Luis Garcia, Dan Azagury, Homero Rivas, John Morton. Stanford
Introduction: Previous studies suggest that modest preoperative weight loss is associated with improved weight loss following bariatric surgery. However, there remains a need to investigate factors which may successfully predict preoperative weight loss among bariatric patients.
Methods and Procedures: This analysis included patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy, or gastric banding at an academic medical center in California. Data were measured at patients’ consult and preoperative clinical visits. Preoperative weight loss outcomes were categorized as follows: no weight loss, lost weight, or gained weight. Associations between categorical sociodemographic and surgical characteristics and preoperative weight loss outcomes were assessed using the Chi-Square Test of Association. Associations between continuous measures and preoperative weight loss outcomes were assessed using ANOVA. A sub-group analysis was completed among participants who lost weight prior to bariatric surgery. Wilcoxon-Rank-Sum and Kruskal-Wallis tests were used to evaluate associations between patient characteristics and the number of pounds lost.
Results: Patients (n=2,597) were predominately ages 45 – 65 (56%), female (80%), White (53%), and privately insured (68%). Patient race was significantly associated with weight loss outcomes (p=0.013): whereas 62% of White patients lost weight prior to surgery, only 54% of Black patients lost preoperative weight. Among privately insured patients, 59% lost weight. In contrast, 64% of patients insured by Medi-Cal/Medicaid lost weight (p=0.049). On average, lower baseline excess body weight was associated with no weight loss. Patients who lost preoperative weight (n=1,570) were included in the sub-group analysis. Male sex (p<.001), Black race (p<0.001), undergoing laparoscopic RYGB (p=0.003), no previous abdominal surgeries (p=0.038), upper tertile baseline weight (p<0.0001), waist circumference (p<.0001), percent body fat (p<.01), BMI (p<0.0001), excess body weight (p<0.0001), and systolic blood pressure (p=0.001) were associated with more pounds lost.
Conclusions: This study demonstrates various associations between sociodemographic and clinical patient characteristics and preoperative weight loss. Given previous literature indicating the positive relationship between preoperative and postoperative weight loss following bariatric surgery, the results of this study suggest an opportunity to improve preoperative weight loss among specific groups.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88617
Program Number: P553
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster