Predictive pre-surgical factors for failure of sleeve gastrectomy as an obesity surgery

Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. However, long-term outcomes are heterogeneous due to the influence of multiple factors. The aim of this study was to analyse the effect of various psychosocial and demographic factors on medium-term weight loss outcomes.

A retrospective study of a prospective, single-centre series of patients who underwent GV surgery between 2011 and 2020, with a minimum follow-up of 5 years; Failure was defined as EBMIL% <65%. Univariate and multivariate logistic regression models were developed to identify potential predictors of poor outcomes. A predictive nomogram was designed.

A total of 324 patients were analysed, 74% were women. Most patients were married (64.1%), had medium or higher education levels (73%), and belonged to a low-to-middle socioeconomic class (64.26%). High vulnerability (64.13%) and low physical activity levels (97.44%) were common. Anxiety/depressive syndrome was more prevalent in women (55.88% vs. 36.49%; p < 0.05), whereas metabolic syndrome was more frequent in men (43.9% vs. 28.51%; p = 0.015). Factors associated with weight loss failure included marital status, socioeconomic level, vulnerability, and metabolic syndrome (p < 0.05).

SG achieves significant weight loss at 5 years post-surgery. Psychosocial factors such as socioeconomic status, marital status, and vulnerability significantly influence surgical outcomes. Pre-surgical evaluation is essential to identify patients at higher risk of failure, enabling targeted therapies to improve success rates.