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August 29, 2026Obesity SurgeryOpen Access

Preoperative Factors Associated with Weight Loss and Recurrent Weight Gain after Bariatric Surgery: A Longitudinal Study in a UK Public Healthcare Setting

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Key result

Roux-en-Y and one-anastomosis gastric bypass linked to ~5% greater weight loss versus sleeve gastrectomy.

  • P<0.005
  • n=2,092

Why the study?

Although bariatric surgery is an effective treatment for obesity, this study aimed to identify demographic factors associated with weight loss and recurrent weight gain over a 10-year follow-up period.

What preoperative factors predict weight loss and recurrent weight gain over 10 years following bariatric surgery?

Population

2092 bariatric surgery patients

Comparison

Predictors of weight loss and recurrent weight gain across surgical types and demographic factors

Design

Retrospective observational study

Follow-up

10 years

Authors

LALuqman Naim Bin AizanNorthern Health and Social Care TrustASAkheel A. SyedUniversity of ManchesterBABilal AlkhaffafNorthern Health and Social Care Trust

Discussion

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Implication

Demographic factors were associated with 10-year %TWL trajectories after bariatric surgery; leaves open whether they should guide patient selection or trial stratification.

Key Points

  • Identify demographic and clinical predictors of long-term weight loss and recurrent weight gain over a 10-year follow-up period following bariatric surgery.
  • Retrospective observational study of 2,092 bariatric surgery patients in a UK public healthcare setting evaluating percentage total weight loss (%TWL) trends over 10 years.
  • Multivariate regression analysis performed on subsets of 1,032 patients to evaluate predictors of weight loss and 605 patients to identify predictors of recurrent weight gain.
  • Mean %TWL peaked at 2 years post-surgery (31.3 ± 10.7%) before decreasing to 25.1 ± 12.6% at 10 years; 5-year %TWL was higher for Roux-en-Y gastric bypass (27.9 ± 11.5%) and one-anastomosis gastric bypass (28.3 ± 10.1%) than sleeve gastrectomy (22.8 ± 12.5%, p < 0.005).
  • Age, sex, baseline body mass index, diabetes, operation type, and smoking status significantly predicted weight loss up to 2 years postoperatively (p < 0.05).
  • Age, hypertension, Index of Multiple Deprivation quintile, and initial 2-year %TWL significantly predicted recurrent weight gain after 2 years (p < 0.05).

Study Design

Type

Cohort (n=2,092)

Multicenter

No

Structured PICO

What preoperative factors predict weight loss and recurrent weight gain over 10 years following bariatric surgery?

P
Population
2,092 adults with severe obesity undergoing bariatric surgery at a UK public healthcare center, followed for up to 10 years to assess weight loss and recurrent weight gain.
E
Exposure
Bariatric surgery (Roux-en-Y gastric bypass, one-anastomosis gastric bypass, or sleeve gastrectomy)
O
Outcome
Percentage total weight loss (%TWL) trends over 10 years, and predictors of weight loss and recurrent weight gainsurrogate

Main Result

Absolute Event Rate: 27.9% vs 22.8%

p-value: p=<0.005

Bariatric surgery results in significant weight loss peaking at 2 years, with specific preoperative factors such as age, sex, BMI, and diabetes predicting initial weight loss, while age, hypertension, and early weight loss predict recurrent weight gain.

Limitations

  • Retrospective design at a single center, introducing potential procedure-selection bias.
  • Predominantly white Caucasian cohort, limiting generalizability across ethnicities.
  • Large disparity in sex, with a much larger proportion of female patients.
  • Poor follow-up rates that worsened over time (only 29% at 10 years), introducing a high risk of selection and attrition bias.

Cite This Study

Aizan et al. (2026) conducted a cohort in Obesity (n=2,092). Roux-en-Y gastric bypass and one-anastomosis gastric bypass vs. Sleeve gastrectomy was evaluated on Percentage total weight loss (%TWL) at 5 years (p=<0.005). Roux-en-Y gastric bypass and one-anastomosis gastric bypass resulted in significantly greater percentage total weight loss up to 5 years compared to sleeve gastrectomy.

synapsesocial.com/papers/6a92994d8e5d7d1fc0c11232https://doi.org/10.1007/s11695-026-08900-1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Factors associated with different patterns of weight change after bariatric surgery: A longitudinal study2021
  2. 2Bariatric Surgeries, from Weight Loss to Weight Regain: A Retrospective Five-Years Cohort Study2023 · 17 citations
  3. 3Key Time Points After Bariatric Surgery, From Weight Loss To Weight Regain: Long-Term Retrospective Cohort Study2021
  4. 4Weight loss outcomes and associated factors after metabolic bariatric surgery: Analysis of routine clinical data in Scotland2024 · 14 citations
  5. 5Socio-Demographic and Preoperative Clinical Factors Associated With 5-Year Weight Trajectories After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy2024 · 1 citations