4.4 Article

Analysis of Medium-Term Weight Regain 5 Years After Laparoscopic Sleeve Gastrectomy

Journal

OBESITY SURGERY
Volume 29, Issue 11, Pages 3508-3513

Publisher

SPRINGER
DOI: 10.1007/s11695-019-04009-w

Keywords

Sleeve gastrectomy; Weight regain; CT volumetry

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Objective Some patients fail to maintain weight loss after bariatric surgery. Weight regain (WR) disturbs the patients due to possible reappearance of obesity-related comorbidities. This study aimed to assess WR 5 years after laparoscopic sleeve gastrectomy (LSG). Patients and Methods This retrospective study included 100 adults who underwent LGS. The percentage of excess weight loss (%EWL) was recorded. WR was defined as an increase of at least 10% of the lowest postoperative weight. Patients with WR were subjected to CT gastric volumety. Eating behavior was assessed by the Three-Factor Eating Questionnaire-Revised 18-Items (TFEQ-R18). Results Preoperative comorbidities improved in 89.5% of the patients. Twenty-five females (32.5%) got pregnant within 3 years after surgery. Age, maximum weight loss, and uncontrolled and emotional eating scales of the TFEQ-R18 were independently affecting %EWL. Also, pregnancy negatively affected %EWL. Fourteen patients regain weight: 11 females and three males. CT volumetry of the 14 patients showed a median stomach volume of 515 mL (range 172-1066 mL). CT estimated gastric volume was negatively correlated with % EWL (r = - 0.674, p = 0.008). Patients who developed WR were significantly older (p = 0.006), with lower maximum weight loss, and having higher scores of uncontrolled and emotional eating scales of TFEQ-R18. Conclusion Medium-term postsurgical weight regain and unsuccessful weight loss in patients who had undergone LSG is associated with older age, maladaptive eating behavior, larger residual stomach, and pregnancy.

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