Weight regain in patients with symptoms of post-bariatric surgery hypoglycemia.

Abstract

BACKGROUND:

Weight regain (WR) and symptoms of post-bariatric surgery hypoglycemia (PBSH) are metabolic complications observed in a subset of postbariatric patients. Whether hypoglycemic symptoms are an important driver of increased caloric intake and WR after bariatric surgery is unknown.

OBJECTIVE:

This study aims to determine whether patients with PBSH symptoms have greater odds for WR.

SETTING:

Tertiary academic hospital.

METHODS:

Patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy at our tertiary academic hospital from August 2008 to August 2012 were mailed a survey, from which weight trajectory and PBSH symptoms were assessed. Percent WR was calculated as 100×(current weight-nadir weight)/(preoperative weight-nadir weight) and was compared between dates of survey completion and bariatric surgery. The primary outcome was WR≥10%, as a reflection of the median WR among respondents. Multivariable logistic regression was used to determine clinical factors that indicate greater odds for WR≥10% at the P<.05 level.

RESULTS:

Of 1119 potential patients, 428 respondents (40.6%) were eligible for analysis. WR was observed in 79.2% (n = 339), while 20.8% (n = 89) experienced either weight loss or no WR at a mean of 40.6±14.5 months. Median WR was 10.8% (interquartile range, 5.6-19.4). Odds of WR≥10% was significantly increased in those who experienced PBSH symptoms (odds ratio [OR] = 1.66; 95% confidence interval [CI]: 1.04-2.65), reported less adherence to nutritional guideline (OR = 2.36; 95% CI: 1.52-3.67), and had a longer time since surgery (OR = 1.05; 95% CI: 1.03-1.07).

CONCLUSIONS:

We found evidence that the presence of PBSH symptoms was associated with WR. Future studies should elucidate the role of hypoglycemia among other factors in post-bariatric surgery WR.

• Authors: Sanskriti Varma, Jeanne M Clark, Michael Schweitzer, Thomas Magnuson, Todd T Brown, Clare J Lee
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) Vol. 13 Issue 10 Pg. 1728-1734 (Oct 2017) ISSN: 1878-7533 [Electronic] United States
• PMID: 28844575 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose

Topics

• Adult
• Aged
• Bariatric Surgery (adverse effects)
• Blood Glucose (metabolism)
• Energy Intake (physiology)
• Female
• Gastrectomy (adverse effects)
• Gastric Bypass (adverse effects)
• Humans
• Hypoglycemia (blood, etiology, physiopathology)
• Male
• Middle Aged
• Obesity, Morbid (blood, complications, surgery)
• Postoperative Complications (etiology, physiopathology)
• Recurrence
• Retrospective Studies
• Weight Gain (physiology)
• Young Adult