Department of Cardiovascular and Metabolic Diseases, CHU Toulouse, Toulouse, France.
Surg Obes Relat Dis. 2013 Jan-Feb;9(1):118-21. doi: 10.1016/j.soard.2011.10.022. Epub 2011 Nov 26.
After Roux-en-Y gastric bypass (RYGB), failing to lose enough weight or regaining weight is a concern for both patients and healthcare professionals. Our objective was to report the criteria for an early prediction of the failure to lose enough weight in the setting of a private practice and an academic center of obesity surgery.
A retrospective analysis of the 2-year weight loss profiles of patients after RYGB was performed using nonlinear mixed models. A total of 375 morbidly obese adult patients, with a body mass index of 49.3 ± 7.7 kg/m(2), were included. Weight loss success was determined 2 years after surgery using the percentage of excess weight loss criteria. The surgical treatment and the main outcome measurement was standardized RYGB and the percentage of excess weight loss time profiles.
The patients who failed, succeeded, or had intermediate results at 2 years after surgery had different percentage of excess weight loss profiles during this period. At 6 months, 71% of those who had lost <30% of their initial excess weight had not lost ≥50% at 24 months. In contrast, those who had lost >45% were unlikely to have lost <50% of their excess weight.
An early (month 6) prediction of failure to lose significant weight after RYGB can be made, with the threshold at 30% of the initial excess weight loss. Patients who have lost <30% of their initial excess weight are unlikely to have lost ≥50% at 24 months.
在 Roux-en-Y 胃旁路手术后（RYGB），患者和医疗保健专业人员都担心体重减轻不足或体重反弹。我们的目的是报告在私人诊所和肥胖手术学术中心中，预测 RYGB 后体重减轻不足的早期标准。
使用非线性混合模型对 RYGB 后 2 年的体重减轻情况进行了回顾性分析。共纳入 375 名病态肥胖成年患者，体重指数为 49.3 ± 7.7 kg/m2。使用超重减轻百分比标准，在手术后 2 年确定体重减轻成功。手术治疗和主要结果测量是标准化的 RYGB 和超重减轻时间曲线的百分比。
手术后 2 年，失败、成功或结果中等的患者在这段时间内的超重减轻百分比曲线不同。6 个月时，体重减轻<30%初始超重的患者中，有 71%在 24 个月时没有减轻≥50%。相比之下，体重减轻>45%的患者不太可能减轻<50%的超重。
可以在 RYGB 后早期（6 个月）预测体重减轻不足，阈值为初始超重减轻的 30%。体重减轻<30%初始超重的患者不太可能在 24 个月时减轻≥50%。
