Physical inactivity was identified as the only independent risk factor for weight regain after metabolic bariatric surgery, with an odds ratio of 9.92.
What are the definitions and predictors of weight regain after metabolic bariatric surgery?
Physical inactivity emerges as an independent risk factor for weight regain after metabolic bariatric surgery, though the field suffers from a lack of standardized definitions for weight regain.
Abstract Background Metabolic and bariatric surgery (MBS) offers significant benefits, but recurrent weight gain (WR)—defined as substantial weight regain after initial postoperative weight loss—remains a challenge for some patients. However, the lack of a standardized definition makes it difficult to determine the true prevalence of WR and identify its predictors. This study aims to systematically define WR and identify clinically significant predictors to enhance patient counseling. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review and meta-analysis using three databases: PubMed, Scopus, and Web of Science. A random-effects meta-analysis was performed to assess odds ratios (OR) and mean differences for factors associated with WR. Heterogeneity was evaluated using the I² statistic. Results A total of 43 studies were included in the qualitative analysis, and 10 were included in the quantitative analysis. Although there is no universally accepted definition of WR, the most common criterion in this review was regaining ≥10% of nadir weight (46.5%). Age, preoperative body mass index (BMI), time since surgery, diabetes mellitus, dyslipidemia, hypertension, and gender were not significantly associated with an increased risk of WR. Physical activity was the only significant protective factor (OR = 9.92; 95% c.i. = 2.32, 42.45; P = 0.17), with moderate heterogeneity (I² = 46%, P = 0.17). Conclusion The use of multiple definitions and thresholds for WR underscores the need for a standardized criterion. This meta-analysis suggests that WR is influenced by modifiable factors, with physical inactivity emerging as the only independent risk factor.
Amorim-Cruz et al. (2026) studied this question. Physical inactivity was identified as the only independent risk factor for weight regain after metabolic bariatric surgery, with an odds ratio of 9.92.