Weight Loss and Eating Pattern 7 Years After Sleeve Gastrectomy: Experience of a Bariatric Center of Excellence

Abstract

Purpose

Report the analysis from a single center series of consecutive primary sleeve gastrectomy (SG) on the factors affecting weight loss at long term.

Materials and Methods

Patients submitted to primary SG with a follow-up of 7 years were screened. Weight loss was evaluated with %excess weight loss (%EWL) and %excess BMI loss (%BMIL). Weight regain (WR) was defined as in increase of 25% of the obtained %EWL and insufficient weight loss (IWL) as loss < 50% EWL. Eating behaviors were evaluated with 7 days record (7dR). All the variables potentially affecting the weight loss were cross-matched for correlation. The study population was divided in three groups: group A (WR), group B (IWL), and group C (sustained weight loss) for comparative analysis.

Results

A total of 86 patients (21 M/65 F) with a preoperative BMI of 47.08 ± 6.15 kg/m2 were evaluated. Cumulative 7 years weight loss was as follows: 61.66 ± 22.69% EWL and 32 ± 9% EBMIL. A total of 4.6% had an IWL while 27.9% a WR. The analysis showed a significant difference among the daily calories and fats consuming, number of meals, physical activity, grazing/sweet eating habits, and adherence to follow-up (p < 0.05) between groups A and C. Cox hazard demonstrated a significant risk (p < 0.05) to WR in case of adherence to follow-up shorter than 48 months, high daily calories, and fats intake (hazard ratio (HR) range 5–9). Eight patients (9.3%) had a surgical revision.

Conclusion

Our data demonstrated that long-term results (7 years) of SG are strongly related to eating habits and patient’s behaviors.

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Correspondence to Angelo Iossa.

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This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required. 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.

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Iossa, A., Coluzzi, I., Giannetta, I.B. et al. Weight Loss and Eating Pattern 7 Years After Sleeve Gastrectomy: Experience of a Bariatric Center of Excellence. OBES SURG 30, 3747–3752 (2020). https://doi.org/10.1007/s11695-020-04699-7

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Keywords

  • Weight regain
  • Sleeve gastrectomy
  • Insufficient weight loss
  • Bariatric surgery failure
  • Long-term results