What Really Matters in Weight Loss after Bariatric Surgery - 10 Years Follow-Up (BARI-10 -POL Study)

Currently, metabolic bariatric surgery (MBS) is considered the most effective method for achieving substantial and long-term weight-loss in severely obese patients. However, 4 to 40% of bariatric patients do not accomplish optimal results. The study aimed to identify factors contributing to maintain > 50% EWL after MBS at the 10- years observation.

This is a retrospective, multicenter cohort study of patients with obesity who completed 10-years follow-up, undergoing primary laparoscopic MBS surgery in 2007-2014. Data came from 5 bariatric centers. Patients were divided into two groups: patients who achieved more than 50% EWL and those who achieved less than 50% EWL. Uni- and multivariable logistic regression were used to identify predictors of optimal results.

Out of 368 analyzed patients the median BMI before the surgery was 42.73 kg/m2. The most common obesity-related diseases were hypertension (HT) (52.72%) and type 2 diabetes mellitus (T2DM) (30.98%). Sleeve gastrectomy was the most frequently performed procedure (65.22%). The median follow-up was 10.90 years. 59,24% patients achieved > 50% EWL. Uni- and multivariable logistic regression analysis confirmed preoperative weigh loss (OR = 1.04; P = 0.03), T2DM (OR = 0.45; P = 0.003), psychiatric history (OR = 0.38; P = 0.01) and one anastomosis gastric bypass (OAGB) (OR = 4.64; P < 0.0001) to have a significant impact on weight loss outcome 10-years after MBS.

In a 10-year follow-up, patients with greater preoperative weight loss may have a better response to surgery. OAGB emerged as promising type of surgery in terms of weight loss. T2DM and psychiatric history are independent predictors of lower %EWL.