SIgnificant Weight Gain Associated with Laparoscopic Sleeve Gastrectomy

Reconsidering potential surgical option to treat severe obesity…

Laparoscopic sleeve gastrectomy (LSG) is a very common and efficient bariatric procedure used among young patients for weight loss. However, not much information is known about its long-term effects on obesity-related comorbidities.

A cohort study using a retrospective analysis of a prospective cohort was conducted to investigate the long-term effects of LSG on weight loss, diabetes, hypertension, dyslipidemia, and hyperuricemia. Main outcomes and measures included excess weight loss, obesity-related comorbidities, and partial and complete remission at 1, 3, and 5 years of follow-up.

Data was collected from a total of 443 LSGs performed between April 2006 and February 2013. The percentages of excess weight loss was 77%, 70%, and 56% at years 1, 3, and 5, respectively; complete remission of diabetes was maintained in 51%, 38%, and 20%, respectively, and remission of hypertension was maintained in 46%, 48%, and 46%, respectively.

The decrease of low-density lipoprotein cholesterol level was significant only at 1 year (P = .04) and 3 years (P = .04) and the changes in total cholesterol level were not statistically significant.

The results of this study confirm that there is a significant weight regain and a decrease in remission rates of diabetes and other comorbidities over time with long-term use of LSG.

Practice Pearls:

• The percentages of excess weight loss with long-term use of LSGs was 77%, 70%, and 56% at years 1, 3, and 5, respectively; complete remission of diabetes was maintained in 51%, 38%, and 20%, respectively, and remission of hypertension was maintained in 46%, 48%, and 46%, respectively.
• The decrease of low-density lipoprotein cholesterol level was significant only at 1 year (P = .04) and 3 years (P = .04) and the changes in total cholesterol level were not statistically significant.
• The results of this study confirms that there is a significant weight regain and a decrease in remission rates of diabetes and other comorbidities over time with long-term use of LSG.

Golomb I, Ben david M, Glass A, Kolitz T, Keidar A. Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy. JAMA Surgery. 2015.