Defining Weight Loss After Bariatric Surgery: a Call for Standardization

Background Some weight regain is expected after bariatric surgery; however, this concept is not well defined. A favorable weight loss response has commonly been defined as 50% excess weight loss (EWL). The medical literature uses %total weight loss (%TWL), which has recently been adopted in some sur...

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Bibliographic Details
Published in:Obesity surgery 2019-11, Vol.29 (11), p.3493-3499
Main Authors: Grover, Brandon T., Morell, Michael C., Kothari, Shanu N., Borgert, Andrew J., Kallies, Kara J., Baker, Matthew T.
Format: Article
Language:English
Subjects:
Adult
Bariatric Surgery - standards
Body Mass Index
Body Weights and Measures - standards
Body-Weight Trajectory
Female
Fish oils
Follow-Up Studies
Gastrointestinal surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity
Obesity, Morbid - surgery
Original Contributions
Postoperative Period
Reference Standards
Retrospective Studies
Surgery
Treatment Outcome
Weight Loss - physiology
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Summary:Background Some weight regain is expected after bariatric surgery; however, this concept is not well defined. A favorable weight loss response has commonly been defined as 50% excess weight loss (EWL). The medical literature uses %total weight loss (%TWL), which has recently been adopted in some surgical literature. Objective To demonstrate variability in bariatric surgery outcomes based on the definition applied and propose a standardized definition. Methods A retrospective review of patients who underwent bariatric surgery from 2001 to 2016 with ≥ 1 year follow-up was completed. Several previously proposed definitions of weight regain were analyzed. Results One thousand five hundred seventy-four patients met inclusion criteria. Preoperative mean body mass index (BMI) was 47.6 ± 6.4 kg/m 2 . Increased preoperative BMI was associated with increased mean %TWL at 2 years postoperative (29.3 ± 9.1% for BMI  60; P   90%) of patients achieve ≥ 20% TWL and ≥ 50% EWL. Increased preoperative BMI was associated with increased %TWL and decreased %EWL at 2 years postoperative. The incidence of weight regain varies depending on the definition. We propose a standardized definition for identifying good responders following bariatric surgery to be ≥ 20% TWL, as this measure is least influenced by preoperative BMI.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-019-04022-z