[Insufficient loss of weight and/or absence of DM2 remission after Roux-en-Y gastric bypass: factors that may influence the unsatisfactory results]

Abstract

Background: Roux-en-Y gastric by-pass is considered one of the most effective treatments for maintaining long-term weight loss. However, it is associated to failures manifested by the inability to maintain weight loss, weight gain or poor glycemic control.

Objective: Study the possible factors that influence weight loss failure and/or DM2 remission.

Methods: Case-control study of 159 patients submitted to gastric by-pass two or more years postoperatively. Twenty-four individuals with unsatisfactory weight loss and/or DM2 remission were selected as cases and 24 with satisfactory weight loss and/or absence of DM2 remission as controls, matched for age and postoperative time.

Results: Of the 24 cases and controls evaluated, the percentage weight gain was 19.32% and 8.68%, percentage DM2 remission 26.6% and 87.5% and percentage DM2 recurrence 6.6% and 0.0%, respectively. Cases and controls exhibited mean maximum preoperative BMI of 53.50±12.24 kg/m2 and 48.77±5.19 kg/m2, respectively. These values were statistically significant in terms of poor weight management or failed surgery.

Conclusion: Patients with elevated initial maximum BMI (≥ 50kg/m2) displayed higher weight loss failure rates. Food intolerance and socioeconomic differences are considered factors in weight gain.