Weight Regain: when to call a weight loss surgery a success or a failure.

Weight regain after bariatric surgery occurs regardless of the procedure performed [1,2].  However the definition of weight regain can be very broad, and sometimes there no is definition applied, only the perception of a patient that he or she has regain weight. Sometimes, these patients seek medical advice and consider to have a revision or conversion procedure  when they have not met the criteria yet.

However there is still no uniform definition for weight regain, this alters the reported outcomes of any given  bariatric procedure and contribute to the discussion of when should a patient is considered to have a regain or surgery failure, and most importantly, when a patient is candidate for a revision or conversion procedure.

Of the factors identified to be causative of weight regain are: bougie size, remnant gastric antrum and/or fundus size, high ghrelin levels, maladaptive lifestyle behaviors, and a lack of follow-up support,[3].

These are the definitions of weight regain after sleeve gastrectomy reported by systematic review, [3].

1.- An increase of 10Kg from Nadir [4].

2.- An increase of  >25% EWL from Nadir [5].

3.- An increase of 5 Kg/m2 from Ndir [6].

4.- Any weight regain after T2D remision [6].

5.- Weight regain to a BMI >35 Kg/m2 after successful loss [6].

To exactly know if a person or patient has had weight regain and warrants a revisio/conversion procedure it is imperative to meet these criteria, however the  patient first has to know what % excess weight loss, Body Mass Index, and Type 2 Diabetes Remisión “ curation”. For that I have done an article explaining these terms.

[1]  Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled

intervention study of bariatric surgery. J Intern Med 2013;273(3):219–34.

[2]  Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA

2012;308(11):1122–31.

[3]  Lauti M, Kularatna M, Hill AG, MacCormick AD. Weight regain following sleeve gastrectomy – a systematic

review. Obes Surg 2016;26(6):1326–34.

[4] Adams TD, Dividson LE, Litwin Set al. Health benefits of gastric bypass surgery after 6 years.JAMA

2012;308(11):1122-31.

[5] Colquitt JL, Pickett K, Loveman E, FramptonGK, Surgery for weight loss in adults. Cochrane database Syst Rev

2014;8(8):CD003641.

[6] Angrisani L, Santonicola A, Iovino P, FormisanoG, Buchwald H, Scopnaro N, Bariatric surgery

worldwide2013.Obes Surg 2015;25(10):1822-32.