ArticleObesity surgery2011
Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients.
Article in Obesity surgery, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.
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Who cites it
65 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- What Is Weight Loss After Bariatric Surgery Expressed in Percentage Total Weight Loss (%TWL)? A Systematic Review.Obesity surgery · 2021Pooled it
- Lack of Standard Definitions of Primary and Secondary (Non)responders After Primary Gastric Bypass and Gastric Sleeve: a Systematic Review.Obesity surgery · 2019Pooled it
- Preoperative Use of a Mobile Application Within the Multidisciplinary Team Approach - A Randomized Controlled Clinical Trial.Obesity surgery · 2026Trial
- Weight Loss Analysis According to Different Formulas after Sleeve Gastrectomy With or Without Antral Preservation: a Randomised Study.Obesity surgery · 2017Trial
- Prehabilitation for patients undergoing metabolic/bariatric surgery: a retrospective cohort study using propensity score matching.Journal of rehabilitation medicine · 2026Observational
- Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland.International journal of obesity (2005) · 2026Article
- Endoscopic sleeve gastroplasty versus intragastric balloon insertion as bridge-to-surgery procedures for patients with BMI ≥50 kg/mTherapeutic advances in gastroenterology · 2026Article
- Comparison between total weight loss and other metrics after bariatric surgery using a multilevel mixed-effects linear regression model.Surgical endoscopy · 2024Article
- Non-response After Gastric Bypass and Sleeve Gastrectomy-the Theoretical Need for Revisional Bariatric Surgery: Results from the Scandinavian Obesity Surgery Registry.Obesity surgery · 2023Article
- Longer-Term Weight Loss Outcomes Are Not Primarily Driven by Diet Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy.Nutrients · 2023Article
- Remote Follow-up with a Mobile Application Is Equal to Traditional Outpatient Follow-up After Bariatric Surgery: the BELLA Pilot Trial.Obesity surgery · 2023Article
- Parental Obesity Predisposition and Age of Onset Associate with Poor Response to Bariatric and Metabolic Surgery.Obesity surgery · 2023Article
- The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them.Frontiers in surgery · 2023Article
- Analysis of the Variability in Different Criteria to Define the Success of Bariatric Surgery: Retrospective Study 5-Year Follow-Up after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass.Journal of clinical medicine · 2022Article
- Outcomes of the One Anastomosis Gastric Bypass with Various Biliopancreatic Limb Lengths: a Retrospective Single-Center Cohort Study.Obesity surgery · 2021Article
- Reporting Weight Loss 2021: Position Statement of the Dutch Society for Metabolic and Bariatric Surgery (DSMBS).Obesity surgery · 2021Review
- Impact of Self-Monitoring on Weight Loss After Bariatric Surgery.Obesity surgery · 2021Article
- Am I on Track? Evaluating Patient-Specific Weight Loss After Bariatric Surgery Using an Outcomes Calculator.Obesity surgery · 2021Article
- Seeking an Initial-Weight-Independent Metric in a Mediterranean Cohort of Gastric Bypass Patients: the %AWL Revisited.Obesity surgery · 2021Article
- A total weight loss of 25% shows better predictivity in evaluating the efficiency of bariatric surgery.International journal of obesity (2005) · 2021Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors.
Funding
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Abstract
backgroundBariatric results expressed in the relative measure excess weight loss (%EWL) vary significantly by initial body mass index (BMI): the heavier the patient, the lower the %EWL. We examine if this variation is caused by using a wrong outcome measure and argue that no relative weight loss measure can express bariatric or metabolic goals unequivocally.
methodsNadir weight loss results after laparoscopic gastric bypass in 168 women with initial BMI ≥35 to <60 kg/m2 are calculated for %EWL and 61 different relative measures using the formula 100% × (initial BMI - nadir BMI) / (initial BMI-a), with a ranging from -30 to +30. Standard deviations are compared mutually and with those reported in the literature. For each relative measure, the significance of any variation by initial BMI is determined with the Mann-Whitney U test.
resultsMean initial BMI was 44.9 ± 6.7 (35.0-59.7) kg/m2. Mean nadir BMI was 28.8 ± 5.8 (18.5-44.4) kg/m2. Mean nadir excess BMI loss (%EBL; a = 25) was 87.0 ± 28.0 (19.4-155.1)%. Mean nadir (total) weight loss (%TWL; a = 0) was 35.9 ± 8.5 (9.5-57.1)%. Mean nadir %EWL was 77.3 ± 22.8 (17.7-135.2)%. The smallest variation coefficient was 23.7% at a ranging from -1 to +3, including %TWL (a = 0). This is lower than variation coefficients of %EWL results in our series and in the literature. Variation by initial BMI is significant using relative measures with a ≥3, including %EBL and %EWL (both p < 0.0001) and not significant with a <3, including %TWL (p = 0.13).
conclusionsIn contrast to their widespread use, %EBL and %EWL are not suited for comparing different patients or nonrandomized groups. They cause variation by initial BMI, which disappears using %TWL. In general, absolute terms should be preferred for bariatric outcome and goals. The power of bariatric procedures is best represented by their mean %TWL value.
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