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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Sjöström, L., Lindroos, A.-K., Peltonen, M., Torgerson, J., Bouchard, C., Carlsson, B., Dahlgren, S., Larsson, B., Narbro, K., Sjöström, C. D., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa035622 · Cited by 4,457
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Health benefits of gastric bypass surgery after 6 years
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Alcohol Use Thresholds for Identifying Alcohol-related Problems Before and Following Roux-en-Y Gastric Bypass
White, G. E., Courcoulas, A. P., Richardson, G. A., Mair, C., & King, W. C. (2018) · Annals of Surgery · doi:10.1097/sla.0000000000003078 · Cited by 18
“B ariatric surgery results in long-term weight loss, remission of obesity-related comorbidities, and reduced all-cause mortality.(1,2) Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric procedures performed in the United States,(3) likely due to its impressive long-term outcomes.”
BackgroundSelf-citation
Food insecurity in a pre-bariatric surgery sample: prevalence, demographics and food shopping behaviour
Price, J. A., Zickgraf, H. F., & Rigby, A. (2019) · Public Health Nutrition · doi:10.1017/s1368980019001320 · Cited by 18
Mortality after bariatric surgery: findings from a 7-year multicenter cohort study
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Self-citation
Systematic review of online patient resources to support shared decision making for bariatric surgery
Musbahi, A., Brown, L. R., Reddy, A., Viswanath, Y. K. S., Rao, M., & Gopinath, B. (2019) · International Journal of Surgery · doi:10.1016/j.ijsu.2019.12.021 · Cited by 18
Weight loss expectations and weight loss after surgery: the mediating role of body image and weight concerns
Conceição, E., de Lourdes, M., Moreira, L., Pinto‐Bastos, A., & Félix, S. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.03.005 · Cited by 18
Understanding the pathophysiologic pathways that underlie obesity and options for treatment
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Irritable bowel syndrome-like symptoms and health related quality of life two years after Roux-en-Y gastric bypass - a prospective cohort study
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A Qualitative Examination of Emotional Experiences During Physical Activity Post-Metabolic/Bariatric Surgery
Feig, E. H., Harnedy, L. E., Golden, J., Thorndike, A. N., Huffman, J. C., & Psaros, C. (2022) · Obesity Surgery · doi:10.1007/s11695-021-05807-x · Cited by 16
“Obesity is a major public health concern, and metabolic and bariatric surgery (MBS) is the most effective treatment available for severe obesity [1].”
Background
What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery
Zefreh, H., Amani‐Beni, R., Sheikhbahaei, E., Farsi, F., Ahmadkaraji, S., Barzin, M., Darouei, B., Khalaj, A., & Shahmiri, S. S. (2023) · Intern J Endocrinol Metab · doi:10.5812/ijem-136329 · Cited by 19
“As for IWL, the prevalence of WR after LSG (31, 32) and after RYGB, one-anastomosis gastric bypass (OAGB), and LSG combined (33) were 32 - 40% and 20%, respectively.”
BackgroundInfluential
Five-year kidney outcomes of bariatric surgery differ in severely obese adolescents and adults with and without type 2 diabetes
Bjornstad, P., Nehus, E. J., Jenkins, T. M., Mitsnefes, M. M., Moxey‐Mims, M., Dixon, J. B., & Inge, T. H. (2020) · Kidney International · doi:10.1016/j.kint.2020.01.016 · Cited by 17
BODY-Q patient-reported outcomes measure (PROM) to assess sleeve gastrectomy vs. Roux-en-Y gastric bypass: eating behavior, eating-related distress, and eating-related symptoms
Mou, D., de Vries, C. E. E., Pater, N., Poulsen, L., Makarawung, D. J. S., Wiezer, M. J., van Veen, R. N., Hoogbergen, M. M., Sørensen, J. A., Klassen, A. F., et al. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-07886-w · Cited by 17
The Impact of Ethnicity on Metabolic Outcomes After Bariatric Surgery
Valencia, A., Garcia, L. C., & Morton, J. M. (2019) · Journal of Surgical Research · doi:10.1016/j.jss.2018.09.061 · Cited by 17
Self-citation
Integrated Insights into Metabolic and Bariatric Surgery: Improving Life Quality and Reducing Mortality in Obesity
Marin, R.-C., Radu, A.-F., Negru, P. A., Radu, A.-F., Negru, D. C., Aron, R. A. C., Bodog, T. M., Bodog, R. F., Maghiar, P. B., & Brata, R. D. (2024) · Medicina · doi:10.3390/medicina61010014 · Cited by 21
“Also, it was demonstrated that 68% of patients considering MBS who are severely obese also have hypertension [138].”
Influential
Bariatric surgery for treatment of morbid obesity in adults
Park, K. B., & Jun, K. (2024) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2024.219 · Cited by 17
“Among individuals seeking bariatric surgery for severe obesity, approximately 64% have dyslipidemia, characterized by high levels of low-density lipoprotein, elevated triglycerides, and low levels of high-density lipoprotein [56].”
Visceral Adipose Tissue Displays Unique Metabolomic Fingerprints in Obesity, Pre-Diabetes and Type 2 Diabetes
Morais, T., Seabra, A. L., Patrício, B. G., Guimarães, M., Nora, M. C., Oliveira, P. F., Alves, M. G., & Monteiro, M. P. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22115695 · Cited by 16
“Several BCAAs and other essential AAs are known to be involved in glucose homeostasis [23].”
Background
Psychosocial Functioning of Bariatric Surgery Patients 6-Years Postoperative
Marek, R. J., Martin‐Fernandez, K. W., Ben‐Porath, Y. S., & Heinberg, L. J. (2020) · Obesity Surgery · doi:10.1007/s11695-020-05025-x · Cited by 17
The Cost-Effectiveness of Semaglutide and Tirzepatide for Patients With Knee Osteoarthritis and Obesity
Betensky, D. J., Smith, K. C., Katz, J. N., Yang, C. J., Hunter, D. J., Collins, J. E., Feldman, C. H., Messier, S. P., Kim, J., Selzer, F., et al. (2025) · Annals of Internal Medicine · doi:10.7326/annals-24-03609 · Cited by 15
Weight loss outcomes and associated factors after metabolic bariatric surgery: Analysis of routine clinical data in Scotland
Leyaro, B. J., Howie, L., McMahon, K. R., Ali, A., & Carragher, R. (2024) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2024.116151 · Cited by 15
Impact of weight trajectory after bariatric surgery on co-morbidity evolution and burden
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Surgical and Nonsurgical Weight Loss for Patients with Obstructive Sleep Apnea
Saunders, K. H., Igel, L. I., & Tchang, B. G. (2020) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2020.02.003 · Cited by 14
The relationship between kidney function and body mass index before and after bariatric surgery in patients with chronic kidney disease
Fischer, H. J., Weiss, R. E., Friedman, A. N., Imam, T. H., & Coleman, K. J. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.11.010 · Cited by 17
“Modest weight regain such as what occurred after the weight nadir is also common.(40) Within the first two months following surgery, we also observed an immediate and large rise in eGFR that could reflect a real improvement in glomerular filtration, a spurious effect from reduced muscle mass leading to a lower serum c…”
Background
Fibrogenesis Marker PRO-C3 Is Higher in Advanced Liver Fibrosis and Improves in Patients Undergoing Bariatric Surgery
Lassen, P. B., Nori, N., Bédossa, P., Genser, L., Aron‐Wisnewsky, J., Poitou, C., Surabattula, R., Nielsen, M. J., Karsdal, M. A., Leeming, D. J., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab897 · Cited by 15
Three‐ and five‐year follow‐up results of a randomized controlled trial on the effects of cognitive behavioral therapy before bariatric surgery
Paul, L., van der Heiden, C., van Hoeken, D., Deen, M. L., Vlijm, A., Klaassen, R. A., Biter, L. U., & Hoek, H. W. (2022) · International Journal of Eating Disorders · doi:10.1002/eat.23825 · Cited by 15
“As weight regain mainly occurs after the second year postoperative (Courcoulas et al., 2018), the three- and five-year follow-ups were carried out as planned to determine whether weight change differences between groups occurred at long-term follow-up.”
Background
Decision Regret up to 4 Years After Gastric Bypass and Gastric Banding
Wee, C. C., Fleishman, A., McCarthy, A. C., Hess, D. T., Apovian, C. M., & Jones, D. B. (2019) · Obesity Surgery · doi:10.1007/s11695-019-03772-0 · Cited by 15
Clinical Management of Weight Regain and Cardiometabolic Consequences After Discontinuation of GLP ‐1 Receptor Agonists
Shah, E., Al-Shiab, R., Abdo, A., Özbek, L., Covic, A. C., & Kanbay, M. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70713 · Cited by 17
Dynamics of hepatic steatosis resolution and changes in gut microbiome with weight loss in nonalcoholic fatty liver disease
Behari, J., Graham, L., Wang, R., Schirda, C., Borhani, A. A., Methé, B. A., Li, K. W., Morris, A. M., Luu, H. N., Palmieri, S., et al. (2020) · Obesity Science & Practice · doi:10.1002/osp4.476 · Cited by 14
“Differential responses to weight loss intervention have also been reported for patients undergoing weight loss surgery and deserve further research.(31) The microbiota is characterized by a complex arrangement of trillions of microbial cells partitioned into hundreds to thousands of species.”
Background
Marijuana and Bariatric Surgery
Diggins, A. D., & Heinberg, L. J. (2021) · Current Psychiatry Reports · doi:10.1007/s11920-020-01218-4 · Cited by 15
Weighing in on Type 2 Diabetes Remission
Meerasa, A., & Dash, S. (2021) · Diabetes Care · doi:10.2337/dci21-0041 · Cited by 17
“Weight regain is associated with relapse of T2D (4,10,11).”
Background
Molecular remodeling of adipose tissue is associated with metabolic recovery after weight loss surgery
Bouchard‐Mercier, A., de Toro‐Martín, J., Nadeau, M., Lescelleur, O., Lebel, S., Richard, D., Biertho, L. D., Tchernof, A., & Vohl, M. (2022) · Journal of Translational Medicine · doi:10.1186/s12967-022-03485-6 · Cited by 15
“The stomach I have now has a brain connection:” changes in experiences of hunger and fullness following bariatric surgery
Lynch, A. I., Kozak, A. T., & Zalesin, K. C. (2022) · Appetite · doi:10.1016/j.appet.2022.106271 · Cited by 15
Cardiometabolic Improvements After Metabolic Surgery and Related Presurgery Factors
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Multi-sensor ecological momentary assessment of behavioral and psychosocial predictors of weight loss following bariatric surgery: study protocol for a multicenter prospective longitudinal evaluation
Goldstein, S. P., Thomas, J. G., Vithiananthan, S., Blackburn, G. L., Jones, D. B., Webster, J., Jones, R. N., Evans, E. W., Dushay, J. R., Moon, J., et al. (2018) · BMC Obesity · doi:10.1186/s40608-018-0204-6 · Cited by 14
“However, there is substantial individual variability in short- and long-term weight loss [6, 7].”
Background
Reported nutrient intake over 7 years after Roux-en-Y gastric bypass in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study
Raatz, S. K., Johnson, L. K., Caliquary, A., King, W. C., Kalarchian, M. A., Devlin, M. J., Marcus, M. D., & Mitchell, J. E. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.04.007 · Cited by 15
“The pattern of greatest weight loss achievement at two years in these participants is similar to that observed in the entire RYGB LABS-2 cohort (3).”
ResultSelf-citation
Obesity and climate change: co-crises with common solutions
Behrens, P., Champagne, C. M., Halford, J. C. G., Moodie, M., Proietto, J., Rutter, G. A., Samaras, K., & Holly, J. M. P. (2025) · Frontiers in Science · doi:10.3389/fsci.2025.1613595 · Cited by 13
New Insights on the Association Between Socioeconomic Status and Weight Loss After Bariatric Surgery: a Systematic Review and Meta-analysis
Melendez-Araújo, M. S., Berber, L. C. L., de Sousa, K. M. Q., Figueiredo, A. C. M. G., Lamarca, F., Dutra, E. S., & de Carvalho, K. M. B. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06269-5 · Cited by 14
“The mechanisms involved in these associations are complex and need further clarification [2].”
Background
Assessing the state of obesity care: Quality, access, guidelines, and standards
Kaplan, L. M., Apovian, C. M., Ard, J. D., Allison, D. B., Aronne, L. J., Batterham, R. L., Busetto, L., Dicker, D., Horn, D. B., Kelly, A. S., et al. (2024) · Obesity Science & Practice · doi:10.1002/osp4.765 · Cited by 15
“Long ‐ term average weight loss in adults following the most common current metabolic/ bariatric procedures ranges between 20% and 30%, 63 exceeding long ‐ term average weight loss achieved through lifestyle (~4”
BackgroundSelf-citation
Combined non-alcoholic fatty liver disease and type 2 diabetes in severely obese patients—medium term effects of sleeve gastrectomy versus Roux-en-Y-gastric bypass on disease markers
Billmann, F. G., Shishtawi, S. E., Bruckner, T., ElSheikh, M., Müller-Stich, B. P., & Billeter, A. T. (2021) · HepatoBiliary Surgery and Nutrition · doi:10.21037/hbsn-21-71 · Cited by 12
“Therefore, there is a need for medium-to long-term studies to specifically examine the metabolic effects of bariatric surgery in obese patients with NAFLD and T2DM, particularly given that these co-morbidities are associated with the highest risk of progression of NAFLD to cirrhosis and HCC.”
Cost‐Effectiveness of Surgical Weight‐Loss Interventions for Patients With Knee Osteoarthritis and Class III Obesity
Kostic, A. M., Leifer, V. P., Gong, Y., Robinson, M. K., Collins, J. E., Neogi, T., Messier, S. P., Hunter, D. J., Selzer, F., Suter, L. G., et al. (2022) · Arthritis Care & Research · doi:10.1002/acr.24967 · Cited by 13
“cohort, derived from baseline data from the Longitudinal Assessment of Bariatric Surgery (LABS) study, a large, multicenter, observational, prospective study that collected outcomes data up to 7 years following bariatric surgery, including RYGB and LSG (12).”
MethodInfluential
A review on the beneficial effects of bariatric surgery in the management of obesity
Wahab, R. A., & le Roux, C. W. (2022) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2022.2110865 · Cited by 19
Predicting Weight Loss and Comorbidity Improvement 7 Years Following Laparoscopic Sleeve Gastrectomy: Does Early Weight Loss Matter?
Tankel, J., Shlezinger, O., Neuman, M., Hershko‐Moshe, A., Nachum, N. B., Hurvitz, N., & Spira, R. M. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04462-y · Cited by 13
Interrater reliability and internal consistency of the eating disorder examination in the longitudinal assessment of bariatric surgery study
Ivezaj, V., Kalarchian, M. A., King, W. C., Devlin, M. J., Mitchell, J. E., & Crosby, R. D. (2022) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2022.04.015 · Cited by 13
Self-citation
Endoscopic Bariatric and Metabolic Therapies for Liver Disease: Mechanisms, Benefits, and Associated Risks
Ren, M., Zhou, X., Lv, L., & Ji, F. (2022) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2021.00448 · Cited by 12
Association Between Patient Satisfaction With Their Patient-Physician Relationship and Completion of Bariatric Surgery by Race and Ethnicity Among US Adults
Xie, L., Almandoz, J. P., Mathew, M. S., Schellinger, J. N., Kapera, O., Ngenge, S., Marroquin, E. M., McAdams, C. J., Kukreja, S. S., Schneider, B. E., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.47431 · Cited by 12
Characteristics of Patients Lost to Follow-up after Bariatric Surgery
Krietenstein, L., Koschker, A., Miras, A. D., Kollmann, L., Gruber, M., Dischinger, U., Haubitz, I., Faßnacht, M., Warrings, B., & Seyfried, F. (2024) · Nutrients · doi:10.3390/nu16162710 · Cited by 13
“In line with the literature, %TWL was 30% two years after surgery and stabilised at about 27% after five years [1,2,39,40], with no differences between IFU and LTFU cohorts.”
MethodResult
Psychiatric and Cognitive Functioning After Metabolic and Bariatric Surgery: A Systematic Review and Meta‐Analysis
van Reekum, E. A., Darcy, M., Drage, J., Xu, J., Ng, K., Forestell, B., Santesso, N. A., Joundi, R. A., Wong, J. A., Doumouras, A. G., et al. (2025) · Obesity Reviews · doi:10.1111/obr.13968 · Cited by 12
“Heterogeneity was evaluated statistically with the I 2 statistic and explored with a pre-specified subgroup analysis by year after surgery ( ≤ 2 years vs > 2 years), as weight and comorbidity recurrence may begin 2 years after surgery [51].”
Standardized reporting of co-morbidity outcome after bariatric surgery: low compliance with the ASMBS outcome reporting standards despite ease of use
Burger, P. M., Monpellier, V. M., Deden, L. N., Kooiman, L., Liem, R. S. L., Hazebroek, E. J., Janssen, I. M. C., & Westerink, J. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.07.011 · Cited by 12
Early Post-operative Weight Change After Roux-en-Y Gastric Bypass Predicts Weight Loss at 12-Month Follow-up
Silveira, F. C., Docherty, N. G., Sallet, P. C., Moraes, M., Monclaro, T. V., Arruda, M., Pizani, C., Sallet, J. A. A. S., & le Roux, C. W. (2020) · Obesity Surgery · doi:10.1007/s11695-020-04942-1 · Cited by 11
Preoperative inhibitory control predicts weight loss 1 year after bariatric surgery
Walø‐Syversen, G., Kvalem, I. L., Kristinsson, J. A., Eribe, I., Rø, Ø., Brunborg, C., & Dahlgren, C. L. (2020) · European Eating Disorders Review · doi:10.1002/erv.2801 · Cited by 11
Evidence-Based Classification for Post-bariatric Weight Regain from a Benchmark Registry Cohort of 18,403 Patients and Comparison with Current Criteria
Franken, R. J., & van de Laar, A. W. J. M. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06586-3 · Cited by 12
“identified weight trajectories in the Longitudinal Assessment of Bariatric Surgery (LABS) cohort of 2348 participants [10].”
Background
Weight loss trend after bariatric surgery in a population of obese patients
Palumbo, P., Banchelli, F., Miloro, C., Toschi, P. F., Mécheri, F., Gabriele, S., Pantaleoni, M., D’Amico, R., & Menozzi, R. (2023) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2023.06.015 · Cited by 12
Amino Acid Metabolites and Slow Weight Loss in the Early Postoperative Period after Sleeve Gastrectomy
Kwon, Y., Jang, M., Lee, Y., Ha, J., & Park, S. S. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9082348 · Cited by 12
“Bariatric surgery is currently the most successful and durable treatment for the morbidly obese [1–3]; however, there is wide variability in the weight loss response to bariatric surgery [4–6] and over 20% of bariatric patients experience long-term postoperative weight regain [2,7,8].”
Background
Lower survival and higher rates of cirrhosis in patients with ROUX-EN-Y gastric bypass hospitalised with alcohol-associated hepatitis
Anugwom, C. M., Thomson, M., FREESE, R. L., Lake, J. R., & Lim, N. (2023) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2022-001083 · Cited by 12
Weight-Related Outcomes After Revisional Bariatric Surgery in Patients with Non-response After Sleeve Gastrectomy—a Systematic Review
Axer, S. S., Lederhuber, H., Stiede, F., Szabó, É., & Näslund, I. (2023) · Obesity Surgery · doi:10.1007/s11695-023-06630-2 · Cited by 11
“To choose the index operation as reference point implies a higher interest in the effects of bariatric surgery as an entity offering the opportunity to analyse individual weight trajectories [34].”
Background
Longitudinal trajectories and psychological predictors of weight loss and quality of life until 3 years after metabolic and bariatric surgery
Slurink, I. A. L., Nyklı́ček, I., Kint, R., Tak, D. J. A. M., Schiffer, A. A., Langenhoff, B. S., Ouwens, M. A., & Soedamah‐Muthu, S. S. (2024) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2024.111590 · Cited by 11
Bariatric Surgery and Weight Gain: Bibliometric Analysis
Seçkin, D., & Cebeci, F. (2024) · Obesity Surgery · doi:10.1007/s11695-024-07055-1 · Cited by 12
“Studies show that patients losing 20–30% of their total weight within a year or two after surgery will regain 7% of the lowest weight averages they have reached in 10 years [6–8].”
Background
Obesity-Related Glomerulopathy: Epidemiology, Pathogenesis, and Current Treatments
Yang, X., Bayliss, G. P., & Zhuang, S. (2024) · Integrative Medicine in Nephrology and Andrology · doi:10.1097/imna-d-24-00011 · Cited by 12
“[66] Although weight loss from bariatric surgery is more pronounced, complications cannot be ignored.”
Different effects of bariatric surgery on epigenetic plasticity in skeletal muscle of individuals with and without type 2 diabetes
Kovac, L., Gancheva, S., Jähnert, M., Sehgal, R., Mastrototaro, L., Schlensak, M., Granderath, F. A., Rittig, K., Roden, M., Schürmann, A., et al. (2024) · Diabetes & Metabolism · doi:10.1016/j.diabet.2024.101561 · Cited by 11
Cardioprotective benefits of metabolic surgery and GLP-1 receptor agonist–based therapies
Morissette, A., & Mulvihill, E. E. (2024) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2024.07.012 · Cited by 12
Short-term results of long biliopancreatic limb Roux-en-Y gastric bypass—is it superior?
Moon, R. C., Bornstein, A., Teixeira, A. F., & Jawad, M. A. (2019) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2019.12.021 · Cited by 11
Understanding Uncontrolled Eating after Bariatric Surgery: The Role of Excessive Skin and Body Image Shame
de Lourdes, M., Cerqueira, L., Pinto‐Bastos, A., Marôco, J. P., Palmeira, L., Brandão, I., Vaz, A. R., & Conceição, E. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10132967 · Cited by 11
“Bariatric surgery is currently the most effective and durable treatment for severe obesity, resulting in significant weight loss and substantial improvements in obesity-related comorbidities [1] and patients’ psychosocial function [2].”
Background
Bariatric surgery in patients with breast and endometrial cancer in California: population-based prevalence and survival
Lee, E., Kawaguchi, E. S., Zhang, J., Kim, S. E., Deapen, D., Liu, L., Sheidaee, N., Hwang, A. E., Kang, I. M., Sandhu, K. K., et al. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.09.017 · Cited by 11
Weight loss before bariatric surgery and its impact on poor versus excellent outcomes at 2 years
Rodríguez, F., Herrera-González, A., Sepúlveda, E. M., Guilbert, L., Hernández, L. A., Peñuñuri, L. F., Rodríguez, F. M., & Zerrweck, C. (2022) · Langenbeck s Archives of Surgery · doi:10.1007/s00423-021-02399-z · Cited by 11
“Patients with longer duration of T2DM, insulin use, and poor glycemic control prior to surgery have been identified to be most likely to experience non-remission [33].”
Background
Bariatric Surgeon Perspective on Revisional Bariatric Surgery (RBS) for Weight Recurrence
Giannopoulos, S., Kapsampelis, P., Pokala, B., Connors, J. D. N., Hilgendorf, W. A., Timsina, L., Clapp, B. L., Ghanem, O. M., Kindel, T. L., & Stefanidis, D. (2023) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2023.02.027 · Cited by 11
Weight Regain in the Second Year after Sleeve Gastrectomy Could Be a Predictor of Long-Term Outcomes?
Kapała, J. M., Maroszczuk, T., Lewandowska, J. A., Lech, P., & Dowgiałło‐Gornowicz, N. (2023) · Medicina · doi:10.3390/medicina59040766 · Cited by 12
“Although patterns varied, the majority of patients followed trajectories in which they regained weight from 3 to 7 years after the surgery [13].”
Background
Variation by race/ethnicity in the utilization and weight loss following metabolic bariatric surgery
Chen, G., Donahoo, W. T., Cardel, M. I., Holgerson, A. A., Ayzengart, A., Johnson-Mann, C. N., & Gurka, M. J. (2023) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2023.06.007 · Cited by 11
Metabolite signature of diabetes remission in individuals with obesity undergoing weight loss interventions
Thaker, V., Kwee, L. C., Chen, H., Bahnson, J. L., Ilkayeva, O., Muehlbauer, M. J., Wolfe, B. M., Purnell, J. Q., Pi-Sunyer, X., Newgard, C. B., et al. (2023) · Obesity · doi:10.1002/oby.23943 · Cited by 11
“Results of longitudinal follow-up of LABS-2 participants, including impact on T2D, have been previously reported [15,16].”
BackgroundSelf-citation
Psychological, behavioral, and weight-related aspects of patients undergoing reoperative bariatric surgery after gastric band: comparison with primary surgery patients
Conceição, E., Pinto‐Bastos, A., de Lourdes, M., Brandão, I., Teixeira, C., & Machado, P. P. P. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.02.011 · Cited by 11
End‐of‐Trial Health Outcomes in Look AHEAD Participants who Elected to have Bariatric Surgery
Wadden, T. A., Chao, A. M., Bahnson, J. L., Bantle, J. P., Clark, J. M., Gaussoin, S. A., Jakicic, J. M., Johnson, K., Miller, G. D., Unick, J. L., et al. (2019) · Obesity · doi:10.1002/oby.22411 · Cited by 14
“However, LAGB is no longer widely used in the United States because of lesser longterm benefits as compared with RYGB and SG (13,16,17).”
BackgroundSelf-citation
Distal gastric bypass revision for weight recurrence or nonresponse to primary procedure: initial experience and outcomes in an academic practice
Pokala, B., Giannopoulos, S., Athanasiadis, D. I., Motamedi, S. M. K., & Stefanidis, D. (2022) · Surgical Endoscopy · doi:10.1007/s00464-022-09719-4 · Cited by 11
Long-Term Changes in Bone Density and Bone Metabolism After Gastric Bypass Surgery: a Retrospective Cohort Study
Sperb, L. F., Leotti, V. B., Silveiro, S. P., de Azevedo, M. J., & Viana, L. V. (2023) · Obesity Surgery · doi:10.1007/s11695-022-06448-4 · Cited by 10
“Despite some participants being at the regain weight phase, the remission rate of chronic diseases related to severe obesity plus sustained weight loss was comparable with other successful results expected for the post-RYGB procedure state [41, 42].”
Result
Full-dose rivaroxaban in patients with a history of bariatric surgery: bridging the knowledge gap through a phase 1 study
Leven, C., Delavenne, X., Roche, C., Bressollette, L., Couturaud, F., Lacut, K., & Thereaux, J. (2024) · Journal of Thrombosis and Haemostasis · doi:10.1016/j.jtha.2024.06.024 · Cited by 11
Primary care practitioner and patient perspectives on care following bariatric surgery: A meta‐synthesis of qualitative research
Badorrek, S., Franklin, J., McBride, K. A., Conway, L. J., & Williams, K. (2024) · Obesity Reviews · doi:10.1111/obr.13829 · Cited by 10
The impact of self-efficacy and health literacy on outcome after bariatric surgery in Sweden: a protocol for a prospective, longitudinal mixed-methods study
Jaensson, M., Dahlberg, K., Nilsson, U. G., & Stenberg, E. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-027272 · Cited by 10
“However, the long-term efficacy of bariatric surgery differs between individuals.(9) In terms of complications, individual characteristics such as age (>50 years), specific obesity-related comorbidities and intraoperative adverse events such as bleeding are associated with increased postoperative complication rates.”
Background
Bariatric/Metabolic Surgery
Castagneto‐Gissey, L., Casella-Mariolo, J., & Mingrone, G. (2021) · Handbook of experimental pharmacology · doi:10.1007/164_2021_565 · Cited by 11
Changes in bone quality after Roux-en-Y gastric bypass: A prospective cohort study in subjects with and without type 2 diabetes
Blom-Høgestøl, I. K., Mala, T., Kristinsson, J. A., Brunborg, C., Gulseth, H. L., & Eriksen, E. F. (2019) · Bone · doi:10.1016/j.bone.2019.115069 · Cited by 10
Comparison of Comorbidity Treatment and Costs Associated With Bariatric Surgery Among Adults With Obesity in Canada
Davis, J. A., & Saunders, R. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.19545 · Cited by 10
Use of post-discharge heparin prophylaxis and the risk of venous thromboembolism and bleeding following bariatric surgery
Fennern, E. B., Farjah, F., Chen, J. Y., Verdial, F. C., Cook, S. B., Wolff, E. M., & Khandelwal, S. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-08049-7 · Cited by 10
Testosterone Therapy for Prevention and Treatment of Obesity in Men
Caliber, M., & Saad, F. (2020) · Androgens Clinical Research and Therapeutics · doi:10.1089/andro.2020.0010 · Cited by 11
Long‐term outcomes of metabolic surgery in overweight and obese patients with type 2 diabetes in Asia
Huang, Y., Lin, Y., Lee, W., Hur, K. Y., Kasama, K., Cheng, A. K. S., Lee, M., Wong, S. K., Soong, T., Lee, K., et al. (2020) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14279 · Cited by 11
“Sustained improvement in cholesterol and TG levels was reported in the LABS-2 study up to 7 years.(46) Although the change patterns of individual variables differed, the lipid profile improved significantly through 5 years in the current study, and this effect was similar between procedures, except for the low improve…”
BackgroundResultInfluential
Weight-loss thresholds after bariatric surgery and cardiovascular outcomes: more is better
Jiménez, A., Pané, A., Ibarzábal, A., de Hollanda, A., Tundidor, D., Balibrea, J. M., Andreu, A., Molero, J., Cañizares, S., Obach, A., et al. (2021) · International Journal of Obesity · doi:10.1038/s41366-021-00986-0 · Cited by 12
Psychosocial and behavioral correlates of weight loss 12 to 15 years after bariatric surgery
Martin‐Fernandez, K. W., Creel, D. B., & Schuh, L. M. (2021) · Journal of Behavioral Medicine · doi:10.1007/s10865-021-00263-5 · Cited by 12
Computational approaches to predicting treatment response to obesity using neuroimaging
Kozarzewski, L., Maurer, L., Mähler, A., Spranger, J., & Weygandt, M. (2021) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-021-09701-w · Cited by 9
Exploring microRNAs as predictive biomarkers for type 2 diabetes mellitus remission after sleeve gastrectomy: A pilot study
Wojciechowska, G. E. P., Szczerbiński, Ł., Krętowski, M., Niemira, M., Hady, H. R., & Kretowski, A. J. (2022) · Obesity · doi:10.1002/oby.23342 · Cited by 9
“SG is a simpler surgery procedure but it has a lower T2D remission rate than Roux- enY gastric bypass (RYGB) (4,11).”
BackgroundInfluential
Gut microbiota responses to bariatric surgery are associated with metabolic outcomes and type 2 diabetes remission
Olsson, L. M., Borgeraas, H., Chakaroun, R., Hofsø, D., Hertel, J. K., Dwibedi, C. K., Mitteregger, M., Holst, J. J., Tremaroli, V., Hjelmesaeth, J. S., et al. (2026) · Nature Metabolism · doi:10.1038/s42255-026-01525-9 · Cited by 10
“However, long-term weight loss is heterogeneous among individuals following different procedures 3 , and the metabolic improvements underlying T2D remission are only partially explained by weight loss 4 .”
Predictors of Success in Bariatric Surgery
Masnyj, S. V., Shea, B. J., & Khaitan, L. (2020) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-020-0637-6 · Cited by 9
Real-world evidence of health outcomes and medication use 24 months after bariatric surgery in the public healthcare system in Brazil: a retrospective, single-center study
Pajecki, D., Kawamoto, F. M., Dantas, A. C. B., Andrade, P. C., Brasil, N. C., Junqueira, S. M., de Oliveira, F. M. P., Ribeiro, R. A., & Santo, M. A. (2020) · Clinics · doi:10.6061/clinics/2020/e1588 · Cited by 10
“Our findings are also consistent with those reported by a recent study describing the long-term (7 years) weight change and health status following Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding (17), which show sustained weight loss and comorbidity remission specifically with bypass procedures.”
Result
Bariatric and metabolic surgery in patients with morbid obesity and multiple sclerosis - a nationwide, matched cohort study
Stenberg, E., Forsberg, L., Hedström, A. K., Hillert, J. A., & Näslund, E. B. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.02.013 · Cited by 9
Metabolic and Inflammatory Profiles of Post-Bariatric Patients with Weight Recidivism
Lopes, K. G., Romagna, E. C., da Silva, D. S., Bezerra, M. D. C. T., Leal, P. R. F., Pinto, J. E. D. S. S., Bouskela, E., de Souza, M. D. G. C., & Kraemer‐Aguiar, L. G. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06025-9 · Cited by 10
Reevaluating the Binge Eating Scale cut-off using DSM-5 criteria: analysis and replication in preoperative metabolic and bariatric surgery samples
Jeong, H., Hapenciuc, G., Meza, E., Le, J. T., Heinberg, L. J., & Marek, R. J. (2023) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2023.02.014 · Cited by 9
The Influence of Single Nucleotide Polymorphisms On Body Weight Trajectory After Bariatric Surgery: A Systematic Review
Duarte, A. C. S., da Silva, N. R., Gonçalves, V. S. S., Corgosinho, F. C., de Carvalho, K. M. B., & Horst, M. A. (2023) · Current Obesity Reports · doi:10.1007/s13679-023-00514-3 · Cited by 9
Factors Associated with Persistent Obstructive Sleep Apnea After Bariatric Surgery: A Narrative Review
Demaeyer, N., & Bruyneel, M. (2024) · Nature and Science of Sleep · doi:10.2147/nss.s448346 · Cited by 9
Unintended consequences for patients denied bariatric surgery: a 12-year follow-up
Kappus, M. S., Phillips, B. T., Zenquis, N., Larionova, E., Cudmore, J., & Jones, D. B. (2020) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2020.06.050 · Cited by 9
Am I on Track? Evaluating Patient-Specific Weight Loss After Bariatric Surgery Using an Outcomes Calculator
Varban, O. A., Bonham, A. J., Stricklen, A. L., Ross, R., Carlin, A. M., Finks, J. F., & Ghaferi, A. A. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05397-8 · Cited by 9
Ockham’s razor and the metabolic syndrome
Pories, W. J., Jones, T. E., Houmard, J. A., DeMaria, E. J., & Dohm, G. L. (2021) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2021.04.004 · Cited by 9
Self-citation
Rural/urban weight‐loss outcomes following bariatric surgery
Bauman, V., Apostolopoulos, A. N., Hasse, G. L., Parkman, T. J., & Ross, K. M. (2021) · Obesity Science & Practice · doi:10.1002/osp4.515 · Cited by 9
Decision Regret after Laparoscopic Sleeve Gastrectomy—5 Years’ Perspective
Bartosiak, K., Janik, M. R., Kowalewski, P., Walędziak, M. S., & Kwiatkowski, A. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05480-0 · Cited by 9
“Bariatric surgery is a highly effective treatment option for patients with severe obesity [2, 3].”
Background
Health state utilities associated with weight loss in type 2 diabetes and obesity
Boye, K. S., Matza, L. S., Stewart, K. D., Andrews, H., Howell, T. A., Stefański, A., Malley, K. G., Ishak, K. J., & Landó, L. F. (2021) · Journal of Medical Economics · doi:10.1080/13696998.2021.2002062 · Cited by 9
Effect of Significant Postoperative Complications on Decision Regret After Laparoscopic Sleeve Gastrectomy: a Case–Control Study
Bartosiak, K., Janik, M. R., Walędziak, M. S., Paśnik, K., & Kwiatkowski, A. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06113-w · Cited by 9
Sex-specific differences in metabolic outcomes after sleeve gastrectomy and intermittent fasting in obese middle-aged mice
Emiliano, A. B., Lopatinsky, N. R., Kraljević, M., Higuchi, S., He, Y., Haeusler, R. A., & Schwartz, G. J. (2022) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00017.2022 · Cited by 9
The Long-Term Impact of Postoperative Educational Programs on Weight Loss After Roux-en-Y Gastric Bypass
Bjerkan, K. K., Sandvik, J., Nymo, S., Græslie, H., Johnsen, G., Mårvik, R., Hyldmo, Å. A., Kulseng, B. E., Høydal, K. L., & Hoff, D. A. L. (2022) · Obesity Surgery · doi:10.1007/s11695-022-06187-6 · Cited by 9
“About one in four of the patients undergoing RYGB procedure in the Longitudinal Assessment of Bariatric Surgery (LABS) study did not achieve 20% weight reduction from operation to 7-year follow-up [4].”
Background

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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