Background

Weight regain is a non desirable long term event that occurs after bariatric surgery, which can potentially compromise many of the health benefits achieved with it. The aims of this multicentre study are to determine the prevalence of weight regain after bariatric surgery and identify possible non surgical predictors.

Methods

The study design is a retrospective multicentre cohort study involving 254 bariatric patients (RYGB=59.45%, SG=40.55% (p=0.003)) with postoperative follow-up for 5 years or greater performed by 11 surgical teams from Argentina. Preoperative BMI of patients averaged 47.06±7.7 (SD), mean weight was 126.2 kg±25.2 (SD). Those who regained ≥15% of the nadir weight post surgery were considered 'regainers', and individuals who regained <15% were categorized as weight loss 'maintainers'.

Results

Minimum BMI averaged 29.25±5.8(SD) with maximum weight loss observed over the period between 6 and 24 months postoperatively, current BMI 34.05±7.3 (SD), and mean age was 50±10.32(SD). Of the 254 participants included 44.09% were regainers and 55.91% were maintainers. No significant differences were observed between ‘regainers’ and ‘maintainers’ in terms of age, gender, type of baritaric procedure performed, age of overweight onset, coexistence, preoperative BMI ≥50, frequency of weight monitoring or the person in charge of monitoring. The significance of each variable was analysed contrasting both groups: consumption frequency of breakfast (p=0.31), lunch (p=0.004), snack (p=0.9), dinner (p=0.021), afternoon snack (p=0.91), light meal (p=0.41), midnight snack (p=0.33), early eaters (p=0.016), healthy eating habits (p<0.0001), grazing (p<0.0001), binge eating (p=0.25), sweet eaters (p=0.037), night eating (p=0.47), current drinking (p=0.024), drinking frequency (p=0.11), habit of exercise (p=0.006), exercise intensity (p=0.45), proper sleeping (p=0.54), work in relation to food (p=0.94), consumption of supplements (p=0.19), postoperative psychotherapy (p=0.25), use of psychiatric medication after surgery (p=0.10), psychiatric disease diagnosed before (p=0.21) and after surgery (p=0.0002), traumatic event after surgery (p=0.0002), health related quality of life questionnaire (BAROS), self-esteem (p=0.001), physical wellbeing (p=0.15), social relationships (p=0.019), work (p=0.019), sexuality (p=0.012).

Conclusions

Bariatric surgery promotes adequate reduction of excess bodyweight, with significant weight regain. The lack of lunch and dinner habit, not being an early eater, having unhealthy eating habits, grazing, being a sweet eater, having a drinking habit, having a sedentary lifestyle, having a psychiatric disease diagnosed after surgery, suffering a traumatic event, lack of self-esteem, lack of physical wellbeing, and the lack of social relationships in work and sexual enviroments, were the determining factors of weight regain.