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. 2019 Feb;27(2):217-225.
doi: 10.1002/oby.22360. Epub 2018 Nov 13.

Weight Recidivism After Roux-en-Y Gastric Bypass Surgery: An 11-Year Experience in a Multiethnic Medical Center

Dylan D Thomas  1 , Wendy A Anderson  2 , Caroline M Apovian  1 , Donald T Hess  2 , Liqun Yu  1 , Amanda Velazquez  1   3 , Brian Carmine  2 , Nawfal W Istfan  1
Affiliations

Weight Recidivism After Roux-en-Y Gastric Bypass Surgery: An 11-Year Experience in a Multiethnic Medical Center

Dylan D Thomas et al. Obesity (Silver Spring). 2019 Feb.

Abstract

Objective: Weight recidivism following Roux-en-Y gastric bypass (RYGB) is common and is associated with recurrence of comorbidities. Studies with long-term follow-up of recidivism quantified by weight regain (WR) are lacking. A retrospective review of all RYGB at our center from 2004 to 2015 was performed to examine the effects of race and type 2 diabetes on WR following RYGB.

Methods: Multivariable linear mixed models were used for the effects of time and race on weight, WR relative to nadir weight (WR/nadir), and WR relative to maximal weight loss, and Cox regressions were used for low, moderate, and high WR/nadir.

Results: A total of 1,395 participants were identified. The sample was limited to African American (AA), Caucasian American (CA), and Hispanic American (HA) participants. The effects of time (P < 0.0001), race (P < 0.0001), and race × time interaction (P = 0.0008) on weight trajectory were significant. AA had significantly more WR than CA (P < 0.01). AA and HA had a higher hazard ratio for having low, moderate, and rapid WR/nadir.

Conclusions: Racial disparities after RYGB include WR and particularly affect AA. Understanding the etiologic factors that contribute to these disparities is important to optimize the long-term clinical outcomes of bariatric surgery.

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Figures

Figure 1:
Figure 1:
Weight trajectory after RYGB in a racially mixed patient population. Weights shown as a percent of the immediate pre-operative weight. A) mean ± SE for all subjects; B) means ± SE by race. AA: African American; HA: Hispanic American; CA: Caucasian American. Number of subjects at baseline, 1–2 years, 2–3 years, 3–4 years, 4–5 years, 5–6 years, beyond 6 years: Overall: 603, 576, 465, 327, 214, 157, 147 AA: 195, 187, 163, 119, 73, 52, 57 HA: 100, 98, 74, 61, 35, 22, 17 CA: 308, 291, 228, 147, 106, 83, 73
Figure 1:
Figure 1:
Weight trajectory after RYGB in a racially mixed patient population. Weights shown as a percent of the immediate pre-operative weight. A) mean ± SE for all subjects; B) means ± SE by race. AA: African American; HA: Hispanic American; CA: Caucasian American. Number of subjects at baseline, 1–2 years, 2–3 years, 3–4 years, 4–5 years, 5–6 years, beyond 6 years: Overall: 603, 576, 465, 327, 214, 157, 147 AA: 195, 187, 163, 119, 73, 52, 57 HA: 100, 98, 74, 61, 35, 22, 17 CA: 308, 291, 228, 147, 106, 83, 73
Figure 2:
Figure 2:
A. Weight regain over time by race. B. Weight regain / maximum weight loss over time by race. C. Weight regain / nadir weight over time by race. D. Monthly weight regain / maximal weight loss over time by race.
Figure 2:
Figure 2:
A. Weight regain over time by race. B. Weight regain / maximum weight loss over time by race. C. Weight regain / nadir weight over time by race. D. Monthly weight regain / maximal weight loss over time by race.
Figure 2:
Figure 2:
A. Weight regain over time by race. B. Weight regain / maximum weight loss over time by race. C. Weight regain / nadir weight over time by race. D. Monthly weight regain / maximal weight loss over time by race.
Figure 2:
Figure 2:
A. Weight regain over time by race. B. Weight regain / maximum weight loss over time by race. C. Weight regain / nadir weight over time by race. D. Monthly weight regain / maximal weight loss over time by race.
Figure 3:
Figure 3:
Cox regression for weight regain / nadir greater than the thresholds of 1.49%, 6.25%, and 14.29% by race A. Weight regain/nadir weight >1.49%. B. Weight regain/nadir weight >6.25%. C. Weight regain/nadir weight >14.29%.
Figure 3:
Figure 3:
Cox regression for weight regain / nadir greater than the thresholds of 1.49%, 6.25%, and 14.29% by race A. Weight regain/nadir weight >1.49%. B. Weight regain/nadir weight >6.25%. C. Weight regain/nadir weight >14.29%.
Figure 3:
Figure 3:
Cox regression for weight regain / nadir greater than the thresholds of 1.49%, 6.25%, and 14.29% by race A. Weight regain/nadir weight >1.49%. B. Weight regain/nadir weight >6.25%. C. Weight regain/nadir weight >14.29%.
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