Effect of preoperative body mass index on weight loss after obesity surgery
Open accessAbstract
Background Previous studies suggest that individuals with body mass index (BMI) above versus below 60 kg/m(2) attain lower percentage of excess weight loss (%EWL) after bariatric surgery. The objectives of this study were to (1) test whether conclusions drawn about the effect of preoperative BMI on postoperative weight loss depend on the outcome measure, (2) test for evidence of a threshold effect at BMI = 60 kg/m(2), and (3) test the effect from surgery to 12-month follow-up, relative to 12- to 36-month follow-up.Methods Retrospective analyses of participants grouped according to preoperative BMI: 35-39.9 (n = 232); 40-49.9 (n = 1166); 50-59.9 (n = 429);≥60 (n = 166).Results As anticipated, individuals with higher versus lower preoperative BMI had greater total weight loss but lower %EWL at all postoperative time points (all, P<.0005). However, these individuals also had lower percentage of initial weight loss (%IWL) at all time points beyond 1 month postsurgery (all, P<.0005). From 12- to 36-months, individuals with BMI 35-39.9 had 3.2±14.3 %IWL (P<.0001); 40-49.9 had 1.0±8.9 %IWL (P<.0005); 50-59.9 had-2.4±10.0 %IWL (P<.0005); and≥60 had-3.6±11.5 %IWL (P<.0005). Overall F3,1989 = 20.2, P< .0005.Conclusions Conclusions drawn about the effect of preoperative BMI may depend on the outcome measure. A dosage effect of preoperative BMI was apparent, with heavier individuals showing lower percentages of initial and excess weight loss, regardless of BMI above or below 60 kg/m(2). Finally, this effect was particularly apparent after the initial 12-month rapid weight loss phase, when less obese (BMI<50) individuals continued losing weight, while heavier individuals (BMI≥50) regained significant weight.
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Patients with a pre-surgical BMI of ≥50 kg/m2 are more likely to regain weight, while a lower pre-surgical BMI is associated with more successful weight loss 12 to 36 months after surgery.
“Patients with a pre-surgical BMI of ≥ 50 kg/m2 are more likely to regain weight, while a lower pre-surgical BMI has been associated with more successful weight loss outcomes 12 to 36 months after surgery [48].”
From Patients' Experiences of Weight Regain After Bariatric Surgery (2022) · cites this paper as [48]
Higher preoperative BMI was associated with weight regain and a worse weight trajectory, where patients with baseline BMI ≥50 kg/m2 were more likely to have significant weight regain, while those with BMI <50 kg/m2 were more likely to continue losing weight at 12 months post-surgery.
“higher preoperative BMI was associated with WR and a worse weight trajectory, where patients with baseline BMI ≥ 50 kg/m2 were more likely to have significant WR, while those with BMI < 50 kg/m2 were more likely to continue losing weight at 12 months post-surgery [76].”
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- Authors
- Ochner, C. N., Jochner, M. C. E., Caruso, E. A., Teixeira, J., & Xavier Pi-Sunyer, F.
- Affiliations
- St. Luke's-Roosevelt Hospital Center (US)
- Corresponding author
- Ochner, Christopher N.
- Venue
- Surgery for Obesity and Related Diseases
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 9
- Issue
- 3
- Pages
- 423-427
- ISSN
- 1550-7289 (ISSN-L)
- PMC
- PMC3674202
- OpenAlex
- W2072823620
- Cited by
- 96
- References
- 23
- Citations by year
- 2026: 9 · 2025: 4 · 2024: 12 · 2023: 13 · 2022: 9 · 2021: 13 · 2020: 7 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 1
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Surgery for Obesity and Related Diseases (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK026687)
- National Center for Research Resources (KL2RR024157)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- bariatric surgery
- MeSH terms
- Adult, Female, Humans, Male, Obesity, Morbid, Laparoscopy, Postoperative Care, Preoperative Care, Retrospective Studies, Gastric Bypass, Gastroplasty, Weight Loss, Body Mass Index, Treatment Outcome
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