Background

Failure of desired weight loss and weight regain are common after bariatric surgery given the chronic, relapsing physiology of obesity. Interventions for secondary treatments need to be characterized.

Methods

We conducted a single institution retrospective chart review from 2012 to 2021. The inclusion criteria included completion of minimally invasive BPD/DS ≥18 months from vertical sleeve gastrectomy (VSG). The primary endpoint was percent excess body weight loss (%EBWL) at 12- and 18-months post completion.

Results

Eighty patients met the inclusion criteria, however 47 were excluded for poor follow-up data (N=33). Analyses included means, frequencies, and percentages; analysis of variance was used to compare means between groups; patients were grouped by age, gender, race, and BMI. 72% of patients were females. The average age was 46±11yrs, average time between VSG and BPD/DS completion was 5±3years, and average BMI before completion was 46±6kg/m2. %EBWL after BPD/DS was 37±16% at 12 months and 43±17% at 18 months. No significant differences were noted in post completion %EBWL between patients in the younger (<40yrs) or older (≥40yrs) age groups. Lower pre-completion BMI (<45kg/m2) was associated with higher 12 month post completion %EBWL 48±18% vs 32±13% for ≥45kg/m2 (p=0.011). Self-identified African American patients demonstrated greater weight loss than self-identified White patients at 18 months post completion; 61±9 % vs. 37±15%. (p=0.00417).

Conclusions

Patients with poor weight loss or weight regain after vertical sleeve gastrectomy can benefit from the completion of BPD/DS regardless of the time interval. Completion of DS is an effective treatment for chronic obesity.