Additional metabolic effects of bariatric surgery in patients with a poor mid‐term weight loss response: A 5‐year follow‐up study

Abstract

To ascertain the 5‐year metabolic effects of bariatric surgery in poor weight loss (WL) responders and establish associated factors. Methods: Retrospective analysis of a non‐randomised prospective cohort of bariatric surgery patients completing a 5‐year follow‐up. Mid‐term poor WL was considered when 5‐year excess weight loss was <50%. Results: Forty‐three (20.3%) of the 212 included patients were mid‐term poor WL responders. They showed an improvement in all metabolic markers at 2 years, except for total cholesterol. This improvement with respect to baseline was maintained at 5 years for plasma glucose, HbA1c, HOMA, HDL and diastolic blood pressure; however, LDL cholesterol, triglycerides and systolic blood pressure were similar to presurgical values. Comorbidity remission rates were comparable to those obtained in the good WL group except for hypercholesterolaemia (45.8% vs. poor WL, p = 0.005). On multivariate analysis, lower baseline HDL cholesterol levels, advanced age and lower preoperative weight loss were independently associated with poor mid‐term WL. Conclusions: Although that 1 in 5 patients presented suboptimal WL 5 years after bariatric surgery, other important metabolic benefits were maintained.