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Bariatric Surgery

A total weight loss of 25% shows better predictivity in evaluating the efficiency of bariatric surgery

International Journal of Obesity volume 45, pages 396–403 (2021)Cite this article

Subjects

Abstract

Objectives

The need for a unified definition of weight loss (WL) after bariatric surgery has recently been highlighted. We aimed to evaluate the reliability of two clinically common WL indications including percentage of total WL (%TWL) and percentage of excess WL (%EWL) through comparing their performances in predicting metabolic syndrome (MetS) remission 1 year after bariatric surgery.

Methods

A total of 430 individuals with obesity who underwent bariatric surgery were enrolled. Participants were evaluated for changes in anthropometric parameters, metabolic indexes, MetS components and medications before and 1 year after surgery. MetS was defined using the criteria of the National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans.

Results

The prevalence of MetS is 92.3% (397) at baseline. One year after bariatric surgery, 337 individuals (84.9%) were in MetS remission. The multivariate adjusted ORs were 1.16 (95% confidence interval [CI] 1.10–1.22) for each 1% increase in %TWL for MetS remission and 1.18 (95% CI 1.11–1.25) for each 5% increase in %EWL. This association with MetS remission remained statistically significant for %TWL after additional adjustment for %EWL (P for trend 0.029), and disappeared for %EWL. Receiver operating curve (ROC) analyses showed that the %TWL was more predictive than the %EWL (AUC%TWL vs. AUC%EWL, 0.749 vs. 0.700, p = 0.023). The Youden index indicated that the optimal %TWL cutoff point to identify MetS remission was 25%.

Conclusions

We recommend that good responders to bariatric surgery should be defined as those exhibiting %TWL ≥ 25%.

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Fig. 1: ROC curve of the %TWL and %EWL for the remission of MetS 1 year after bariatric surgery.

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Acknowledgements

This study was supported by grants from National Key Research and Development Project of China (2016YFA0502003), National Natural Science Foundation of China (81670791) and Municipal Natural Science Foundation of Shanghai (17ZR1421200).

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Author notes

  1. These authors contributed equally: Yinfang Tu, Yunhui Pan, Weiping Jia, Yuqian Bao, Haoyong Yu

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China

    Yinfang Tu, Yunhui Pan, Junfeng Han, Jiemin Pan, Weiping Jia, Yuqian Bao & Haoyong Yu

  2. Department of Bariatric & Metabolic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

    Pin Zhang

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  1. Yinfang Tu
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Correspondence to Weiping Jia, Yuqian Bao or Haoyong Yu.

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Tu, Y., Pan, Y., Han, J. et al. A total weight loss of 25% shows better predictivity in evaluating the efficiency of bariatric surgery. Int J Obes 45, 396–403 (2021). https://doi.org/10.1038/s41366-020-00690-5

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