Preoperative weight loss is not a predictor of postoperative weight loss after laparoscopic Roux-en-Y gastric bypass.

BACKGROUND: Identification of preoperative predictors of weight loss after laparoscopic Roux-en-Y gastric bypass (LRYGB) can lead to improved clinical outcomes. The purpose of this study was to determine whether preoperative weight loss was associated with improved percentage of excess weight loss (%EWL) 1 year after LRYGB.

METHODS: A retrospective analysis was performed on the data from 295 patients who had undergone LRYGB at our institution from July 2004 to November 2005. Routine preoperative weight loss goals were implemented to facilitate the laparoscopic approach and ensure compliance with an appropriate nutritional and exercise program. Patients with an initial consultation BMI of <50, 50-59, and > or =60 kg/m(2) were given weight loss goals of 5 lb and 5% and 10% of body weight, respectively.

RESULTS: The mean age was 45 +/- 10 years, and 89% were women and 70% were white. The mean BMI at the initial consultation was 51 +/- 7 kg/m(2). A significant inverse correlation was found between the preoperative BMI and %EWL at 1 year postoperative (P <.001). When controlling for BMI, no correlation was found between the %EWL and percentage of preoperative weight loss or attainment of the weight loss goals. The weight loss goals were met or surpassed by 79% of patients, and the mean %EWL at 1 year was 66%. Whites had greater %EWL at 1 year postoperatively compared with African Americans (67% versus 61%; P = .002). When controlling for age, gender, race, and consultation BMI, the preoperative weight loss did not predict for the %EWL at 1 year.

CONCLUSION: The results of this study have shown that preoperative weight loss does not predict postoperative weight loss 1 year after LRYGB. A lower BMI, younger age, and white race predicted better %EWL.