abdominal Center, Meilahti Hospital, Helsinki University Hospital, P.O. Box 340, FIN-00029 HUS, Helsinki, Finland

    Timo Sane

Authors
  1. Tuula Pekkarinen
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  2. Harri Mustonen
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  4. Nabil Jaser
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Correspondence to Tuula Pekkarinen.

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The authors declare that they have no conflict of interest.

Statement of Human Rights

This study protocol was approved by the Ethics Committee of Helsinki University Hospital and performed in compliance with the Declaration of Helsinki. All procedures were performed in accordance with the ethical standards of the regional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Pekkarinen, T., Mustonen, H., Sane, T. et al. Long-Term Effect of Gastric Bypass and Sleeve Gastrectomy on Severe Obesity: Do Preoperative Weight Loss and Binge Eating Behavior Predict the Outcome of Bariatric Surgery?. OBES SURG 26, 2161–2167 (2016). https://doi.org/10.1007/s11695-016-2090-7

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