Weight Gain After Short- and Long-Limb Gastric Bypass in Patients Followed for Longer Than 10 Years

TLDR

Long‑term (>10 years) outcomes after gastric bypass have not been reported in the literature. This study followed 228 patients (83.8 %) for a mean of 11.4 years after isolated Roux‑en‑Y gastric bypass to assess long‑term weight trajectories. Individual patient data were compared at nadir, 5 years, and >10 years post‑surgery, evaluating BMI and %EWL for both long‑ and short‑limb procedures. Super‑obese patients lost weight more rapidly initially but gained more quickly after the nadir, and at 10 years the failure rate rose to 20.4 % in morbidly obese and 34.9 % in super‑obese patients, with no difference between long‑ and short‑limb procedures; overall weight gain continues after the nadir, yet long‑term mortality remains low at 3.1 %.

Abstract

To complete a long-term (>10 years) follow-up of patients undergoing isolated roux-en-Y gastric bypass for severe obesity.Long-term results of gastric bypass in patients followed for longer than 10 years is not reported in the literature.Accurate weights were recorded on 228 of 272 (83.8%) of patients at a mean of 11.4 years (range, 4.7-14.9 years) after surgery. Results were documented on an individual basis for both long- and short-limb gastric bypass and compared with results at the nadir BMI and % excess weight loss (%EWL) at 5 years and >10 years post surgery.There was a significant (P < 0.0001) increase in BMI in both morbidly obese (BMI < 50 kg/m) and super obese patients (BMI > 50 kg/m) from the nadir to 5 years and from 5 to 10 years. The super obese lost more rapidly from time zero and gained more rapidly after reaching the lowest weight at approximately 2 years than the morbidly obese patients. There was no difference in results between the long- and short-limb operations. There was a significant increase in failures and decrease in excellent results at 10 years when compared with 5 years. The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients.The gastric bypass limb length does not impact long-term weight loss. Significant weight gain occurs continuously in patients after reaching the nadir weight following gastric bypass. Despite this weight gain, the long-term mortality remains low at 3.1%.