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. 2017 Oct;13(10):1728-1734.
doi: 10.1016/j.soard.2017.06.004. Epub 2017 Jun 23.

Weight regain in patients with symptoms of post-bariatric surgery hypoglycemia

Sanskriti Varma  1 , Jeanne M Clark  2 , Michael Schweitzer  3 , Thomas Magnuson  3 , Todd T Brown  4 , Clare J Lee  5
Affiliations

Weight regain in patients with symptoms of post-bariatric surgery hypoglycemia

Sanskriti Varma et al. Surg Obes Relat Dis. 2017 Oct.

Abstract

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×(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.

Keywords: Bariatric surgery; Glucose metabolism; Postbariatric hypoglycemia; Treatment outcomes; Weight regain.

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Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of Post-bariatric Surgery Hypoglycemic Symptoms PBSH: Post-Bariatric Surgery Hypoglycemia, Each bar reflects [number of respondents with PBSH symptoms]/[number of respondents who regained the specified amount of weight]: ≤0%WR = [19/89]; 0–5.6%WR = [24/84]; 5.6–10.8%WR = [36/86]; 10.8–19.4%WR = [38/82]; >19.4%WR = [28/87].
Figure 2
Figure 2
Odds of Regaining over 10% of Maximum Weight Loss given the Potential Clinical Correlates RYGB: Roux-en-Y Gastric Bypass. SG: Sleeve Gastrectomy.
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