Background: Gastric bypass and adjustable gastric banding are currently the most commonly performed weight loss surgeries. The results are encouraging for most patients; however, even among surgeons that perform hundreds of these procedures, some of their patients do better than others. This article has set out to define differences among those that succeed compared to those that fail to lose significant excessive weight after bariatric surgery. Methods: We performed a retrospective review of our prospective database collected over the last four years. We studied 484 bariatric patients who had at least one year follow up. We defined a success as greater than 50% excess weight loss (EWL) and defined failure as less than 30% EWL. Student’s t-tests were performed between succeeding and failing groups of bypass patients, band patients, males, females, Caucasians and minorities for the following variables: age, height, starting body mass index (sBMI), starting excessive weight (sEW), and starting weight (SW). Findings: We observed an overall success rate of 58% and a failure rate of 15%. Age was significantly lower in the successful group (p=0.012). Starting BMI was significantly lower in successful band patients (p=0.0007). Starting EW was significantly lower in both the successful band and bypass groups (p=0.0005 and p=0.015, respectively); likewise, so was SW (p=0.001 and p=0.0055, respectively). Among different ethnicities, age was significantly lower in the successful Caucasian group, and sBMI was significantly lower in the successful minority group. For bypass patients and Caucasians, the unsuccessful group was significantly taller than the successful group (p is 0.0003 and 0.014, respectively). Gender was not a significant variable in success or failure, regardless of procedure. Conclusion: Without consideration for the procedure to be performed, succeeding patients were younger. In band patients, a higher sBMI was found in the failing group. For band and bypass patients who succeeded, the average SW and EW were lower. Successful Bypass patients were significantly shorter than their failing counterparts. Among Caucasians, successful patients were significantly younger and shorter; and, among minorities, the succeeding group had a lower sBMI. These variables give us further insight into the complexity of succeeding to lose EW, and the results will ultimately help us determine how we can help our patients consistently succeed.
Program Number: P026