Weight loss surgery (WLS) is neither risk-free nor universally effective. Few studies have examined what proportion of patients regret having undergone WLS.
We interviewed patients at two WLS centers before and after WLS about weight loss, quality of life/QOL (Impact of Weight on QOL-lite), and decision regret (modified Brehaut Regret scale, range 0–100). We conducted separate multivariable logistic regression models to examine the association between weight loss and ∆QOL scores and having decision regret (score > 50).
Of 205 RYGB patients, only 2.2% (year 1) to 5.1% (year 4, n = 134) reported regret scores > 50 over 4 years; 2.0–4.5% did not think they made the right decision; 2.0–4.5% would not undergo WLS again. In contrast, of 188 gastric banding patients (n = 123 at year 4), 8.2–20.3% had regret scores > 50; 5.9–19.5% did not think they made the right decision; 7.1–19.5% would not undergo WLS again. Weight loss and ∆QOL scores were significant correlates of decision regret after banding although weight loss was a stronger correlate with lower model quasi-likelihood under the independence model criterion score. Four years after banding, mean weight loss for patients with regret scores > 50 was 7.4% vs. 21.1% for those with scores < 50; the AOR for regret score > 50 was 0.90 (95% CI 0.87–0.94) for every 1% greater weight loss. Poor sexual function, but not weight loss or other QOL factors, was significantly correlated with decision regret after RYGB.
Few patients regret undergoing RYGB but 20% regret undergoing gastric banding with weight loss being a major driver.
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This study was funded by R01 DK073302; one of the authors (CW) also received support from a NIH midcareer mentorship award (NIH K24 DK087932).
The study was approved by institutional review boards (IRB) at the Beth Israel Deaconess Medical Center, Boston Medical Center, and University of Massachusetts Center for Survey Research (all in Boston, MA).
Conflict of Interest
One of the authors reports ownership interest in Allurion (DJ). Another author (CA) also reports receiving consulting fees for being on the advisory boards of Nutrisystem, Zafgen, Sanofi-Aventis, Orexigen, EnteroMedics, GI Dynamics, Scientific Intake, Gelesis, Novo Nordisk, SetPoint Health, Xeno Biosciences, Rhythm Pharm, Eisai, and Takeda, and research funding from Aspire Bariatrics, GI Dynamics, Orexigen, Takeda and the Vela Foundation, Gelesis, Energesis, and Coherence Lab; this author also participated in the Takeda Speakers Bureau for the medication Contrave and owned stock in Science-Smart LLC.
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Wee, C.C., Fleishman, A., McCarthy, A.C. et al. Decision Regret up to 4 Years After Gastric Bypass and Gastric Banding. OBES SURG 29, 1624–1631 (2019). https://doi.org/10.1007/s11695-019-03772-0