Introduction

Outcomes of long-term (5–10-year) weight loss have not been investigated thoroughly and the role of pre-operative weight loss on long-term weight loss, among other factors, are unknown. Our regional bariatric service introduced a 12 week intensive pre-operative information course (IPIC) to optimise pre-operative weight loss and provide education prior to bariatric surgery. The present study determines the effect of pre-operative weight loss and an intense pre-operative information course (IPIC), on long-term weight outcomes and sustained weight loss post-bariatric surgery.

Methods

Data were collected prospectively from a bariatric center (2008–2022). Excess weight loss (EWL) ≥ 50% and ≥ 70% were considered outcome measures. Survival analysis and logistic regression identified variables associated with overall and sustained EWL ≥ 50% and ≥ 70%.

Results

Three hundred thirty-nine patients (median age, 49 years; median follow-up, 7 years [0.5–11 years]; median EWL%, 49.6%.) were evaluated, including 158 gastric sleeve and 161 gastric bypass. During follow-up 273 patients (80.5%) and 196 patients (53.1%) achieved EWL ≥ 50% and ≥ 70%, respectively. In multivariate survival analyses, pre-operative weight loss through IPIC, both < 10.5% and > 10.5% EWL, were positively associated with EWL ≥ 50% (HR 2.23, p < 0.001) and EWL ≥ 70% (HR 3.24, p < 0.001), respectively. After a median of 6.5 years after achieving EWL50% or EWL70%, 56.8% (154/271) had sustained EWL50% and 50.6% (85/168) sustained EWL70%. Higher pre-operative weight loss through IPIC increased the likelihood of sustained EWL ≥ 50% (OR, 2.36; p = 0.013) and EWL ≥ 70% (OR, 2.03; p = 0.011) at the end of follow-up.

Conclusions

IPIC and higher pre-operative weight loss improve weight loss post-bariatric surgery and reduce the likelihood of weight regain during long-term follow-up.

中文翻译：

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强化术前信息课程 (IPIC) 和术前减肥可实现减肥手术后长期持续减肥：来自三级转诊中心 11 年的结果

介绍

长期（5-10年）体重减轻的结果尚未得到彻底研究，术前体重减轻对长期体重减轻的作用等因素尚不清楚。我们的区域减肥服务推出了为期 12 周的强化术前信息课程 (IPIC)，以优化术前减肥并在减肥手术前提供教育。本研究确定了术前减肥和密集的术前信息课程（IPIC）对长期体重结果和减肥手术后持续减肥的影响。

方法

数据是从减肥中心前瞻性收集的（2008-2022 年）。过度减重 (EWL) ≥ 50% 和 ≥ 70% 被视为结果指标。生存分析和逻辑回归确定了与总体和持续 EWL ≥ 50% 和 ≥ 70% 相关的变量。

结果

对 339 名患者（中位年龄 49 岁；中位随访 7 年 [0.5-11 年]；中位 EWL%，49.6%）进行了评估，其中包括 158 例胃套和 161 例胃旁路术。随访期间，分别有 273 名患者（80.5%）和 196 名患者（53.1%）达到 EWL ≥ 50% 和 ≥ 70%。在多变量生存分析中，通过 IPIC 实现的术前体重减轻（EWL < 10.5% 和 > 10.5%）与 EWL ≥ 50%（HR 2.23，p  < 0.001）和 EWL ≥ 70%（HR 3.24，p  < 0.001），分别。达到 EWL50% 或 EWL70% 后平均 6.5 年后，56.8% (154/271) 维持 EWL50%，50.6% (85/168) 维持 EWL70%。通过 IPIC 实现的术前体重减轻增加了 随访结束时持续 EWL ≥ 50%（OR，2.36； p  = 0.013）和 EWL ≥ 70%（OR，2.03；p = 0.011）的可能性。

结论

IPIC 和较高的术前体重减轻可改善减肥手术后的体重减轻，并降低长期随访期间体重反弹的可能性。