Table 3.
Associations between common measures of weight regain and concurrent declines in select health outcomes among adults who underwent Roux-en-Y gastric bypass.
| Progression of diabetesa n=689 |
Clinically important decline in physical HRQoLb n=903 |
Clinically important decline in mental HRQoLb n=903 |
Clinically important decline in satisfactionc n=272 |
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RRd | (95% CI) | P value | BICe | RRd | (95% CI) | P value | BICe | RRd | (95% CI) | P value | BICe | RRd | (95% CI) | P value | BICe | |
| Weight regain, continuousf | ||||||||||||||||
| Weight in kg, per 9.1 kg | 1.40 | (1.18–1.67) | <.001 | 1543.2 | 1.21 | (1.12–1.31) | <.001 | 3541.9 | 1.08 | (1.00–1.17) | 0.050 | 3739.2 | 1.41 | (1.14–1.74) | 0.002 | 584.4 |
| BMI, per 3.2 kg/m² | 1.41 | (1.19–1.68) | <.001 | 1543.2 | 1.21 | (1.12–1.31) | <.001 | 3542.8 | 1.09 | (1.01–1.18) | 0.03 | 3738.5 | 1.44 | (1.16–1.78) | <.001 | 583.3 |
| % pre-surgery weight, per 6.9% | 1.45 | (1.22–1.73) | <.001 | 1541.9 | 1.22 | (1.12–1.32) | <.001 | 3544.1 | 1.11 | (1.02–1.20) | 0.02 | 3737.7 | 1.45 | (1.12–1.87) | 0.005 | 585.5 |
| % nadir weight, per 11.0% | 1.36 | (1.15–1.60) | <.001 | 1545.5 | 1.16 | (1.07–1.25) | <.001 | 3551.2 | 1.08 | (1.00–1.17) | 0.04 | 3738.8 | 1.35 | (1.07–1.70) | 0.011 | 586.9 |
| % max weight lost, per 18.9% | 1.51 | (1.27–1.78) | <.001 | 1535.8 | 1.28 | (1.18–1.38) | <.001 | 3532.8 | 1.11 | (1.02–1.20) | 0.02 | 3737.6 | 1.56 | (1.19–2.04) | 0.001 | 582.6 |
| Clinically important weight regaing | ||||||||||||||||
| ≥10 kg | 1.56 | (1.15–2.11) | 0.004 | 1549.4 | 1.39 | (1.19–1.63) | <.001 | 3548.0 | 1.12 | (0.96–1.30) | 0.15 | 3741.9 | 1.91 | (1.21–3.01) | 0.006 | 584.3 |
| ≥ 5 BMI points | 1.66 | (1.19–2.30) | 0.002 | 1548.6 | 1.40 | (1.18–1.65) | <.001 | 3550.2 | 1.23 | (1.04–1.45) | 0.014 | 3737.3 | 1.84 | (1.13–3.01) | 0.02 | 586.9 |
| ≥10% of pre-surgery weight | 1.63 | (1.19–2.25) | 0.003 | 1549.5 | 1.45 | (1.23–1.71) | <.001 | 3544.4 | 1.17 | (1.00–1.38) | 0.054 | 3739.6 | 1.73 | (1.05–2.84) | 0.03 | 587.1 |
| ≥10% of nadir weight | 1.37 | (1.02–1.84) | 0.03 | 1553.2 | 1.36 | (1.15–1.59) | <.001 | 3552.0 | 1.11 | (0.95–1.29) | 0.19 | 3741.0 | 1.82 | (1.14–2.91) | 0.013 | 586.5 |
| ≥15% of nadir weight | 1.41 | (1.03–1.92) | 0.03 | 1554.0 | 1.36 | (1.16–1.59) | <.001 | 3550.3 | 1.19 | (1.01–1.39) | 0.03 | 3739.6 | 1.51 | (0.93–2.46) | 0.09 | 589.8 |
| ≥10% of max weight lost | 1.42 | (1.02–1.98) | 0.04 | 1554.0 | 1.42 | (1.17–1.72) | <.001 | 3550.4 | 1.09 | (0.92–1.29) | 0.31 | 3742.2 | 2.54 | (1.34–4.82) | 0.005 | 582.9 |
| ≥20% of max weight lost | 1.64 | (1.22–2.19) | <.001 | 1547.2 | 1.55 | (1.33–1.82) | <.001 | 3535.5 | 1.23 | (1.06–1.43) | 0.008 | 3735.8 | 2.33 | (1.50–3.63) | <.001 | 579.4 |
| ≥25% of max weight lost | 1.64 | (1.21–2.20) | 0.001 | 1547.3 | 1.43 | (1.22–1.68) | <.001 | 3546.5 | 1.16 | (0.99–1.36) | 0.06 | 3739.9 | 2.22 | (1.44–3.42) | <.001 | 575.9 |
Abbreviations: BIC=Bayesian Information Criterion; HRQoL=health-related quality of life; max=maximum; RR= Relative Risk.
A change from not taking diabetes medication to taking diabetes medication, change from not taking insulin to taking insulin, or an increase of glycated hemoglobin (HbA1c) by at least 0.5% plus a post-weight nadir value of 5.7% or greater.
A decrease of ≥5 points on the Short-Form 36-item Physical Component Summary (PCS) or Mental Component Summary (MCS) score, respectively.
An increase of ≥1 on a 7 point scale to a rating of at least 3 (i.e., “somewhat satisfied” – “very dissatisfied”).
Adjusted for pre-surgery factors related to missing data (i.e., site, age and smoking status), MCS, PCS or HbA1c at time of weight loss nadir, respectively, and time since weight nadir as a continuous fixed effect (only linear term retained). Sample size for each model is based on n=1286 minus those with missing outcome data.
A difference of more than 2 is good evidence that the model with the lower BIC has better fit.
RR is reported per median weight regain across post-nadir time points.