Patient selection: morbidly obese, undergoing roux-en-Y gastric bypass
Parameters:
(1) presurgical weight in kilograms
(2) minimum weight after surgery (nadir)
(3) current weight in kilograms
maximum weight loss =
= (presurgical weight) - (minimum postoperative weight)
weight regain =
= (current weight) - (minimum postoperative weight)
weight regain as percent of maximum weight loss =
= (weight regain) / (maximum weight loss) * 100%
A significant weight regain was a regain ratio > 20%.
Risk factors affecting maximum weight loss (nadir):
(1) pre-operative drug use (opiates, cocaine, amphetamines, etc)
(2) medical comorbidities after surgery (hypertensions, diabetes, CHF, angina, hypercholesterolemia, gout, sleep apnea, back pain, musculoskeletal disease or arthritis, polycystic ovary syndrome if female)
Risk factors affecting weight regain:
(1) failure to adhere to dietary restrictions
(2) failure to adhere to exercise and physical activity requirements
(3) nocturnal eating
(4) depression
(5) problematic alcohol use
