Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group

Abstract

Background

There is little robust data on weight regain (WR) after bariatric surgery making it difficult to counsel patients regarding long-term outcomes of different bariatric procedures. The purpose of this study was to see WR in medium and long term after SG, RYGB, and OAGB in Indian population.

Methods

In a multicentre study, data on preoperative and postoperative weights over 5 years were collected. Multiple definitions were applied to find the proportion of patients with significant WR increase of 25% of lost weight from nadir (definition 1), weight gain of > 10 kg from nadir (definition 2), and BMI gain of > 5 kg/m2 from nadir (definition 3). The proportion of those with significant WR was compared across sub-groups.

Results

A total of 9617 patients were included. Median WR at 5 years was 14.1% of lost weight, 1.92 kg/m2, and 5 kg. Significant WR using definition 1 was 35.1%, 14.6%, and 3% after sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and mini-one anastomosis gastric bypass (OAGB) respectively. Severe albumin deficiency was highest in OAGB (5.9%) patients followed by SG (2.9%) and RYGB (2.2%) at 5 years(p = 0.023). Haemoglobin levels < 10 g/dL were seen in 8.2%, 9.0%, and 13.9% of SG, RYGB, and OAGB patients respectively (p = 0.041).

Conclusions

In the first comparative study of WR, OAGB had lesser WR in comparison to SG and RYGB but had the most impact on Hb and albumin levels in the long term. Definition selection for reporting WR has a significant impact on the results. There is a need for standardising the reporting of WR in bariatric literature.

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Acknowledgments

We are thankful to Dr. Aparna Govil Bhasker for the help in organising the study as well as guidance in writing the manuscript, Kankona Dey for the help in data compilation, Dr. Laila Baig for organising the consensus meeting, Manjari Agarwal for data compilation, and Mr. Souvik Dutta for statistical analysis.

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SJB, KM, and SS conceived the idea for the topic. SJB initiated the research and wrote the manuscript. PP collected most of the data and wrote the manuscript. SJB and PP contributed equally to the manuscript. KM and SS wrote and edited parts of the manuscript. All authors participated in the discussions on the topic. All authors have seen the final version and approve of it.

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Correspondence to Pallawi Priya.

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IBSOR Collaborators

Dr. Abhay Agarwal - Apollo Hospitals, Mumbai, India; Hinduja Hospitals, Mumbai, India; Sevenhills Hospitals, Mumbai, India

Dr. Arun Prasad - Manipal Hospitals, Dwarka, New Delhi, India

Dr. Atul Peters - Apollo Institute of Metabolic and Bariatric Surgery, New Delhi, India

Dr. Deep Goel - BLK Superspeciality Hospital, New Delhi, India

Dr. Digvijaysingh Bedi - Hope Obesity Centre, Ahmedabad, India

Dr. Jaydeep H. Palep - Nanavati Superspeciality Hospital, Mumbai, India

Dr. Lakshmi Kona Kumari - Gleneagles Global Hospital, Hyderabad

Dr. Mahendra Narwaria - Asian Bariatrics Pvt ltd, Ahmedabad, India

Dr. Manish Baijal - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Manish Khaitan - Columbia Asia Hospital, Ahmedabad, India

Dr. Mathias Fobi - Mohak Bariatrics and Robotics, Indore, India

Dr. Mohit Bhandari - Mohak Bariatrics and Robotics, Indore, India

Dr. Nandkishore Dukipatti - Livlife Hospitals, Hyderabad, India

Dr. Nidhi Khandelwal - Nanavati Superspeciality Hospital, Mumbai, India

Dr. Om Tantia - ILS Hospitals, Kolkata

Dr. P. Pravin Raj - Gem Hospital and Research Centre, Coimbatore, India

Dr. Pallawi Priya - Belle Vue Clinic, Kolkata, India

Dr. Parveen Bhatia - Bhatia Global Hospital, Sir Ganga Ram Hospital, New Delhi, India

Dr. Pradeep Chowbey - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Rajkumar Palaniappan - Apollo Hospitals, Chennai, India

Dr. Rajkumar JS - Lifeline Hospitals, Chennai, India

Dr. Rajesh Khullar - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Ramen Goel - Wockhardt Hospital, Mumbai, India

Dr. Randeep Wadhawan - Fortis Hospitals, Vasan Kunj, New Delhi, India

Dr. Sarfaraz J. Baig - Belle Vue Clinic, Kolkata, India

Dr. Shivaram HV - Aster CMI Hospital, Bengaluru, India

Dr. Sreejoy Pattnaik - Shanti Memorial Hospital, Cuttack, India

Dr. Sudheer Kalhan - Sir Ganga Ram Hospital, New Delhi, India

Dr. Sumeet Shah - Max Smart Superspeciality Hospital, New Delhi, India

Dr. Surendra Ugale - Kirloskar Hospitals, Hyderabad, India

Dr. Vandana Soni - Max Superspeciality Hospital Saket, New Delhi, India

Dr. Vivek Bindal - Sir Ganga Ram Hospital, New Delhi, India

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Baig, S.J., Priya, P., Mahawar, K.K. et al. Weight Regain After Bariatric Surgery—A Multicentre Study of 9617 Patients from Indian Bariatric Surgery Outcome Reporting Group. OBES SURG 29, 1583–1592 (2019). https://doi.org/10.1007/s11695-019-03734-6

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Keywords

  • Bariatric surgery
  • Obesity surgery
  • Weight regain
  • Sleeve gastrectomy
  • Gastric sleeve
  • Gastric bypass
  • Roux-en-Y gastric bypass
  • Mini-one anastomosis gastric bypass