ArticleInternational journal of obesity (2005)2022
Weight-loss thresholds after bariatric surgery and cardiovascular outcomes: more is better.
Article in International journal of obesity (2005), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Therapeutic Options for Recurrence of Weight and Obesity Related Complications After Metabolic and Bariatric Surgery: An IFSO Position Statement.Obesity surgery · 2024Guideline
- Glucose-Dependent Insulinotropic Polypeptide and Glucagon After Weight Loss Induced by Diet or Bariatric Surgery.Obesity (Silver Spring, Md.) · 2025Trial
- GLP-1 Receptor Agonists Post-Bariatric Surgery (GRABS) Trial: Rationale, Design and Baseline Characteristics.Diabetes, obesity & metabolism · 2026Article
- Predictive Effect of Preoperative Bone Marrow Fat Fraction on Postoperative Bone Mineral Density After Bariatric Surgery: a Prospective Cohort Study.Obesity surgery · 2026Article
- Association of Weight Loss Composition Following Metabolic-Bariatric Surgery With Incident Major Adverse Cardiovascular Events and All-Cause Mortality.Clinical obesity · 2026Article
- Characteristics of changes in bone mineral density and body composition in obesity patients after metabolic and bariatric surgery: A prospective cohort study.Diabetes, obesity & metabolism · 2025Article
- Challenges of Revisional Metabolic and Bariatric Surgery: A Comprehensive Guide to Unraveling the Complexities and Solutions of Revisional Bariatric Procedures.Journal of clinical medicine · 2024Review
- Perceived Benefits of Bariatric Surgery: Patient Perspectives.Obesity surgery · 2024Observational
- Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesWhether the extent of weight loss (WL) modulates bariatric surgery (BS) cardiovascular benefits has scarcely been assessed. Several WL thresholds have been commonly used to classify BS patients as good or poor responders without a proven clinical relevance. We examined the relationship between the magnitude of WL after BS and post-surgery major adverse cardiovascular-event (MACE) incidence. We also compared the performance of three different insufficient weight-loss (IWL) criteria for their association with MACE. SUBJECTS AND
methodsAll individuals who underwent a primary Roux-en Y gastric bypass (RYGB) or sleeve gastrectomy (SG) in our institution at least six years before data analysis (12/2020) were included in the study. Data on MACE were available in 1638 of 1700 participants (96.4%). Proportional-hazard Cox analyses were performed to ascertain the association between MACE, WL, and the three IWL criteria. IWL was defined as: <50% excess weight loss (<50% EWL), <20% total body-weight loss (<20% TBWL), and -1 standard deviation of alterable weight-loss percentage (<1 SD% AWL).
resultsDuring a mean follow-up of 10.2 ± 2.8 years, 86 participants experienced a first post-surgery MACE. Higher WL at one year (HR: 0.77 (95% CI: 0.61-0.98)) and 5 years (HR: 0.63 (95% CI: 0.42-0.92)) was related to a lower incidence of MACE. All short-term criteria for defining IWL were similarly associated with MACE, yet <1 SD% AWL identified more at-risk subjects. Five-year TBWL < 20% and 5-year <1 SD-AWL% were significantly associated with a higher risk for CV events. TBWL < 20% identified more subjects at risk.
conclusionsThe extent of WL is closely related to long-term MACE incidence. Patients who lost -1SD% AWL at one year or <20% TBWL at five years may be considered poor responders.
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