Weight regain in patients with symptoms of post–bariatric surgery hypoglycemia

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19 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1728-1734
Number of pages7
JournalSurgery for Obesity and Related Diseases
Volume13
Issue number10
DOIs
StatePublished - Oct 2017

Keywords

  • Bariatric surgery
  • Glucose metabolism
  • Postbariatric hypoglycemia
  • Treatment outcomes
  • Weight regain

ASJC Scopus subject areas

  • Surgery

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