Journal
SURGERY FOR OBESITY AND RELATED DISEASES
Volume 13, Issue 10, Pages 1728-1734Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.soard.2017.06.004
Keywords
Weight regain; Bariatric surgery; Glucose metabolism; Treatment outcomes; Postbariatric hypoglycemia
Categories
Funding
- National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health [K23 DK107921]
- National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) [UL1 TR001079]
- NIH Roadmap for Medical Research
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Background: Weight regain (WR) and symptoms of post bariatric surgery hypoglycemia (PBSH) are metabolic complications observed in a subset of postbariatric patients. Whether hypoglycemic symptoms are an important driver of increased caloric intake and WR after bariatric surgery is unknown. Objective: This study aims to determine whether patients with PBSH symptoms have greater odds for WR. Setting: Tertiary academic hospital. Methods: Patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy at our tertiary academic hospital from August 2008 to August 2012 were mailed a survey, from which weight trajectory and PBSH symptoms were assessed. Percent WR was calculated as 100 x (current weight nadir weight)/(preoperative weight nadir weight) and was compared between dates of survey completion and bariatric surgery. The primary outcome was WR >= 10%, as a reflection of the median WR among respondents. Multivariable logistic regression was used to determine clinical factors that indicate greater odds for WR >= 10% at the P <.05 level. Results: Of 1119 potential patients, 428 respondents (40.6%) were eligible for analysis. WR was observed in 79.2% (n = 339), while 20.8% (n = 89) experienced either weight loss or no WR at a mean of 40.6 +/- 14.5 months. Median WR was 10.8% (interquartile range, 5.6-19.4). Odds of WR >= 10% was significantly increased in those who experienced PBSH symptoms (odds ratio [OR] = 1.66; 95% confidence interval [CI]: 1.04-2.65), reported less adherence to nutritional guideline (OR = 2.36; 95% CI: 1.52-3.67), and had a longer time since surgery (OR = 1.05; 95% CI: 1.03-1.07). Conclusions: We found evidence that the presence of PBSH symptoms was associated with WR. Future studies should elucidate the role of hypoglycemia among other factors in post bariatric surgery WR. (C) 2017 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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