Patient Behaviors and Characteristics Related to Weight Regain After Roux-en-Y Gastric Bypass: A Multicenter Prospective Cohort Study

Abstract

Objective: To identify patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass surgery (RYGB).

Background: There is considerable variation in the magnitude of weight regain after RYGB, highlighting the importance of patient-level factors.

Methods: A prospective cohort study of adults who underwent bariatric surgery in 6 US cities between 2006 and 2009 included presurgery, and 6-month and annual assessments for up to 7 years. Of 1573 eligible participants, 1278 (81%) with adequate follow-up were included (80% female, median age 46 years, median body mass index 46 kg/m). Percentage of maximum weight lost was calculated each year after weight nadir.

Results: Weight was measured a median of 8 (25th-75th percentile, 7-8) times over a median of 6.6 (25th-75th percentile, 5.9-7.0) years. β coefficients, that is, the mean weight regain, compared with the reference, and 95% confidence interval, are reported. Postsurgery behaviors independently associated with weight regain were: sedentary time [2.9% (1.2-4.7), for highest vs lowest quartile], eating fast food [0.5% (0.2-0.7) per meal/wk], eating when feeling full [2.9% (1.2-4.5)], eating continuously [1.6% (0.1-3.1)], binge eating and loss-of-control eating [8.0% (5.1-11.0) for binge eating; 1.6 (-0.1 to 3.3) for loss of control, vs neither], and weighing oneself <weekly [4.2% (2.9-5.4)]. Postsurgery characteristics independently associated with greater weight regain included: younger age, venous edema, poorer physical function, and more depressive symptoms.

Conclusion: Several behaviors and characteristics associated with greater weight regain were identified, which inform integrated healthcare approaches to patient care and identify high-risk patients to improve long-term weight loss maintenance after RYGB.