Cited by 699Bariatric Surgery and OutcomesBody Contouring and SurgeryMinimally Invasive Surgical Techniques

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Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study

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Courcoulas, Anita P., King, Wendy C., Belle, Steven H., Berk, Paul, Flum, David R., Garcia, Luis, Gourash, William, Horlick, Mary, Mitchell, James E., Pomp, Alfons, Pories, Walter J., Purnell, Jonathan Q., Singh, Ashima, Spaniolas, Konstantinos, Thirlby, Richard, Wolfe, Bruce M., Yanovski, Susan Z.·2018·JAMA Surgery

DOI 10.1001/jamasurg.2017.5025PMC PMC6584318

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Abstract

Importance: More information is needed about the durability of weight loss and health improvements after bariatric surgical procedures. Objective: To examine long-term weight change and health status following Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). Design, Setting, and Participants: The Longitudinal Assessment of Bariatric Surgery (LABS) study is a multicenter observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers. Adults undergoing bariatric surgical procedures as part of clinical care between 2006 and 2009 were recruited and followed up until January 31, 2015. Participants completed presurgery, 6-month, and annual research assessments for up to 7 years. Main Outcome and Measures: Percentage of weight change from baseline, diabetes, dyslipidemia, and hypertension, determined by physical measures, laboratory testing, and medication use. Results: Of 2348 participants, 1738 underwent RYGB (74%) and 610 underwent LAGB (26%). For RYBG, the median age was 45 years (range, 19-75 years), the median body mass index (calculated as weight in kilograms divided by height in meters squared) was 47 (range, 34-81), 1389 participants (80%) were women, and 257 participants (15%) were nonwhite. For LAGB, the median age was 48 years (range, 18-78), the body mass index was 44 (range, 33-87), 465 participants (76%) were women, and 63 participants (10%) were nonwhite. Follow-up weights were obtained in 1300 of 1569 (83%) eligible for a year-7 visit. Seven years following RYGB, mean weight loss was 38.2 kg (95% CI, 36.9-39.5), or 28.4% (95% CI, 27.6-29.2) of baseline weight; between years 3 and 7 mean weight regain was 3.9% (95% CI, 3.4-4.4) of baseline weight. Seven years after LAGB, mean weight loss was 18.8 kg (95% CI, 16.3-21.3) or 14.9% (95% CI, 13.1-16.7), with 1.4% (95% CI, 0.4-2.4) regain. Six distinct weight change trajectory patterns for RYGB and 7 for LAGB were identified. Most participants followed trajectories in which weight regain from 3 to 7 years was small relative to year-3 weight loss, but patterns were variable. Compared with baseline, dyslipidemia prevalence was lower 7 years following both procedures; diabetes and hypertension prevalence were lower following RYGB only. Among those with diabetes at baseline (488 of 1723 with RYGB [28%]; 175 of 604 with LAGB [29%]), the proportion in remission at 1, 3, 5, and 7 years were 71.2% (95% CI, 67.0-75.4), 69.4% (95% CI, 65.0-73.8), 64.6% (95% CI, 60.0-69.2), and 60.2% (95% CI, 54.7-65.6), respectively, for RYGB and 30.7% (95% CI, 22.8-38.7), 29.3% (95% CI, 21.6-37.1), 29.2% (95% CI, 21.0-37.4), and 20.3% (95% CI, 9.7-30.9) for LAGB. The incidence of diabetes at all follow-up assessments was less than 1.5% for RYGB. Bariatric reoperations occurred in 14 RYGB and 160 LAGB participants. Conclusions and Relevance: Following bariatric surgery, different weight loss patterns were observed, but most participants maintained much of their weight loss with variable fluctuations over the long term. There was some decline in diabetes remission over time, but the incidence of new cases is low following RYGB. Trial Registration: clinicaltrials.gov Identifier: NCT00465829.

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Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.
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Carlsson, L. M. S., Peltonen, M., Ahlin, S., Anveden, Å., Bouchard, C., Carlsson, B., Jacobson, P., Lönroth, H., Maglio, C., Näslund, I., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1112082 · Cited by 794
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Long-term Outcomes Following Bariatric Surgery
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A longitudinal examination of suicide-related thoughts and behaviors among bariatric surgery patients
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Self-citation
Pros and cons of gastric bypass surgery in individuals with obesity and type 2 diabetes: nationwide, matched, observational cohort study
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MethodResultInfluentialSelf-citation
Long-Term Iron and Vitamin B12 Deficiency Are Present after Bariatric Surgery, despite the Widespread Use of Supplements
Lombardo, M., Franchi, A., Rinaldi, R., Rizzo, G., D’Adamo, M., Guglielmi, V., Bellia, A., Padua, E., Caprio, M., & Sbraccia, P. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094541 · Cited by 37
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“5 years after surgery—a time when weight loss is usually stabilized [6]; and T2, 3 years after surgery—a time of increased susceptibility for weight regain [7,8].”
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Is It Possible to Predict Weight Loss After Bariatric Surgery?—External Validation of Predictive Models
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“Studies were categorised as having a high, moderate or low risk of bias (see Table S2 in supplementary ﬁ le for further details).”
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Torrego-Ellacuría, M., Barabash, A., Larrad-Sáinz, A., Hernández-Nuñez, G. M., Matía‐Martín, P., Pérez‐Ferre, N., Marcuello, C., Sánchez-Pernaute, A., Torres, A. J., Calle‐Pascual, A. L., et al. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05497-5 · Cited by 36
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“Additionally, other authors have noted that despite an observed superiority of SG procedures for medium-term weight loss, RYGB was superior in terms of both the short- and long-term aspects of weight loss [11].”
Background
Cognitive Behavioral Therapy Versus Usual Care Before Bariatric Surgery: One-Year Follow-Up Results of a Randomized Controlled Trial
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Treating the Chronic Disease of Obesity
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“We observed a rate of complete medication discontinuation that was consistent with published early postoperative diabetes remission estimates—ranging from 30 to 86% for VSG (we estimated 58% with initial drug discontinuation)(16,29,30) and 50% to 82% for RYGB (we estimated 68%).(7,12,14,29,31,32) This finding is reass…”
Result
Association between weight loss and serum biomarkers with risk of incident cancer in the Longitudinal Assessment of Bariatric Surgery cohort
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Self-citation
Changes of Taste, Smell and Eating Behavior in Patients Undergoing Bariatric Surgery: Associations with PROP Phenotypes and Polymorphisms in the Odorant-Binding Protein OBPIIa and CD36 Receptor Genes
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The Impact of Telephone-Based Cognitive Behavioral Therapy on Mental Health Distress and Disordered Eating Among Bariatric Surgery Patients During COVID-19: Preliminary Results from a Multisite Randomized Controlled Trial
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Recompensation in MASLD-related cirrhosis via metabolic bariatric surgery
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Associations Between Physical Activity and Changes in Weight Across 7 Years After Roux-en-Y Gastric Bypass Surgery
King, W. C., Hinerman, A. S., White, G. E., Courcoulas, A. P., BuSaad, M. A., & Belle, S. H. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000004456 · Cited by 34
Self-citation
Bariatric Surgery Lowers the Risk of Major Cardiovascular Events
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“This analysis includes a significant number of patients who underwent AGB.”
BackgroundInfluentialSelf-citation
Effects of Bariatric Surgery on COVID-19: a Multicentric Study from a High Incidence Area
Marchesi, F., Valente, M., Riccò, M., Rottoli, M., Baldini, E., Mécheri, F., Bonilauri, S., Boschi, S., Bernante, P., Sciannamea, A., et al. (2021) · Obesity Surgery · doi:10.1007/s11695-020-05193-w · Cited by 32
“This is normally the minimum time to weight loss stabilization and remission of comorbidities [16, 17].”
Background
Evaluation of Resting Energy Expenditure in Subjects with Severe Obesity and Its Evolution After Bariatric Surgery
Fidilio, E., Comas, M., Giribés, M., Cárdenas, G., Vilallonga, R., Palma, F., Burgos, R., Simó, R., & Ciudin, A. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05578-5 · Cited by 31
A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions
Herbozo, S., Brown, K. L., Burke, N. L., & LaRose, J. G. (2023) · Current Obesity Reports · doi:10.1007/s13679-023-00493-5 · Cited by 33
Trajectories of Depressive Symptoms and Relationships With Weight Loss in the Seven Years After Bariatric Surgery
Smith, K. E., Mason, T. B., Cao, L., Crosby, R. D., Steffen, K. J., Garcia, L., King, W. C., & Mitchell, J. E. (2020) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2020.08.007 · Cited by 31
Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey
Lv, J., Fan, B., Wei, M., Zhou, G., Dayimu, A., Wu, Z., Su, C., & Zhang, T. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000972 · Cited by 31
Relationship between depression, weight, and patient satisfaction 2 years after bariatric surgery
Martens, K. M., Hamann, A., Miller-Matero, L. R., Miller, C., Bonham, A. J., Ghaferi, A. A., & Carlin, A. M. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.09.024 · Cited by 32
“The finding that the proportion of participants with clinical depression began to increase from year 1 to year 2 postoperatively could similarly be explained in that this is when weight loss often begins to plateau and some patients will begin to experience weight regain [23].”
Background
Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery
Hilbert, A., Staerk, C., Strömer, A., Mansfeld, T., Sander, J., Seyfried, F., Kaiser, S., Dietrich, A., & Mayr, A. J. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.26244 · Cited by 31
What is Obesity?
Purnell, J. Q. (2023) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2023.03.001 · Cited by 32
Self-citation
Towards precision medicine in bariatric surgery prescription
Pereira, S. S., Guimarães, M., & Monteiro, M. P. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09801-9 · Cited by 34
“Patients generally achieve a maximum weight loss 1 or 2 years after bariatric surgical procedures, but there is a wide interindividual response to the various types of bariatric surgery, particularly during longer-term follow-up [16, 17].”
Background
Psychological Functioning and Well-Being Before and After Bariatric Surgery; What is the Benefit of Being Self-Compassionate
Pyykkö, J. E., Aydin, Ö., Gerdes, V. E. A., Acherman, Y. I. Z., Groen, A. K., van de Laar, A. W., Nieuwdorp, M., Sanderman, R., & Hagedoorn, M. (2022) · British Journal of Health Psychology · doi:10.1111/bjhp.12532 · Cited by 28
Nutritional Challenges and Treatment After Bariatric Surgery
Moize, V. L., Laferrère, B., & Shapses, S. A. (2024) · Annual Review of Nutrition · doi:10.1146/annurev-nutr-061121-101547 · Cited by 33
“Improvement of these conditions is proportional to the magnitude of weight loss (16, 30).”
Bariatric surgery among vulnerable populations: The effect of the Affordable Care Act’s Medicaid expansion
Gould, K. M., Zeymo, A., Chan, K. S., DeLeire, T., Shara, N. M., Shope, T. R., & Al‐Refaie, W. B. (2019) · Surgery · doi:10.1016/j.surg.2019.05.005 · Cited by 28
The Impact of Bariatric Surgery on Incident Microvascular Complications in Patients With Type 2 Diabetes: A Matched Controlled Population-Based Retrospective Cohort Study
Singh, P., Adderley, N. J., Subramanian, A., Gokhale, K. M., Singhal, R., Toulis, K. A., Bellary, S., Nirantharakumar, K., & Tahrani, A. A. (2020) · Diabetes Care · doi:10.2337/dc20-0571 · Cited by 33
“The Longitudinal Assessment of Bariatric Surgery (LABS) Study examined the impact of RYGB and GB over a follow up period of up to seven years and found beneficial effect on weight loss, diabetes and hypertension status (44).”
Background
Obesity Management in Cardiometabolic Disease: State of the Art
Iwamoto, S. J., Abushamat, L. A., Zaman, A., Millard, A. J., & Cornier, M. (2021) · Current Atherosclerosis Reports · doi:10.1007/s11883-021-00953-0 · Cited by 32
Long-Term Trajectories in Weight and Health Outcomes Following Multidisciplinary Publicly Funded Bariatric Surgery in Patients with Clinically Severe Obesity (≥ 3 Associated Comorbidities): A Nine-Year Prospective Cohort Study in Australia
Tan, M. M. C., Jin, X., Taylor, C., Low, A. K., Page, P. L., Martin, D., Li, A., Joseph, D., & Kormas, N. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11154466 · Cited by 32
A Systematic Review on Participant Diversity in Clinical Trials—Have We Made Progress for the Management of Obesity and Its Metabolic Sequelae in Diet, Drug, and Surgical Trials
Johnson-Mann, C. N., Cupka, J. S., Ro, A., Davidson, A., Armfield, B. A., Miralles, F., Markal, A., Fierman, K. E., Hough, V. C., Newsom, M., et al. (2022) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-022-01487-0 · Cited by 34
“Sex differences in studies also differ, with females being significantly overrepresented as participants in weight-loss and bariatric surgery studies [21–26].”
Result
Proximal Roux-en-Y gastric bypass: Addressing the myth of limb length
Ahmed, B. H., King, W. C., GOURASH, W. F., Hinerman, A. S., Belle, S. H., Pomp, A., Pories, W. J., & Courcoulas, A. P. (2019) · Surgery · doi:10.1016/j.surg.2019.05.046 · Cited by 28
Self-citation
Changes in Bone Marrow Adipose Tissue One Year After Roux-en-Y Gastric Bypass: A Prospective Cohort Study
Blom-Høgestøl, I. K., Mala, T., Kristinsson, J. A., Hauge, E., Brunborg, C., Gulseth, H. L., & Eriksen, E. F. (2019) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3814 · Cited by 26
“Specifically, we wanted to investigate if such changes in BMAT fraction differed in participants with and without T2D.”
BackgroundInfluential
Factors affecting relapse of type 2 diabetes after bariatric surgery in Sweden 2007–2015: a registry-based cohort study
Jans, A., Szabó, É., Näslund, I., Ottosson, J., Näslund, E. B., & Stenberg, E. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.12.005 · Cited by 29
“However, it has been previously shown that the degree of initial weight loss can be used to predict long-term weight trajectory [31].”
Background
Effects of bariatric surgery on testosterone level and sexual function in men with obesity: A retrospective study
Chen, G., Sun, L., Jiang, S., Chen, X., Zhu, J., Zhao, X., Yu, S., Dong, Z., Chen, Y., Zhang, W., et al. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1036243 · Cited by 41
Effect of Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) on Weight Loss Following Bariatric Treatment
Kramer, C. K., Retnakaran, M., & Viana, L. V. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae176 · Cited by 30
Resting Energy Expenditure and Metabolic Adaptation in Adolescents at 12 Months After Bariatric Surgery
Chu, L., Steinberg, A., Mehta, M., O’Kane, C., Toulany, A., Langer, J. C., & Hamilton, J. K. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2018-02244 · Cited by 27
Surgical therapy of weight regain after Roux-en-Y gastric bypass
Felsenreich, D. M., Langer, F. B., Bichler, C., Kristo, I., Jedamzik, J., Eilenberg, M., Arnoldner, M. A., & Prager, G. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.07.002 · Cited by 26
“WR (calculated from the lowest postoperative weight) after RYGB (as after most bariatric procedures) is a welldocumented issue, and studies with long-term follow-up have been illustrating this fact to various degrees [4,12,13].”
Background
Weight Loss After Sleeve Gastrectomy: Does Type 2 Diabetes Status Impact Weight and Body Composition Trajectories?
Diedisheim, M., Poitou, C., Genser, L., Amouyal, C., Bouillot, J., Ciangura, C., Oppert, J., Clément, K., & Aron‐Wisnewsky, J. (2020) · Obesity Surgery · doi:10.1007/s11695-020-05075-1 · Cited by 26
“We herein confirm that the amount of weight-loss and its trajectories post-SG display high variability, in agreement with other weight-loss interventions such as dietary interventions (25), adjustable gastric banding, and RYGB (2, 26).”
BackgroundResultInfluential
Five-year weight loss, physical activity, and eating style trajectories after bariatric surgery
Voorwinde, V., Hoekstra, T., Monpellier, V. M., Steenhuis, I. H., Janssen, I. M. C., & van Stralen, M. M. (2022) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2022.03.020 · Cited by 28
Clinical Outcomes and Hospital Utilization Among Patients Undergoing Bariatric Surgery With Telemedicine Preoperative Care
Hlavin, C. A., Ingraham, P., Byrd, T., Hyre, N., Gabriel, L., Agrawal, N., Allen, L., Kenkre, T. S., Watson, A. R., Kaynar, A. M., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.55994 · Cited by 27
Self-citation
Five-year Weight Loss Maintenance With Obesity Pharmacotherapy
Weintraub, M. A., D’Angelo, D., Tchang, B. G., Sahagun, A., Andre, C., Aronne, L. J., & Shukla, A. P. (2023) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad100 · Cited by 31
Do Insurance-mandated Precertification Criteria and Insurance Plan Type Determine the Utilization of Bariatric Surgery Among Individuals With Private Insurance?
Gasoyan, H., Soans, R. S., Ibrahim, J. K., Aaronson, W. E., & Sarwer, D. B. (2020) · Medical Care · doi:10.1097/mlr.0000000000001358 · Cited by 25
“The Comparison Group included adults from the 2016 outpatient database who met the following criteria: (1) had a diagnosis code for morbid (severe) obesity; (2) did not have a record of any bariatric procedure during 2015–2016 in the inpatient or outpatient databases; (3) and did not have a diagnosis code for heart fa…”
Method
Remission and Relapse of Dyslipidemia After Vertical Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass in a Racially and Ethnically Diverse Population
Coleman, K. J., Basu, A., Barton, L. J., Fischer, H. J., Arterburn, D. E., Barthold, D., Courcoulas, A. P., Crawford, C. L., Kim, B. B., Fedorka, P. N., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.33843 · Cited by 29
Self-citation
ASMBS Position Statement on medium- and long-term durability of weight loss and diabetic outcomes after conventional stapled bariatric procedures
Azagury, D. E., Papasavas, P. K., Hamdallah, I. N., Gagner, M., & Kim, J. J. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.08.001 · Cited by 25
The (dys)regulation of energy storage in obesity
Levin, B. E., Geary, N., & Lutz, T. A. (2025) · Physiological Reviews · doi:10.1152/physrev.00002.2024 · Cited by 27
Drug- and alcohol-related mortality risk after bariatric surgery: evidence from a 7-year prospective multicenter cohort study
White, G. E., Courcoulas, A. P., & King, W. C. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.04.007 · Cited by 24
Self-citation
Physical Activity and Excess Body Weight and Adiposity for Adults. American College of Sports Medicine Consensus Statement
Jakicic, J. M., Apovian, C. M., Barr‐Anderson, D. J., Courcoulas, A. P., Donnelly, J. E., Panteleimon Ekkekakis, A., Hopkins, M., Lambert, M., Napolitano, M. A., & Volpe, S. L. (2024) · Translational Journal of the American College of Sports Medicine · doi:10.1249/tjx.0000000000000266 · Cited by 25
Self-citation
Examination of Elective Bariatric Surgery Rates Before and After US Affordable Care Act Medicaid Expansion
Hanchate, A. D., Qi, D., Paasche‐Orlow, M. K., Lasser, K. E., Liu, Z., Lin, M., & Lewis, K. H. (2021) · JAMA Health Forum · doi:10.1001/jamahealthforum.2021.3083 · Cited by 24
Medication Use for Obesity-Related Comorbidities After Sleeve Gastrectomy or Gastric Bypass
Howard, R., Chao, G. F., Yang, J., Thumma, J. R., Arterburn, D. E., Telem, D. A., & Dimick, J. B. (2022) · JAMA Surgery · doi:10.1001/jamasurg.2021.6898 · Cited by 23
Associations of changes in physical activity and sedentary time with weight recurrence after bariatric surgery: a 5-year prospective study
Sundgot‐Borgen, J., Bond, D. S., Sniehotta, F. F., Kvalem, I. L., Hansen, B. H., Bergh, I., Rø, Ø., & Mala, T. (2023) · International Journal of Obesity · doi:10.1038/s41366-023-01284-7 · Cited by 23
“At 5 years, nearly all patients have experienced some amount of weight recurrence [6, 7, 9], thus it is important to look at whether variability in current PA and ST levels relate to the amount of weight recurrence.”
Background
The Neurobiology of Eating Behavior in Obesity: Mechanisms and Therapeutic Targets: A Report from the 23rd Annual Harvard Nutrition Obesity Symposium
Becetti, I., Bwenyi, E. L., de Araújo, I. E., Ard, J. D., Cryan, J. F., Farooqi, I. S., Ferrario, C. R., Gluck, M. E., Holsen, L. M., Kenny, P. J., et al. (2023) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2023.05.003 · Cited by 26
Randomized Controlled Trial of Treatments for Loss‐of‐Control Eating Following Bariatric Surgery
Grilo, C. M., Ivezaj, V., Duffy, A. J., & Gueorguieva, R. V. (2021) · Obesity · doi:10.1002/oby.23124 · Cited by 22
“5%]), which did not differ significantly (χ2(2) = 0.”
Background
Psychotropic Medications in Metabolic and Bariatric Surgery: Research Updates and Clinical Considerations
Coughlin, J. W., Steffen, K. J., Sockalingam, S., & Mitchell, J. E. (2022) · Current Psychiatry Reports · doi:10.1007/s11920-022-01317-4 · Cited by 23
Self-citation
Revisional Surgery or Pharmacotherapy for Insufficient Weight Loss and Weight Regain After Primary Bariatric Procedure: a Descriptive Study
Dharmaratnam, V. M., Lim, E. K. W., Eng, A. K. H., Chan, W. H., Tan, H. C., Ho, E. T. L., Kovalik, J., Ganguly, S., Tan, J. T. H., Lee, P. C., et al. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06191-w · Cited by 22
“The revisional surgery outcomes for SG to RYGB for WR vs IWL.”
Influential
Remission and Relapse of Hypertension After Bariatric Surgery: A Retrospective Study on Long-Term Outcomes
Fisher, D. P., Liu, L., Arterburn, D. E., Coleman, K. J., Courcoulas, A. P., Haneuse, S., Johnson, E., Li, R. A., Theis, M. K., Taylor, B., et al. (2022) · Annals of Surgery Open · doi:10.1097/as9.0000000000000158 · Cited by 24
Self-citation
Changes in Eating Behaviors and Their Relation to Weight Change 6 and 12 Months After Bariatric Surgery
Allison, K. C., Wu, J., Spitzer, J. C., McCuen‐Wurst, C., Ashare, R. L., Tewksbury, C. M., Lagrotte, C. A., Wadden, T. A., Williams, N. N., & Sarwer, D. B. (2023) · Obesity Surgery · doi:10.1007/s11695-022-06442-w · Cited by 23
“Previous longitudinal studies, such as the LABS study, have shown that identifying as White and as a woman was related to more favorable weight loss trajectories up to 7 years after surgery [2].”
BackgroundResult
Anterior Cervical Discectomy and Fusion Outcomes in Patients With and Without Bariatric Surgery—Weight Loss Does Make a Difference
Joo, P. Y., Zhu, J. R., Wilhelm, C. V., Tang, K., Day, W. W., Moran, J. T., & Grauer, J. N. (2023) · Spine · doi:10.1097/brs.0000000000004580 · Cited by 24
Examining emotion-, personality-, and reward-related dispositional tendencies in relation to eating pathology and weight change over seven years in the Longitudinal Assessment of Bariatric Surgery (LABS) study
Lavender, J. M., King, W. C., Kalarchian, M. A., Devlin, M. J., Hinerman, A. S., Gunstad, J., Marcus, M. D., & Mitchell, J. E. (2019) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2019.10.014 · Cited by 22
“However, there is clear variability in long-term outcomes, even among patients who undergo the same surgical procedure (Courcoulas et al., 2018).”
BackgroundSelf-citation
Changes in Smoking Behavior Before and After Gastric Bypass
King, W. C., White, G. E., Belle, S. H., Yanovski, S. Z., Pomp, A., Pories, W. J., Wolfe, B. M., Ahmed, B., & Courcoulas, A. P. (2020) · Annals of Surgery · doi:10.1097/sla.0000000000003828 · Cited by 22
“Design and Participants Adults with obesity undergoing their first bariatric surgery from April 2006 to April 2009 at 10 US clinical centers of the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study were enrolled.(13) The study protocol was approved by each center’s institutional review board.”
MethodSelf-citation
Endoscopic management of weight regain following Roux-en-Y gastric bypass
de Moura, D. T. H., & Thompson, C. C. (2019) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2019.1571907 · Cited by 22
“The success of RYGB may be partially credited to restriction produced by the small gastric pouch and stoma, resulting in reduced caloric intake, as well as a bypass of the digestive and absorptive regions of the GI tract, but the mechanisms by which gastric bypass leads to weight loss are not completely understood [3,…”
Background
Psychosocial Interventions to Reduce Eating Pathology in Bariatric Surgery Patients: A Systematic Review
Newman, A. K.-R., Herbozo, S., Russell, A., Eisele, H., Zasadzinski, L., Hassan, C., & Sanchez-Johnsen, L. (2021) · Journal of Behavioral Medicine · doi:10.1007/s10865-021-00201-5 · Cited by 21
Primary and Secondary Nonresponse Following Bariatric Surgery: a Survey Study in Current Bariatric Practice in the Netherlands and Belgium
Uittenbogaart, M., de Witte, E., Romeijn, M. M., Luijten, A. A. P. M., van Dielen, F. M. H., & Leclercq, W. K. G. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04574-5 · Cited by 22
Differences in physical and mental health-related quality of life outcomes 3 years after bariatric surgery: a group-based trajectory analysis
Youssef, A., Keown‐Stoneman, C. D. G., Maunder, R., Wnuk, S., Wiljer, D., Mylopoulos, M., & Sockalingam, S. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.06.014 · Cited by 21
Predictors of long‐term weight loss trajectories during a behavioral weight loss intervention: An exploratory analysis
Ostendorf, D. M., Blankenship, J. M., Grau, L., Arbet, J., Mitchell, N. S., Creasy, S. A., Caldwell, A. E., Melanson, E. L., Phelan, S., Bessesen, D. H., et al. (2021) · Obesity Science & Practice · doi:10.1002/osp4.530 · Cited by 23
Predicting satisfaction with outcome and follow‐up care 5 years after bariatric surgery: A prospective evaluation
Kvalem, I. L., Gabrielsen, L., Eribe, I., Kristinsson, J. A., & Mala, T. (2022) · Obesity Science & Practice · doi:10.1002/osp4.594 · Cited by 21
“Long‐term weight loss and improvements in comorbidities after bariatric surgery are well documented.(1,2) Another measure of a successful outcome is patient satisfaction.”
Background
Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients
Voglino, C., Badalucco, S., Tirone, A., Ciuoli, C., Cantara, S., Benenati, N., Bufano, A., Formichi, C., Croce, F., Gaggelli, I., et al. (2022) · Updates in Surgery · doi:10.1007/s13304-022-01314-5 · Cited by 21
Targeting skeletal muscle mitochondrial health in obesity
Pileggi, C. A., Hooks, B. G., McPherson, R., Dent, R. R. M., & Harper, M.-E. (2022) · Clinical Science · doi:10.1042/cs20210506 · Cited by 21
How to address weight regain after bariatric surgery in an individualized way
COHEN, R. V., & Petry, T. B. Z. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09806-4 · Cited by 22
“Although they are not classified as non-responders, patients with BMI over 50 kg/m2 may predict IWL and/or WR [12, 13].”
Background
Preoperative versus intraoperative diagnosis of hiatal hernia in bariatric population
Mani, V. R. K., Kalabin, A., Nwakanama, C., Suman, P., & Ahmed, L. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.08.553 · Cited by 21
Symptoms of bipolar disorder are associated with lower bariatric surgery completion rates and higher food addiction
Holgerson, A. A., Clark, M. M., Frye, M. A., Kellogg, T. A., Mundi, M. S., Veldić, M., & Grothe, K. B. (2020) · Eating Behaviors · doi:10.1016/j.eatbeh.2020.101462 · Cited by 20
When Definitions Differ, are Comparisons Meaningful? Definitions of Weight Regain After Bariatric Surgery and Their Associations with Patient Characteristics and Clinical Outcomes - A Need for a Revisit?
Elhag, W., Lock, M., & Ansari, W. E. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06528-z · Cited by 20
Genetic variants associated with weight loss and metabolic outcomes after bariatric surgery: A systematic review
van der Meer, R., Mohamed, S. A., Monpellier, V. M., Liem, R. S. L., Hazebroek, E. J., Franks, P. W., Frayling, T. M., Janssen, I. M. C., & Serlie, M. J. M. (2023) · Obesity Reviews · doi:10.1111/obr.13626 · Cited by 20
“11,12 13 – 15 The extent to which specific genetic variants contribute to this interindividual variation is unclear.”
Background
Association between metabolic surgery and cardiovascular outcome in patients with hypertension: A nationwide matched cohort study
Stenberg, E., Cao, Y., Marsk, R., Sundbom, M., Jernberg, T., & Näslund, E. B. (2020) · PLoS Medicine · doi:10.1371/journal.pmed.1003307 · Cited by 21
“Observational studies suggest that remission rates of hypertension as high as 40% can be expected at midterm follow-up after metabolic surgery [10].”
BackgroundResult
Physical Exercise following bariatric surgery in women with Morbid obesity
Soriano‐Maldonado, A., Martínez-Forte, S., Márquez, M. F., Martínez‐Rosales, E., Hernández‐Martínez, A., Carretero‐Ruiz, A., Villa‐González, E., Barranco-Ruíz, Y., Rodríguez-Pérez, M. A., Torrente‐Sánchez, M. J., et al. (2020) · Medicine · doi:10.1097/md.0000000000019427 · Cited by 19
“For many women with severe/morbid obesity, bariatric surgery([26,27]) is the first step towards a change in their lifestyle and quality of life, as it significantly reduces excess weight([28]) and promotes the remission of metabolic syndrome, hypertension or type 2 diabetes,([29]) which in turn significantly decreases…”
Background
A preliminary study on the psychosocial impact of COVID-19 lockdown in post-bariatric surgery women: the importance of eating behavior, health care access, and social support
Félix, S., de Lourdes, M., Ribeiro, I., Cunha, B., Ramalho, S. M., Vaz, A., Machado, P. P. P., & Conceição, E. (2021) · Current Psychology · doi:10.1007/s12144-021-01529-6 · Cited by 19
Neurocognitive and Psychopathological Predictors of Weight Loss After Bariatric Surgery: A 4-Year Follow-Up Study
Bianciardi, E., Raimondi, G., Samela, T., Innamorati, M., Contini, L. M., Procenesi, L., Fabbricatore, M., Imperatori, C., & Gentileschi, P. (2021) · Frontiers in Endocrinology · doi:10.3389/fendo.2021.662252 · Cited by 19
Association of Bariatric Surgery With Vascular Outcomes
Gokce, N., Karki, S., Dobyns, A., Zizza, E., Sroczynski, E., Palmisano, J. N., Mazzotta, C., Hamburg, N. M., Pernar, L. I. M., Carmine, B. J., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.15267 · Cited by 19
Acute Effects of Sleeve Gastrectomy on Glucose Variability, Glucose Metabolism, and Ghrelin Response
Wang, L., Shi, C., Yan, H., Xia, M., Zhu, X., Sun, X., Yang, X., Jiao, H., Wu, H., Lou, W., et al. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05534-3 · Cited by 19
A Systematic Review of Genetic Correlates of Weight Loss After Bariatric Surgery
Gupta, S. R., Zhou, Y., Wadden, T. A., Berkowitz, R. I., & Chao, A. M. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05585-6 · Cited by 22
“Despite the well-established use of bariatric surgery to treat obesity, significant interindividual variability has been noted in short-term and long-term weight loss [1, 2].”
Background
A 7-Year Study of the Durability of Improvements in Pain, Physical Function, and Work Productivity After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy
King, W. C., Hinerman, A. S., & White, G. E. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.31593 · Cited by 19
Self-citation
Pain is adversely related to weight loss maintenance following bariatric surgery
Williams‐Kerver, G. A., Bond, D. S., Crosby, R. D., Cao, L., Engel, S. G., Mitchell, J. E., & Steffen, K. J. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.08.025 · Cited by 19
Self-citation
One Year Follow-Up of Taste-Related Reward Associations with Weight Loss Suggests a Critical Time to Mitigate Weight Regain Following Bariatric Surgery
Smith, K., Aghababian, A. H., Papantoni, A., Veldhuizen, M. G., Kamath, V. J., Harris, C., Moran, T. H., Carnell, S., & Steele, K. E. (2021) · Nutrients · doi:10.3390/nu13113943 · Cited by 19
Barriers to Bariatric Surgery: a Mixed Methods Study Investigating Obstacles Between Clinic Contact and Surgery
Hlavin, C. A., Sebastiani, R. S., Scherer, R., Kenkre, T. S., Bernardi, K., Reed, D. A., Ahmed, B. H., & Courcoulas, A. P. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06761-6 · Cited by 18
Self-citation
Sex- and operation-dependent effects on 5-year weight loss results of bariatric surgery
Samuels, J. M., Albaugh, V. L., Yu, D., Chen, Y., Williams, D. B., Spann, M. D., Wang, L., Flynn, C. R., & English, W. J. (2024) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2024.01.013 · Cited by 17
Outcomes of concomitant antiobesity medication use with endoscopic sleeve gastroplasty in clinical US settings
Gala, K. S., Ghusn, W., Brunaldi, V., McGowan, C., Sharaiha, R. Z., Maselli, D. B., VanderWel, B., Kedia, P. S., Ujiki, M. B., Wilson, E., et al. (2024) · Obesity Pillars · doi:10.1016/j.obpill.2024.100112 · Cited by 18
“This heterogeneity of weight loss and different trajectories of weight loss have been described in bariatric surgery literature previously [8 – 10], and needs further study in the realm of precision medicine.”
Economic evaluation of weight loss and transplantation strategies for kidney transplant candidates with obesity
Puttarajappa, C. M., Smith, K. J., Ahmed, B. H., Bernardi, K., Lavenburg, L.-M. U., Hoffman, W., & Molinari, M. (2024) · American Journal of Transplantation · doi:10.1016/j.ajt.2024.07.024 · Cited by 19

Authors: Courcoulas, A. P., King, W. C., Belle, S. H., Berk, P., Flum, D. R., Garcia, L., Gourash, W., Horlick, M., Mitchell, J. E., Pomp, A., Pories, W. J., Purnell, J. Q., Singh, A., Spaniolas, K., Thirlby, R., Wolfe, B. M., & Yanovski, S. Z.
Affiliations: University of Pittsburgh Medical Center (US)
University of Pittsburgh (US)
Columbia University (US)
University of Washington (US)
University of North Dakota (US)
National Institute of Diabetes and Digestive and Kidney Diseases (US)
Neuropsychiatric Research Institute (US)
Weill Cornell Medicine (US)
East Carolina University (US)
Oregon Health & Science University (US)
Corresponding author: Courcoulas, Anita P.
ORCID: Courcoulas, Anita P.
King, Wendy C.
Flum, David R.
Gourash, William
Mitchell, James E.
Pomp, Alfons
Pories, Walter J.
Purnell, Jonathan Q.
Singh, Ashima
Spaniolas, Konstantinos
Wolfe, Bruce M.
Venue: JAMA Surgery
Publisher: American Medical Association (AMA)
Published: 2018-05-01
Volume: 153
Issue: 5
Pages: 427
ISSN: 2168-6254 (ISSN-L)
DOI: 10.1001/jamasurg.2017.5025
PMC: PMC6584318
OpenAlex: W2771736595
Cited by: 699
References: 18
Citations by year: 2026: 63 · 2025: 70 · 2024: 77 · 2023: 92 · 2022: 93 · 2021: 102 · 2020: 97 · 2019: 69 · 2018: 35
FWCI: 56.28
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: JAMA Surgery (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (U01DK066471, U01DK066557, U01DK066526, U01DK066568, U01DK108320, U01DK066667, U01DK066585)
National Center for Research Resources (UL1RR024153, M01RR000037, UL1RR024996)
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, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, weight loss, weight regain, diabetes remission, dyslipidemia, hypertension, obesity, metabolic surgery outcomes, body mass index
MeSH terms: Body-Weight Trajectory, Adult, Aged, Female, Follow-Up Studies, Health Status, Humans, Male, Middle Aged, Obesity, Morbid, Retrospective Studies, Time Factors, Weight Loss, Body Mass Index, Treatment Outcome, Bariatric Surgery, Young Adult

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Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study

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