What is the clinical evidence from this study?

Study design: Cohort. Population: Severe obesity (n=18082). Intervention: Lowest quartile of percentage total weight loss (%TWL) at 3 months vs. Higher quartiles of %TWL at 3 months (Below Median, Above Median, High). Primary outcome: Difference in percentage total weight loss (%TWL) change from 3 to 60 months (RYGB group, Low vs Below Median quartile) (B -1.03 %TWL, 95% CI -1.51 to -0.54, p=<0.001).

July 16, 2022Obesity SurgeryOpen Access

Early Postoperative Weight Loss Predicts Weight Loss up to 5 Years After Roux-En-Y Gastric Bypass, Banded Roux-En-Y Gastric Bypass, and Sleeve Gastrectomy

Q: What are the key findings of this study?

Patients in the lowest quartile of total weight loss at 3 months after bariatric surgery had significantly lower weight loss trajectories up to 5 years postoperatively compared to those in higher quartiles.

Q: What does this research mean for the field?

Patients in the lowest quartile of total weight loss at 3 months after bariatric surgery maintain significantly lower weight loss trajectories up to 5 years postoperatively across multiple procedure types. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Lowest quartile weight loss at three months post-bariatric surgery predicts poorer five-year weight loss trajectories.

B -1.03 %TWL
95% CI -1.51 to -0.54
P<0.001
n=18,082

Why the study?

Previous studies showed early postoperative weight loss identified patients with lower weight loss after bariatric surgery, but follow-up was limited to 12-36 months.

Does early postoperative weight loss at 3 months predict long-term weight loss trajectories up to 5 years in patients undergoing bariatric surgery?

Population

Patients undergoing RYGB (n=13,106), SG (n=3585), or BRYGB (n=1391)

Comparison

Lowest %TWL quartile at 3 months vs other %TWL quartiles

Design

Cohort study

Follow-up

5 years

Authors

OTOnno M. Tettero VMValerie M. MonpellierNederlandse Obesitas Kliniek IJIgnace M. C. JanssenNederlandse Obesitas Kliniek

Discussion

Member takes

Overview

Lowest-quartile 3-month weight loss was associated with inferior 5-year trajectories after bariatric surgery; supports early stratification but leaves open whether interventions alter outcomes.

Study Design

Type

Cohort (n=18,082)

Multicenter

Yes

Structured PICO

Does early postoperative weight loss at 3 months predict long-term weight loss trajectories up to 5 years in patients undergoing bariatric surgery?

Population

18,082 patients with severe obesity who underwent primary bariatric surgery (RYGB, SG, or BRYGB) and were followed for up to 5 years to assess weight loss trajectories.

Exposure

Lowest quartile of percentage total weight loss (%TWL) at 3-month follow-up after bariatric surgery

Comparator

Other quartiles of percentage total weight loss (%TWL) at 3-month follow-up

Outcome

Weight loss trajectories up to 5 years postoperativelysurrogate

Main Result

Mean Difference: -1.03 (95% CI -1.51–-0.54)

p-value: p=<0.001

Early weight loss at 3 months after bariatric surgery predicts long-term weight loss trajectories up to 5 years, allowing for early identification of patients who may benefit from additional behavioral or medical interventions.

Limitations

Patient retention rates decreased with each subsequent follow-up year, potentially leaving patients lost to follow-up underexposed.
Outcomes other than weight loss, such as predicted reduction of comorbidities, were not assessed for intervention selection.
The use of %TWL quartiles to distinguish groups may not reflect absolute clinical success, as even the lowest quartile achieved significant weight loss at 5 years.

Cite This Study

Tettero et al. (2022) conducted a cohort in Severe obesity (n=18,082). Lowest quartile of percentage total weight loss (%TWL) at 3 months vs. Higher quartiles of %TWL at 3 months (Below Median, Above Median, High) was evaluated on Difference in percentage total weight loss (%TWL) change from 3 to 60 months (RYGB group, Low vs Below Median quartile) (B -1.03 %TWL, 95% CI -1.51 to -0.54, p=<0.001). Patients in the lowest quartile of total weight loss at 3 months after bariatric surgery had significantly lower weight loss trajectories up to 5 years postoperatively compared to those in higher quartiles.

synapsesocial.com/papers/6aaa3f83cb4848aa8fe9dee9 https://doi.org/10.1007/s11695-022-06166-x

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July 16, 2022Obesity SurgeryOpen Access

Early Postoperative Weight Loss Predicts Weight Loss up to 5 Years After Roux-En-Y Gastric Bypass, Banded Roux-En-Y Gastric Bypass, and Sleeve Gastrectomy

View Full Paper

Ask AI

Bookmark

Key result

Lowest quartile weight loss at three months post-bariatric surgery predicts poorer five-year weight loss trajectories.

B -1.03 %TWL
95% CI -1.51 to -0.54
P<0.001
n=18,082

Why the study?

Previous studies showed early postoperative weight loss identified patients with lower weight loss after bariatric surgery, but follow-up was limited to 12-36 months.

Does early postoperative weight loss at 3 months predict long-term weight loss trajectories up to 5 years in patients undergoing bariatric surgery?

Population

Patients undergoing RYGB (n=13,106), SG (n=3585), or BRYGB (n=1391)

Comparison

Lowest %TWL quartile at 3 months vs other %TWL quartiles

Design

Cohort study

Follow-up

5 years

Authors

OTOnno M. Tettero VMValerie M. MonpellierNederlandse Obesitas Kliniek IJIgnace M. C. JanssenNederlandse Obesitas Kliniek

Discussion

Member takes

Overview

Lowest-quartile 3-month weight loss was associated with inferior 5-year trajectories after bariatric surgery; supports early stratification but leaves open whether interventions alter outcomes.

Study Design

Type

Cohort (n=18,082)

Multicenter

Yes

Structured PICO

Does early postoperative weight loss at 3 months predict long-term weight loss trajectories up to 5 years in patients undergoing bariatric surgery?

Population

18,082 patients with severe obesity who underwent primary bariatric surgery (RYGB, SG, or BRYGB) and were followed for up to 5 years to assess weight loss trajectories.

Exposure

Lowest quartile of percentage total weight loss (%TWL) at 3-month follow-up after bariatric surgery

Comparator

Other quartiles of percentage total weight loss (%TWL) at 3-month follow-up

Outcome

Weight loss trajectories up to 5 years postoperativelysurrogate

Main Result

Mean Difference: -1.03 (95% CI -1.51–-0.54)

p-value: p=<0.001

Limitations

Patient retention rates decreased with each subsequent follow-up year, potentially leaving patients lost to follow-up underexposed.
Outcomes other than weight loss, such as predicted reduction of comorbidities, were not assessed for intervention selection.
The use of %TWL quartiles to distinguish groups may not reflect absolute clinical success, as even the lowest quartile achieved significant weight loss at 5 years.

Cite This Study

synapsesocial.com/papers/6aaa3f83cb4848aa8fe9dee9 https://doi.org/10.1007/s11695-022-06166-x

Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

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