Weight loss during medical weight management does not predict weight loss after bariatric surgery: A retrospective cohort study

Abbott, S., Lawson, J., Singhal, R., Parretti, H. and Tahrani, A. A. (2020) Weight loss during medical weight management does not predict weight loss after bariatric surgery: A retrospective cohort study. Surgery for Obesity and Related Diseases. ISSN 1550-7289

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Abstract

Background: Many bariatric surgical centres mandate achieving weight loss targets through medical weight management programmes prior to offering bariatric surgery, but the evidence for this is unclear. Setting; Multi-centre community- and acute-based medical weight management (MWM) services referring to one regional bariatric centre, United Kingdom (UK) Objectives To examine the relationship between weight changes during (1) MWM and (2) pre-operative low-energy-diet (LED), and weight changes at 12 and 24 months post-surgery. Methods: A retrospective cohort study of patients who attended MWM and then underwent a primary laparoscopic bariatric procedure (adjustable gastric banding (LAGB), or Roux-en-Y gastric bypass (RYGB)) in a single bariatric centre in the UK between 2013 and 2015. Data were collected from patient electronic records. Results: 208 patients were included (LAGB n=128, RYGB n=80). Anthropometric data were available for 94.7% and 88.0% of participants at 12 and 24 months, respectively. There was no relationship between weight loss during MWM and post-surgery at either 12 or 24 months. Weight loss during the pre-operative LED predicted greater weight loss following LAGB (β= 0.251, p=0.006) and less weight loss after RYGB (β= -0.390, p=0.003) at 24 months, after adjusting for age, gender, ethnicity, baseline weight and LED duration. Conclusions: Weight loss in MWM does not predict greater weight loss outcomes up to 24 months following LAGB or RYGB. Greater weight loss during the pre-operative LED predicted greater weight loss post-LAGB and less weight loss post-RYGB. Our results suggest that patients should not be denied bariatric surgery due to not achieving weight loss in MWM. Weight loss responses to pre-operative LEDs as a predictor of post-surgical weight loss requires further investigation.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 23 Jul 2020 23:47
Last Modified: 23 Jul 2020 23:47
URI: https://ueaeprints.uea.ac.uk/id/eprint/76255
DOI: 10.1016/j.soard.2020.06.049

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