ArticleObesity surgery2026
Long-Term Outcomes and Predictors of Recurrent Weight Gain After Sleeve Gastrectomy, Roux-En-Y Gastric Bypass, and One Anastomosis Gastric Bypass: Turkish Metabolic and Bariatric Surgery Follow-up Study (TMBS Study).
Article in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMetabolic and bariatric surgery (MBS) achieves effective weight loss, but long-term outcomes vary by procedure. We compared procedure-specific total weight loss (%TWL), recurrent weight gain (RWG), and metabolic outcomes across three MBS procedures.
methodsThis nationwide, multicenter, retrospective cohort study (n = 1,498; 78.8% women; 37 centers) used stratified random sampling. Primary outcomes were %TWL and RWG (≥ 10% of total weight lost from nadir and sensitivity analysis used the IFSO 2024 threshold of > 30%). Multivariable regression and propensity score matching (PSM) addressed baseline imbalances.
resultsProcedures included Sleeve Gastrectomy (SG, n = 1,321), Roux-en-Y Gastric Bypass (RYGB, n = 124), and One Anastomosis Gastric Bypass (OAGB, n = 53). Median follow-up: SG 66 [IQR 35-91], RYGB 55 [34-98], OAGB 53 [25-100] months (p = 0.704). Nadir %TWL was comparable (~ 38%, p = 0.683). At last follow-up, median %TWL differed significantly (OAGB 33.6%, RYGB 31.7%, SG 29.6%; p = 0.010). OAGB was independently associated with lower RWG than SG (OR 0.34, 95% CI 0.18-0.64; p < 0.001), and this association was confirmed in the PSM cohort (OAGB vs SG: RWG, 37.7% vs 61.6%; p = 0.004; %TWL, 33.8% vs 30.2%; p = 0.046). Metabolic and renal parameters differed across procedure groups, but standardized remission or relapse endpoints were not assessed.
conclusionIn this Turkish multicenter retrospective cohort with long-term follow-up, OAGB was associated with greater current %TWL and lower RWG compared with SG, while RYGB showed intermediate weight outcomes. Given the small OAGB subgroup, confirmation in larger prospective studies is warranted. KEY POINTS: Short-term weight loss was similar across SG, RYGB, and OAGB. RYGB and OAGB were associated with more favorable long-term weight loss than SG. OAGB was associated with a lower RWG than SG in this cohort (absolute risk difference -20.1%; NNT=4.9), but larger prospective studies with standardized follow-up are needed.
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