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Published in: Obesity Surgery 7/2021

01-07-2021 | Sleeve Gastrectomy | Original Contributions

Is It Possible to Predict Weight Loss After Bariatric Surgery?—External Validation of Predictive Models

Authors: Izabela A. Karpińska, Jan Kulawik, Magdalena Pisarska-Adamczyk, Michał Wysocki, Michał Pędziwiatr, Piotr Major

Published in: Obesity Surgery | Issue 7/2021

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Abstract

Background

Bariatric surgery is the most effective obesity treatment. Weight loss varies among patients, and not everyone achieves desired outcome. Identification of predictive factors for weight loss after bariatric surgery resulted in several prediction tools proposed. We aimed to validate the performance of available prediction models for weight reduction 1 year after surgical treatment.

Materials and Methods

The retrospective analysis included patients after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) who completed 1-year follow-up. Postoperative body mass index (BMI) predicted by 12 models was calculated for each patient. The correlation between predicted and observed BMI was assessed using linear regression. Accuracy was evaluated by squared Pearson’s correlation coefficient (R2). Goodness-of-fit was assessed by standard error of estimate (SE) and paired sample t test between estimated and observed BMI.

Results

Out of 760 patients enrolled, 509 (67.00%) were women with median age 42 years. Of patients, 65.92% underwent SG and 34.08% had RYGB. Median BMI decreased from 45.19 to 32.53kg/m2 after 1 year. EWL amounted to 62.97%. All models presented significant relationship between predicted and observed BMI in linear regression (correlation coefficient between 0.29 and 1.22). The best predictive model explained 24% variation of weight reduction (adjusted R2=0.24). Majority of models overestimated outcome with SE 5.03 to 5.13kg/m2.

Conclusion

Although predicted BMI had reasonable correlation with observed values, none of evaluated models presented acceptable accuracy. All models tend to overestimate the outcome. Accurate tool for weight loss prediction should be developed to enhance patient’s assessment.

Graphical abstract

Appendix
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Literature
1.
go back to reference Colquitt JL, Pickett K, Loveman E, et. al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;(8):CD003641. Colquitt JL, Pickett K, Loveman E, et. al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;(8):CD003641.
2.
go back to reference Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29:782–95.CrossRef Welbourn R, Hollyman M, Kinsman R, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29:782–95.CrossRef
3.
go back to reference Cottam S, Cottam D, Cottam A, et al. The use of predictive markers for the development of a model to predict weight loss following vertical sleeve gastrectomy. Obes Surg. 2018;28:3769–74.CrossRef Cottam S, Cottam D, Cottam A, et al. The use of predictive markers for the development of a model to predict weight loss following vertical sleeve gastrectomy. Obes Surg. 2018;28:3769–74.CrossRef
4.
go back to reference Al-Khyatt W, Ryall R, Leeder P, et al. Predictors of inadequate weight loss after laparoscopic gastric bypass for morbid obesity. Obes Surg. 2017;27:1446–52.CrossRef Al-Khyatt W, Ryall R, Leeder P, et al. Predictors of inadequate weight loss after laparoscopic gastric bypass for morbid obesity. Obes Surg. 2017;27:1446–52.CrossRef
5.
go back to reference Homer CV, Tod AM, Thompson AR, et al. Expectations and patients’ experiences of obesity prior to bariatric surgery: a qualitative study. BMJ Open. 2016;6:e009389.CrossRef Homer CV, Tod AM, Thompson AR, et al. Expectations and patients’ experiences of obesity prior to bariatric surgery: a qualitative study. BMJ Open. 2016;6:e009389.CrossRef
6.
go back to reference Coupaye M, Sabaté JM, Castel B, et al. Predictive factors of weight loss 1 year after laparoscopic gastric bypass in obese patients. Obes Surg. 2010;20:1671–7.CrossRef Coupaye M, Sabaté JM, Castel B, et al. Predictive factors of weight loss 1 year after laparoscopic gastric bypass in obese patients. Obes Surg. 2010;20:1671–7.CrossRef
7.
go back to reference Adams ST, Salhab M, Hussain ZI, et al. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013;89(1053):411–6. Adams ST, Salhab M, Hussain ZI, et al. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013;89(1053):411–6.
8.
go back to reference Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity. 2014;22:888–94.CrossRef Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity. 2014;22:888–94.CrossRef
9.
go back to reference Van Hout GCM, Verschure SKM, Van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15(4):552–60. Van Hout GCM, Verschure SKM, Van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15(4):552–60.
10.
go back to reference Sockalingam S, Cassin S, Crawford SA, et al. Psychiatric predictors of surgery non-completion following suitability assessment for bariatric surgery. Obes Surg. 2013;23:205–11.CrossRef Sockalingam S, Cassin S, Crawford SA, et al. Psychiatric predictors of surgery non-completion following suitability assessment for bariatric surgery. Obes Surg. 2013;23:205–11.CrossRef
11.
go back to reference Wedin S, Madan A, Correll J, et al. Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients. Eat Behav. 2014;15:619–24.CrossRef Wedin S, Madan A, Correll J, et al. Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients. Eat Behav. 2014;15:619–24.CrossRef
12.
go back to reference Chen CY, Lee CH, Lee HM, et al. Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population. Sci Rep. 2020;10(1):12788 Chen CY, Lee CH, Lee HM, et al. Check point to get adequate weight loss within 6-months after laparoscopic sleeve gastrectomy for morbid obesity in Asian population. Sci Rep. 2020;10(1):12788
13.
go back to reference Shen SC, Wang W, Tam KW, et al. Validating risk prediction models of diabetes remission after sleeve gastrectomy. Obes Surg. 2019;29:221–9.CrossRef Shen SC, Wang W, Tam KW, et al. Validating risk prediction models of diabetes remission after sleeve gastrectomy. Obes Surg. 2019;29:221–9.CrossRef
15.
go back to reference Major P, Stefura T, Małczak P, et al. Postoperative care and functional recovery after laparoscopic sleeve gastrectomy vs. laparoscopic Roux-en-Y gastric bypass among patients under ERAS protocol. Obes Surg. 2018;28:1031–9.CrossRef Major P, Stefura T, Małczak P, et al. Postoperative care and functional recovery after laparoscopic sleeve gastrectomy vs. laparoscopic Roux-en-Y gastric bypass among patients under ERAS protocol. Obes Surg. 2018;28:1031–9.CrossRef
16.
go back to reference Major P, Wysocki M, Torbicz G, et al. Risk factors for prolonged length of hospital stay and readmissions after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2018;28:323–32.CrossRef Major P, Wysocki M, Torbicz G, et al. Risk factors for prolonged length of hospital stay and readmissions after laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2018;28:323–32.CrossRef
17.
go back to reference Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506. Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.
18.
go back to reference Halverson JD, Zuckerman GR, Koehler RE, et al. Gastric bypass for morbid obesity. A medical-surgical assessment. Ann Surg. 1981;194:152–60.CrossRef Halverson JD, Zuckerman GR, Koehler RE, et al. Gastric bypass for morbid obesity. A medical-surgical assessment. Ann Surg. 1981;194:152–60.CrossRef
19.
go back to reference Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41.CrossRef Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41.CrossRef
20.
go back to reference Baltasar A, Serra C, Bou R, et al. Expected body mass index after bariatric surgery. Cir Esp. 2009;86:308–12.CrossRef Baltasar A, Serra C, Bou R, et al. Expected body mass index after bariatric surgery. Cir Esp. 2009;86:308–12.CrossRef
21.
go back to reference Baltasar A, Perez N, Serra C, et al. Weight loss reporting: predicted body mass index after bariatric surgery. Obes Surg. 2011;21:367–72.CrossRef Baltasar A, Perez N, Serra C, et al. Weight loss reporting: predicted body mass index after bariatric surgery. Obes Surg. 2011;21:367–72.CrossRef
22.
go back to reference Wood GC, Benotti P, Gerhard GS, Miller EK, Zhang Y, Zaccone RJ, et al. A patient-centered electronic tool for weight loss outcomes after Roux-en-Y gastric bypass. J Obes. 2014;2014:364941 Wood GC, Benotti P, Gerhard GS, Miller EK, Zhang Y, Zaccone RJ, et al. A patient-centered electronic tool for weight loss outcomes after Roux-en-Y gastric bypass. J Obes. 2014;2014:364941
23.
go back to reference Wise ES, Hocking KM, Kavic SM. Prediction of excess weight loss after laparoscopic Roux-en-Y gastric bypass: data from an artificial neural network. Surg Endosc. 2016;30:480–8.CrossRef Wise ES, Hocking KM, Kavic SM. Prediction of excess weight loss after laparoscopic Roux-en-Y gastric bypass: data from an artificial neural network. Surg Endosc. 2016;30:480–8.CrossRef
24.
go back to reference Goulart A, Leão P, Costa P, et al. Doctor, How much weight will I lose?—a new individualized predictive model for weight loss. Obes Surg. 2016;26:1357–9.CrossRef Goulart A, Leão P, Costa P, et al. Doctor, How much weight will I lose?—a new individualized predictive model for weight loss. Obes Surg. 2016;26:1357–9.CrossRef
25.
go back to reference Seyssel K, Suter M, Pattou F, et al. A predictive model of weight loss after Roux-en-Y gastric bypass up to 5 years after surgery: a useful tool to select and manage candidates to bariatric surgery. Obes Surg. 2018;28:3393–9.CrossRef Seyssel K, Suter M, Pattou F, et al. A predictive model of weight loss after Roux-en-Y gastric bypass up to 5 years after surgery: a useful tool to select and manage candidates to bariatric surgery. Obes Surg. 2018;28:3393–9.CrossRef
26.
go back to reference Janik MR, Rogula TG, Mustafa RR, et al. Setting realistic expectations for weight loss after laparoscopic sleeve gastrectomy. Wideochirurgia I Inne Tech Maloinwazyjne. 2019;14:415–9. Janik MR, Rogula TG, Mustafa RR, et al. Setting realistic expectations for weight loss after laparoscopic sleeve gastrectomy. Wideochirurgia I Inne Tech Maloinwazyjne. 2019;14:415–9.
27.
go back to reference Velázquez-Fernández D, Sánchez H, Monraz F, et al. Development of an interactive outcome estimation tool for laparoscopic Roux-en-Y gastric bypass in Mexico based on a cohort of 1002 patients. Obes Surg. 2019;29:2878–85.CrossRef Velázquez-Fernández D, Sánchez H, Monraz F, et al. Development of an interactive outcome estimation tool for laparoscopic Roux-en-Y gastric bypass in Mexico based on a cohort of 1002 patients. Obes Surg. 2019;29:2878–85.CrossRef
28.
go back to reference Buchwald H, Estok R, Fahrbach K, et al. Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis. Am J Med. 2009;122:248–256.e5.CrossRef Buchwald H, Estok R, Fahrbach K, et al. Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis. Am J Med. 2009;122:248–256.e5.CrossRef
29.
go back to reference Kang JH, Le QA. Effectiveness of bariatric surgical procedures: a systematic review and network meta-analysis of randomized controlled trials. Medicine (United States). 2017;96(46):e8632. Kang JH, Le QA. Effectiveness of bariatric surgical procedures: a systematic review and network meta-analysis of randomized controlled trials. Medicine (United States). 2017;96(46):e8632.
30.
go back to reference Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9:21–5.CrossRef Rawlins L, Rawlins MP, Brown CC, et al. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9:21–5.CrossRef
31.
go back to reference Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366:1577–85.CrossRef Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366:1577–85.CrossRef
32.
go back to reference Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153:427–34.CrossRef Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153:427–34.CrossRef
33.
go back to reference Sharples AJ, Mahawar K, Cheruvu CVN. Systematic review and retrospective validation of prediction models for weight loss after bariatric surgery. Surg Obes Relat Dis. 2017;3(11):1914–1920. Sharples AJ, Mahawar K, Cheruvu CVN. Systematic review and retrospective validation of prediction models for weight loss after bariatric surgery. Surg Obes Relat Dis. 2017;3(11):1914–1920.
34.
go back to reference Molina López A, Sabench Pereferrer F, Vives Espelta M, et al. Usefulness of Baltasar’s expected body mass index as an indicator of bariatric weight loss surgery. Obes Surg. 2016;26:2712–7.CrossRef Molina López A, Sabench Pereferrer F, Vives Espelta M, et al. Usefulness of Baltasar’s expected body mass index as an indicator of bariatric weight loss surgery. Obes Surg. 2016;26:2712–7.CrossRef
35.
go back to reference Vines L, Schiesser M. Gastric bypass: current results and different techniques. Dig Surg. 2014;31:33–9.CrossRef Vines L, Schiesser M. Gastric bypass: current results and different techniques. Dig Surg. 2014;31:33–9.CrossRef
36.
go back to reference Guldogan CE, Ozozan OV, Ozmen MM. Sleeve gastrectomy and its modifications. Ann Laparosc Endosc Surg. 2020;5:27–7. Guldogan CE, Ozozan OV, Ozmen MM. Sleeve gastrectomy and its modifications. Ann Laparosc Endosc Surg. 2020;5:27–7.
37.
go back to reference Dworak J, Wysocki M, Rzepa A, et al. Learning curve for laparoscopic Roux-en-Y gastric bypass based on the experience of a newly created bariatric center. Polish J Surg. 2020;92:23–30.CrossRef Dworak J, Wysocki M, Rzepa A, et al. Learning curve for laparoscopic Roux-en-Y gastric bypass based on the experience of a newly created bariatric center. Polish J Surg. 2020;92:23–30.CrossRef
38.
go back to reference Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.
39.
go back to reference Balasar Ö, Çakır T, Erkal Ö, et al. The effect of rs9939609 FTO gene polymorphism on weight loss after laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30:121–5.CrossRef Balasar Ö, Çakır T, Erkal Ö, et al. The effect of rs9939609 FTO gene polymorphism on weight loss after laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30:121–5.CrossRef
40.
go back to reference MacLean PS, Blundell JE, Mennella JA, et al. Biological control of appetite: a daunting complexity. Obesity. 2017;25:S8–16.CrossRef MacLean PS, Blundell JE, Mennella JA, et al. Biological control of appetite: a daunting complexity. Obesity. 2017;25:S8–16.CrossRef
Metadata
Title
Is It Possible to Predict Weight Loss After Bariatric Surgery?—External Validation of Predictive Models
Authors
Izabela A. Karpińska
Jan Kulawik
Magdalena Pisarska-Adamczyk
Michał Wysocki
Michał Pędziwiatr
Piotr Major
Publication date
01-07-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-021-05341-w

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