Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.
Open accessAbstract
IMPORTANCE: Severe obesity (body mass index [BMI] ≥35) is associated with a broad range of health risks. Bariatric surgery induces weight loss and short-term health improvements, but little is known about long-term outcomes of these operations. OBJECTIVE: To report 3-year change in weight and select health parameters after common bariatric surgical procedures. DESIGN AND SETTING: The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium is a multicenter observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers. PARTICIPANTS AND EXPOSURE: Adults undergoing first-time bariatric surgical procedures as part of routine clinical care by participating surgeons were recruited between 2006 and 2009 and followed up until September 2012. Participants completed research assessments prior to surgery and 6 months, 12 months, and then annually after surgery. MAIN OUTCOMES AND MEASURES: Three years after Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB), we assessed percent weight change from baseline and the percentage of participants with diabetes achieving hemoglobin A1c levels less than 6.5% or fasting plasma glucose values less than 126 mg/dL without pharmacologic therapy. Dyslipidemia and hypertension resolution at 3 years was also assessed. RESULTS: At baseline, participants (N = 2458) were 18 to 78 years old, 79% were women, median BMI was 45.9 (IQR, 41.7-51.5), and median weight was 129 kg (IQR, 115-147). For their first bariatric surgical procedure, 1738 participants underwent RYGB, 610 LAGB, and 110 other procedures. At baseline, 774 (33%) had diabetes, 1252 (63%) dyslipidemia, and 1601 (68%) hypertension. Three years after surgery, median actual weight loss for RYGB participants was 41 kg (IQR, 31-52), corresponding to a percentage of baseline weight lost of 31.5% (IQR, 24.6%-38.4%). For LAGB participants, actual weight loss was 20 kg (IQR, 10-29), corresponding to 15.9% (IQR, 7.9%-23.0%). The majority of weight loss was evident 1 year after surgery for both procedures. Five distinct weight change trajectory groups were identified for each procedure. Among participants who had diabetes at baseline, 216 RYGB participants (67.5%) and 28 LAGB participants (28.6%) experienced partial remission at 3 years. The incidence of diabetes was 0.9% after RYGB and 3.2% after LAGB. Dyslipidemia resolved in 237 RYGB participants (61.9%) and 39 LAGB participants (27.1%); remission of hypertension occurred in 269 RYGB participants (38.2%) and 43 LAGB participants (17.4%). CONCLUSIONS AND RELEVANCE: Among participants with severe obesity, there was substantial weight loss 3 years after bariatric surgery, with the majority experiencing maximum weight change during the first year. However, there was variability in the amount and trajectories of weight loss and in diabetes, blood pressure, and lipid outcomes. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00465829.
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Insurance Coverage Criteria for Bariatric Surgery: A Survey of Policies
Gebran, S. G., Knighton, B., Ngaage, L. M., Rose, J. A., Grant, M. P., Liang, F., Nam, A. J., Kavic, S. M., Kligman, M. D., & Rasko, Y. M. (2020) · Obesity Surgery · doi:10.1007/s11695-019-04243-2 · Cited by 56 · see citing works
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Lifestyle Management for Enhancing Outcomes after Bariatric Surgery
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Distress Tolerance and Psychological Comorbidity in Patients Seeking Bariatric Surgery
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Behavioral Interventions to Attenuate Driven Overeating and Weight Regain After Bariatric Surgery
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“In examining long-term weight loss, the outcome will vary widely by type of procedure and by patient characteristics (3).”
BackgroundUrinary sodium excretion after gastric bypass surgery
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Reward-related decision making and long-term weight loss maintenance
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- Authors
- Courcoulas, A. P.
- Affiliations
- University of Pittsburgh Medical Center (US)
- Corresponding author
- Courcoulas, Anita P.
- ORCID
- Courcoulas, Anita P.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2013-11-04
- Volume
- 310
- Issue
- 22
- Pages
- 2416-25
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC3955952
- OpenAlex
- W2124482977
- Cited by
- 799
- References
- 39
- Citations by year
- 2026: 13 · 2025: 23 · 2024: 47 · 2023: 49 · 2022: 41 · 2021: 54 · 2020: 80 · 2019: 57 · 2018: 83 · 2017: 97 · 2016: 101 · 2015: 94 · 2014: 57 · 2013: 2
- FWCI
- 83.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000005, UL1TR000457)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01-DK-66667, U01DK066471, U01DK066557, U01- DK66568, U01DK066526, U01DK066568, U01‐DK66555, U01 DK66526, U01-DK66585, U01DK066555, U01DK066667, U01DK066585, U01‐ DK66471)
- National Center for Research Resources (UL1RR024153, M01-RR 00037, UL1RR025014, M01RR000037, UL1RR024996)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- bariatric surgery, morbid obesity, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, weight loss, diabetes remission, hypertension resolution, long-term health effects, body mass index, metabolic surgery, three-year follow-up, health-related quality of life
- MeSH terms
- Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Obesity, Severity of Illness Index, Cohort Studies, Weight Loss, Treatment Outcome, Diabetes Complications, Bariatric Surgery, Dyslipidemias, Young Adult
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