Background

Patients undergoing bariatric surgery tend to have varying trajectories in terms of weight loss especially after the primary procedure. There are no current methods to identify these trends

Methods

A retrospective, single-center cohort study was performed from 2015-2019. Patients who underwent SG or GBP with a minimum follow-up of 2 years were included in the study. Excess BMI loss was calculated at 3-months, 6-months, 1-year, 2-year, 3-year, 4-year, and at 5-years from the index procedure. A heat map was created based on the performance of the whole cohort based on the tricolor grading scale. The sequential correlation was assessed between outcomes for short-term weight loss (< 2 years) and long-term weight loss (> 2 years).

Results

191 patients were evaluated during the study period. Baseline demographic data are shown in Table 1. Index BMI at the time of the surgery was the only clinical parameter associated with better surgical outcomes. The sequential one-year EBMIL data had a good correlation (R 0.82 - 0.89), however significant discordance was noted between short-term (1-2 years) and long-term follow-up (3-5 years) (R 0.55-0.67) with the inflection point at 2 years. The highest congruence of consistent weight loss pattern is noted at 2 years from the procedure, however, after that, patients tend to have varying trajectories.

Conclusions

Clinical parameters are poor predictors of post-op weight loss. Patients with consistent trajectory even after 2 years tend to remain in the same cohort. Thus, a minimum follow-up of 2 years is recommended.