Weight regain and associated metabolic impacts on patients in a single center

Khalid Alsowaina; Talal Almutairi; Lama Alzelfawi; Reem Altamimi; Laila Aldokhail; Lujain Alaradi; Shahad Alrowais

doi:10.18203/2349-2902.isj20243978

Authors

Khalid Alsowaina Upper GI and Bariatric Surgery Unit, Department of Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Talal Almutairi Department of Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
Lama Alzelfawi College of Medicine, Princess Noura Bint Abdulrahman University, Riyadh, Saudi Arabia
Reem Altamimi College of Medicine, Princess Noura Bint Abdulrahman University, Riyadh, Saudi Arabia
Laila Aldokhail College of Medicine, Princess Noura Bint Abdulrahman University, Riyadh, Saudi Arabia
Lujain Alaradi Princess Noura bint Abdulrahman University,Riyadh,Saudi Arabia
Shahad Alrowais College of Medicine, Princess Noura Bint Abdulrahman University, Riyadh, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-2902.isj20243978

Keywords:

Bariatric surgeries, Weight, Regain, Metabolic

Abstract

Background: Obesity is a global health concern, with 4 million people dying in 2017. Bariatric surgery, particularly sleeve gastrectomy, is effective but has been linked to weight regain. Studies show that only 20% of patients can keep weight off, and 60% require additional surgery due to weight regain. This retrospective study aims to measure long-term outcomes of gastric sleeves and associated risk factors.

Methods: A retrospective study utilizing patient records from 2018 to 2023 aims to collect data from the medical records of individuals aged 15-70 years in Prince Sultan Military Medical City (PSMMC). Patients who were under 15 years old or above 70 years old and those who underwent other types of bariatric surgeries or complications not related to the procedures were excluded.

Results: One hundred and forty-one sleeve gastrectomy patients were analyzed. The mean age was 36.8 (SD=12.9) years, with 51.8% being over 35 years old. Additionally, female patients were dominant (70.9%). No significant differences were observed in the mean values of low density lipoprotein (LDL), triglyceride, and cholesterol before and after the surgery (p>0.05).

Conclusions: This study has found that sleeve gastrectomy is an effective surgical intervention for significantly improving metabolic parameters, including body mass index (BMI), glycated hemoglobin (HbA1c), blood pressure, creatinine, and high density lipoprotein (HDL) levels. No significant changes were observed for LDL, triglycerides, and total cholesterol. The study suggests that sleeve gastrectomy can lead to durable metabolic benefits irrespective of patient demographics, and further research is needed to evaluate its sustainability.

Metrics

Metrics Loading ...

References

World Health Organization. Obesity. Available at: https://www.who.int/health-topics/obesity#tab=tab_ 1. Accessed on 13 October 2024.

Flores-Dorantes MT, Díaz-López YE, Gutiérrez-Aguilar R. Environment and Gene Association With Obesity and Their Impact on Neurodegenerative and Neurodevelopmental Diseases. Front Neurosci. 2020;14. DOI: https://doi.org/10.3389/fnins.2020.00863

Aderinto N, Olatunji G, Kokori E, Olaniyi P, Isarinade T, Yusuf IA. Recent advances in bariatric surgery: a narrative review of weight loss procedures. Ann Med Surg. 2023;85(12):6091-104. DOI: https://doi.org/10.1097/MS9.0000000000001472

Lemanu DP, Singh PP, Rahman H, Hill AG, Babor R, MacCormick AD. Five-year results after laparoscopic sleeve gastrectomy: a prospective study. Surg Obes Relat Dis. 2015;11(3):518-24. DOI: https://doi.org/10.1016/j.soard.2014.08.019

Gentile JKA, Oliveira KD, Pereira JG, Tanaka DY, Guidini GN, Cadona MZ, et al. The intestinal microbiome in patients undergoing bariatric surgery: a systematic review. Arq Bras Cir Dig (São Paulo). 2022;35:1707. DOI: https://doi.org/10.1590/0102-672020220002e1707

Kheirvari M, Dadkhah Nikroo N, Jaafarinejad H, Farsimadan M, Eshghjoo S, Hosseini S, et al. The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review. Heliyon. 2020;6(2):e03496. DOI: https://doi.org/10.1016/j.heliyon.2020.e03496

Saif T, Strain GW, Dakin G, Gagner M, Costa R, Pomp A. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis. 2012;8(5):542-7. DOI: https://doi.org/10.1016/j.soard.2012.01.013

Yu Y, Klem ML, Kalarchian MA, Ji M, Burke LE. Predictors of weight regain after sleeve gastrectomy: an integrative review. Surg Obes Relat Dis. 2019;15(6):995-1005. DOI: https://doi.org/10.1016/j.soard.2019.02.009

Alfadda AA, Al-Naami MY, Masood A, Elawad R, Isnani A, Ahamed SS, et al. Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience. J Clin Med. 2021;10(21):4922. DOI: https://doi.org/10.3390/jcm10214922

Magro DO, Geloneze B, Delfini R, Pareja BC, Callejas F, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648-51. DOI: https://doi.org/10.1007/s11695-007-9265-1

Masood A, Alsheddi L, Alfayadh L, Bukhari B, Elawad R, Alfadda AA. Dietary and Lifestyle Factors Serve as Predictors of Successful Weight Loss Maintenance Postbariatric Surgery. J Obes. 2019;2019:7295978. DOI: https://doi.org/10.1155/2019/7295978

Kowalewski PK, Olszewski R, Walędziak MS, Janik MR, Kwiatkowski A, Gałązka-Świderek N, et al. Long-Term Outcomes of Laparoscopic Sleeve Gastrectomy-a Single-Center, Retrospective Study. Obes Surg. 2018;28(1):130-4. DOI: https://doi.org/10.1007/s11695-017-2795-2

Lind R, Hage K, Ghanem M, Shah M, Vierkant RA, Jawad M, et al. Long-Term Outcomes of Sleeve Gastrectomy: Weight Recurrence and Surgical Non-responders. Obes Surg. 2023;33(10):3028-34. DOI: https://doi.org/10.1007/s11695-023-06730-z

Ben-Porat T, Mashin L, Kaluti D, Goldenshluger A, Shufanieh J, Khalaileh A, et al. Weight Loss Outcomes and Lifestyle Patterns Following Sleeve Gastrectomy: an 8-Year Retrospective Study of 212 Patients. Obes Surg. 2021;31(11):4836-45. DOI: https://doi.org/10.1007/s11695-021-05650-0

Asim S, Dallan D. The success of sleeve gastrectomy in the management of metabolic syndrome and obesity. J Biomed Res. 2015;29(2):93. DOI: https://doi.org/10.7555/JBR.28.20140107

Albaugh VL, He Y, Münzberg H, Morrison CD, Yu S, Berthoud H-R. Regulation of body weight: Lessons learned from bariatric surgery. Mol Metab. 2023;68:101517. DOI: https://doi.org/10.1016/j.molmet.2022.101517

Leanza S, Coco D, Viola MG. Sleeve Gastrectomy: Literature Results. Maedica (Buchar). 2024;19(1):137-46. DOI: https://doi.org/10.26574/maedica.2024.19.1.137

Gigante G, Martines G, Franco I, Capuano P, Memeo V. Short- and medium-term outcomes of laparoscopic sleeve gastrectomy: a single center experience. G Chir. 2014;35(7-8):200-1. DOI: https://doi.org/10.11138/gchir/2014.35.7.200

Kaouk L, Hsu AT, Tanuseputro P, Jessri M. Modifiable factors associated with weight regain after bariatric surgery: a scoping review. F1000 Res. 2020;8:615. DOI: https://doi.org/10.12688/f1000research.18787.2

Hatami M, Pazouki A, Hosseini-baharanchi FS, Kabir A. Bariatric Surgeries, from Weight Loss to Weight Regain: A Retrospective Five-Years Cohort Study. Obes Facts. 2023;16(6):540-7. DOI: https://doi.org/10.1159/000533586

Cooper TC, Simmons EB, Webb K, Burns JL, Kushner RF. Trends in Weight Regain Following Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery. Obes Surg. 2015;25(8):1474-81. DOI: https://doi.org/10.1007/s11695-014-1560-z

Lauti M, Kularatna M, Hill AG, MacCormick AD. Weight Regain Following Sleeve Gastrectomy—a Systematic Review. Obes Surg. 2016;26(6):1326-34. DOI: https://doi.org/10.1007/s11695-016-2152-x

King WC, Hinerman AS, Belle SH, Wahed AS, Courcoulas AP. Comparison of the Performance of Common Measures of Weight Regain After Bariatric Surgery for Association With Clinical Outcomes. JAMA. 2018;320(15):1560. DOI: https://doi.org/10.1001/jama.2018.14433

Cornejo-Pareja I, Molina-Vega M, Gómez-Pérez AM, Damas-Fuentes M, Tinahones FJ. Factors Related to Weight Loss Maintenance in the Medium–Long Term after Bariatric Surgery: A Review. J Clin Med. 2021;10(8):1739. DOI: https://doi.org/10.3390/jcm10081739

Cho Y-H, Lee Y, Choi JI, Lee SR, Lee SY. Weight loss maintenance after bariatric surgery. World J Clin Cases. 2023;11(18):4241-50. DOI: https://doi.org/10.12998/wjcc.v11.i18.4241

Varma S, Clark JM, Schweitzer M, Magnuson T, Brown TT, Lee CJ. Weight regain in patients with symptoms of post–bariatric surgery hypoglycemia. Surg Obes Relat Dis. 2017;13(10):1728-34. DOI: https://doi.org/10.1016/j.soard.2017.06.004

Billing-Bullen G, Nielsen D, Wham C, Kruger R. Enablers and barriers to prevent weight-regain post bariatric surgery – A qualitative enquiry. Eat Behav. 2022;47:101677. DOI: https://doi.org/10.1016/j.eatbeh.2022.101677

Ji Y, Lee H, Kaura S, Yip J, Sun H, Guan L, et al. Effect of Bariatric Surgery on Metabolic Diseases and Underlying Mechanisms. Biomolecules. 2021;11(11):1582. DOI: https://doi.org/10.3390/biom11111582

Varban OA, Bonham AJ, Finks JF, Telem DA, Obeid NR, Ghaferi AA. Is it worth it? Determining the health benefits of sleeve gastrectomy in patients with a body mass index <35 kg/m2. Surg Obes Relat Dis. 2020;16(2):248-53. DOI: https://doi.org/10.1016/j.soard.2019.10.027

Wilmington R, Abuawwad M, Holt G, Anderson R, Aldafas R, Awad S, et al. The Effects of Preoperative Glycaemic Control (HbA1c) on Bariatric and Metabolic Surgery Outcomes: Data from a Tertiary-Referral Bariatric Centre in the UK. Obes Surg. 2024;34(3):850-4. DOI: https://doi.org/10.1007/s11695-023-06964-x

Wysocki M, Walędziak M, Hady HR, Czerniawski M, Proczko-Stepaniak M, Szymański M, et al. Type 2 Diabetes Mellitus and Preoperative HbA1c Level Have no Consequence on Outcomes after Laparoscopic Sleeve Gastrectomy—a Cohort Study. Obes Surg. 2019;29(9):2957-62. DOI: https://doi.org/10.1007/s11695-019-03936-y

Petroni R, Di Mauro M, Altorio SF, Romano S, Petroni A, Penco M. The role of bariatric surgery for improvement of hypertension in obese patients. J Cardiovasc Med. 2017;18(3):152-8. DOI: https://doi.org/10.2459/JCM.0000000000000424

Abellán Garay L, Navarro García MI, González-Costea Martínez R, Torregrosa Pérez NM, Vázquez Rojas JL. Medium/long term evaluation of lipid profile after bariatric surgery (gastric bypass versus sleeve gastrectomy). Endocrinol Diabetes y Nutr (English ed). 2021;68(6):372-80. DOI: https://doi.org/10.1016/j.endien.2021.10.007

Bettini S, Segato G, Prevedello L, Fabris R, Prà CD, Zabeo E, et al. Improvement of Lipid Profile after One-Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy. Nutrients. 2021;13(8):2770. DOI: https://doi.org/10.3390/nu13082770

Park JY. Weight Loss Prediction after Metabolic and Bariatric Surgery. J Obes Metab Syndr. 2023;32(1):46-54. DOI: https://doi.org/10.7570/jomes23008

Dowgiałło-Wnukiewicz N, Janik MR, Lech P, Major P, Pędziwiatr M, Kowalewski PK, et al. Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study. Wideochir Inne Tech Maloinwazyjne. 2020;15(1):123-8. DOI: https://doi.org/10.5114/wiitm.2019.81450

Alqahtani SJ, Alfawaz HA, Moubayed NMS, Hassan WM, Almnaizel AT, Alshiban NMS, et al. Bariatric Surgery as Treatment Strategy of Obesity in Saudi People: Effects of Gut Microbiota. Nutrients. 2023;15(2):361. DOI: https://doi.org/10.3390/nu15020361