Factores asociados a la reganancia de peso clínicamente significativa en pacientes tratados con cirugía bariátrica

Background: Bariatric surgery allows sustainable weight loss, however, between 15-35% of these patients present weight gain, associated with adverse clinical outcomes. Purpose: to describe the factors associated with weight gain in a cohort of patients managed in an obesity clinic. Methodology: A case-control study nested in a cohort was conducted. A case was defined as the patient who presented a weight gain of ≥10% with respect to the minimum postoperative weight in at least one control between the second and tenth year of follow-up, and control as any patient who did not meet said criteria. Clinical, anthropometric, surgical variables and life habits were evaluated. The association between each of the variables considered as a risk factor was evaluated through a univariate and multivariate analysis.Results: 154 patients were included. 31 cases and 123 control cases. In the multivariate analysis, the factors associated with weight gain were pre-surgical BMI >40kg/m2 (OR3.02; 95%CI 1.08-8.46, p=0.035), moderate to intense physical activity (OR 6.07; 95%CI 1.23-29.8 ; p=0.026) and anxiety disorder (OR 5.50; 1.71-17.6; p=0.004). Factors such as pre-surgical weight loss (OR 0.84, 95% CI 0.74-0.98; p=0.021) and diet <1200 calories (OR 0.36; 95% CI 0.13-1.00; p=0.050) decreased the risk of regrowth. Conclusions: 25% of patients present weight gain two to ten years after bariatric surgery. Pre- and post-surgical factors were associated with weight gain, suggesting the importance of long-term multidisciplinary follow-up in patients treated with surgery.