Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes

Melton, Genevieve B.; Steele, Kimberley E.; Schweitzer, Michael A.; Lidor, Anne O.; Magnuson, Thomas H.

doi:10.1007/s11605-007-0427-1

Cited by 175Bariatric Surgery and OutcomesBody Contouring and SurgeryMinimally Invasive Surgical Techniques

Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes

Melton, Genevieve B., Steele, Kimberley E., Schweitzer, Michael A., Lidor, Anne O., Magnuson, Thomas H.·2008·Journal of Gastrointestinal Surgery

DOI 10.1007/s11605-007-0427-1

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Abstract

Although Roux-en-Y gastric bypass surgery (RYGBP) is safe and effective at achieving weight loss in the majority of severely obese patients, a subset fails to achieve expected weight loss outcomes. Factors associated with poor weight loss are not well defined. Patients undergoing open RYGBP using a standardized surgical technique and clinical pathway by a single surgeon at a dedicated bariatric center were reviewed. Suboptimal weight loss was defined as failure to lose at least 40% excess body weight by 12 months postoperatively. Of 555 consecutive patients who underwent RYGBP from 1999 to 2004, a 12-month follow-up was available for the 495 (89%). Suboptimal weight loss occurred in 55 (11%) and was associated on unadjusted bivariate analysis with increased body mass index (BMI; p = 0.0002), diabetes mellitus (p = 0.0002), Medicaid insurance (p = 0.04), and male sex (p = 0.01). On adjusted multivariate analysis, increased BMI (p = 0.003), diabetes (p = 0.002), and male gender (p = 0.04) were associated with suboptimal weight loss, but type of insurance (p = 0.11) was not. Medicaid patients were younger (p = 0.01) and had higher BMI (p = 0.0002). Suboptimal weight loss after RYGBP appears to be associated with greater BMI, male sex, and diabetes but not type of insurance. This study may help identify patients who could benefit from increased perioperative education and counseling or selection of procedures with greater malabsorption.

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As many as 15% to 20% of patients fail to lose weight or regain the lost weight after bariatric surgery.
“As many as 15% to 20% fail to lose weight or regain the lost weight [114, 115].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [114]
Male gender was associated with suboptimal or worse weight loss after Roux-en-Y gastric bypass.
“research suggested that male gender was associated with suboptimal or worse WL after RYGB [34, 78].”
From Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps—a Scoping Review (2021) · cites this paper as [78]
Greater preoperative BMI was significantly associated with suboptimal weight loss.
“Greater preoperative BMI was also significantly associated with suboptimal WL [78, 79].”
From Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps—a Scoping Review (2021) · cites this paper as [78]

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Authors: Melton, G. B., Steele, K. E., Schweitzer, M. A., Lidor, A. O., & Magnuson, T. H.
Affiliations: Johns Hopkins University (US)
Corresponding author: Magnuson, Thomas H.
ORCID: Melton, Genevieve B.
Steele, Kimberley E.
Schweitzer, Michael A.
Lidor, Anne O.
Venue: Journal of Gastrointestinal Surgery
Publisher: Elsevier BV
Published: 2008-02
Volume: 12
Issue: 2
Pages: 250-255
ISSN: 1091-255X (ISSN-L)
DOI: 10.1007/s11605-007-0427-1
OpenAlex: W2025375061
Cited by: 175
References: 32
Citations by year: 2026: 2 · 2025: 7 · 2024: 7 · 2023: 7 · 2022: 14 · 2021: 7 · 2020: 18 · 2019: 9 · 2018: 8 · 2017: 7 · 2016: 10 · 2015: 15 · 2014: 14 · 2013: 15 · 2012: 8
FWCI: 5.31
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Gastrointestinal Surgery (publishedVersion)
PubMed (publishedVersion)
Funders: Johns Hopkins University
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: Roux-en-Y gastric bypass, bariatric surgery, weight loss outcomes, obesity, body mass index, diabetes mellitus, Medicaid, male sex, risk factors, malabsorptive surgery
MeSH terms: Adult, Aged, Diabetes Mellitus, Female, Humans, Insurance, Health, Male, Medicaid, Middle Aged, Obesity, Morbid, Postoperative Period, Risk Factors, Sex Factors, United States, Gastric Bypass, Weight Loss, Comorbidity, Body Mass Index, Multivariate Analysis, Treatment Failure

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Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes

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