Total weight loss after laparoscopic Roux-en-Y gastric bypass is influenced by preoperative weight loss: can we predict the outcome?

Abstract Background Preoperative weight loss is associated with higher postoperative weight loss (WL) at 1-2 year follow up in laparoscopic Roux-en-Y gastric bypass (LRYGB) patients. Objective To evaluate the possible association between preoperative and postoperative WL at 3 year follow up and identify risk factors for insufficient WL. Setting A single center prospective cohort study in the Netherlands. Methods Patients undergoing primary LRYGB and laparoscopic conversion from band to bypass (redo LRYGB) were instructed to lose weight preoperatively. Follow up data were collected 1, 2 and 3 years postoperatively. Weight loss was described as percentage total weight loss (%TWL) and percentage excess body mass index (BMI) loss (%EBMIL). Patients were divided into two groups: group A lost any amount of weight, group B did not lose any weight or gained weight preoperatively. Results: group A consisted of 230 patients (median preoperative %TWL 4.8%), group B of 46 patients (median preoperative %TWL -1.3%). Median BMI at intake was 44.1. Baseline characteristics were similar. %TWL and BMI for group A and B in the primary LRYGB was respectively at 1, 2 and 3 years: 32.2% (BMI 28.6) vs 23.9% (BMI 32.2), 31.8% (BMI 28.9) vs 25.2% (BMI 31.9) and 33.3% (BMI 29.7) vs 21.9% (BMI 34) respectively, all p Conclusion Preoperative WL in primary LRYGB patients can be useful to identify patients at risk of inadequate postoperative WL. In redo LRYGB patients different risk factors be considered for prediction of inadequate postoperative weight loss.