Long Term Results of Sleeve Gastrectomy

[careya123 260]

Long term results of sleeve gastrectomy are just starting to become available in the last few years. Here's one study:

sleep apnea syndrome, and gastroesophageal reflux disease symptoms occurred in 83.8%, 59.7%, 75.6%, and 64.7% of patients, respectively."

So at 6 years, I can hope to have ~70% of my excess weight gone. And more than likely, my co-morbidities will be gone. Take that, Weight Watchers!

[2goldengirl 2,076]

Actually, you can hope for much better results than that. The mean is the average - all participants in the study with their results, even the ones with poor results for whatever reason.

I don't know about you, but I don't plan to be average

[Stevehud 1,790]

Actually, you can hope for much better results than that. The mean is the average - all participants in the study with their results, even the ones with poor results for whatever reason.

I don't know about you, but I don't plan to be average

thats the best damn attitude to have! be the best , keep it up!

[swimbikerun 1,041]

I dont think any one plans on being average, but this is over a 6 year period. I see a lot of posters on places in the first year then it dives off. After that, more of what you see is the regain. Offices don't deal with it, the $$$ are in the surgeries.

[2goldengirl 2,076]

The other thing to remember here is that the study includes the results of individuals who are lost to follow up post-op for a variety of reasons. Surgeons can only report long-term results for patients who return to them long-term so their results can be recorded. Individuals who, for example, have to travel long distances to get to their surgeon may get their more long-term needs met by more local providers, and those results can't be included.

Edited March 6, 2016 by 2goldengirl

[swimbikerun 1,041]

In addition to that, people who have had problems, like myself, who are lost to follow up because of the doctors aren't included.

There are people who wont' go back also because they gain weight and dont' want to admit it.

[Kindle 8,667]

There are also those that lost all their weight, kept it off and have no reason to check back in with their surgeons. I am one of those. Not to mention I had surgery in Mexico, so my 100% + weight loss will likely never get recorded. And yes, I will still be at this weight in another 4 years

You alone would limit your loss to 70%, not any research study.

[swimbikerun 1,041]

You are very rare in terms of what people are saying. I've seen more gain back than keeping it all off. Various levels of keeping it off though.

When we take a look at forums on various media, the trend appears 1 year out and less people show their photos. When they get to 2 years and over, it tends to be more that they need help because of regain.

I went too low, so it was ok for me to gain some back. Even at a regular weight, I have still had multiple Vitamin & other deficiencies. Its probably more of an issue to find out if the person is healthy vs. what the weight is.

[VSGAnn2014 12,992]

First, thank you @@careya123 for finding and posting this longer-term study of sleeve patients' long-term performances.

Second, @@swimbikerun , your criticism of this study seems to ignore the response rate of the study sample (see the red text quoted below) that reveal results are based on a participation / response rate of over 80% of patients who were sleeved from 2006 - 2008 at an Italian hospital. For a six-year study, that's a very good participation / response rate.

METHODS:

A retrospective analysis of prospectively collected data from 182 patients undergoing SG between 2006 and 2008 in the authors' institution. Long-term outcomes at 6 and 7 years were analyzed in terms of weight loss and co-morbidities resolution.

RESULTS:

... One hundred forty-eight patients (81.4%) completed the 72-month (6-year) follow-up.

[vincereautmori 323]

You are very rare in terms of what people are saying. I've seen more gain back than keeping it all off. Various levels of keeping it off though.

When we take a look at forums on various media, the trend appears 1 year out and less people show their photos. When they get to 2 years and over, it tends to be more that they need help because of regain.

I went too low, so it was ok for me to gain some back. Even at a regular weight, I have still had multiple Vitamin & other deficiencies. Its probably more of an issue to find out if the person is healthy vs. what the weight is.

I appreciate your opinion swimbikerun, and btw, congratulations on your weightloss! But if you're basing your conjecture on forum responses, there's a big hole in it. Maybe the reason you don't see posters on in the second year is because they no longer need the support, unless they're having issues again. They may have already posted their pictures and told their stories, no need to look to the forums for support or inspiration. I'm kind of like that, before surgery and the year after, I was on more frequently, asking questions, looking for help, and expressing the positive changes I was going through. But now, I occasionally stop by, offer information or some inspiring experiences to someone who's still on their journey to better health.

[swimbikerun 1,041]

@@VSGAnn2014 I understand your concerns. This is 182 people for the study in Italy.

http://www.niddk.nih.gov/health-information/health-topics/weight-control/Bariatric-Surgery/Pages/labs.aspx#c

"According to the former American Society for Bariatric Surgery (now the American Society for Metabolic and Bariatric Surgery, or ASMBS), the number of procedures increased from about 16,000 in the early 1990s to more than 103,000 in 2003. The ASMBS estimates that 220,000 people in the United States had bariatric surgery in 2008."

http://obesityreporter.com/bariatric-weight-loss-surgery-statistics-updated-2015/

"

The number of bariatric surgeries increased to 179,000 in 2013 with 34.2% of surgeries as Roux-en-Y gastric bypass, 14% gastric banding, 42.1% gastric sleeve, 1% as duodenal switch, 6% as revisional surgery and 2.7% classified as other (American Society for Metabolic and Bariatric Surgery).

While the common misconception is that most patients who have metabolic or bariatric surgery generally regain their weight, the statement is just not true. According to the American Society for Metabolic and Bariatric Surgery, as many as 50 percent of patients may regain a small portion of their weight loss (just 5%) two years or more following surgery. However, according to more longitudinal studies, most bariatric surgery patients maintain successful weight-loss long-term. Successful weight loss is generally defined as weight loss that equals to or greater than 50 percent of their excess body weight."

Less than 200 people over 2 years, and not the same "culture", that's why I'm skeptical.

I am also saying this hearing people who have had problems basically get separated from the surgeon after more than a year.

Again, it needs to include people no longer with their surgeons. It would be better to have an all invite study and find out why these people are no longer with the surgeon. I had a PCP tell me that insurance is why the majority of her patients don't go back (they won't pay for it). I want to consider all aspects. While I'm sure there might be people like you all, your stories can be anecdotal as mine are.

@@vincereautmori I see your point. My question is how many give up? Insurances pay for one shot, one surgery. There isn't a lot more, like a program, for those who gain weight back. Some people may be ok with some weight gain. Lets face it: if you were 300 lbs. and lost down to 150, say you gained to 170 or so, you are still infinitely better off than what you were. Would you complain? Probably not. Would your insurance pay to see the surgeon again? Maybe not.

"In another study published by US National Library of Medicine and the National Institutes of Health, the long-term success rate of those who had laparoscopic sleeve gastrectomy (vertical sleeve) appears to be a weight loss of over 50% and 6+ years of maintenance. Some weight regain occurred during the third and sixth postoperative year. The study’s researchers believe that with regular follow-up visits this weight regain could be prevented."

Look at the success of the 5 day pouch reset Plan. Someone can google the information, read the info, and not even have to post. Same for the forums.

I'm saying we need to consider all facets. I'm not sure that 180+ people in Italy can extrapolate to the fast food on every corner America with hundreds of thousands of surgeries. We need to think about getting people who are away from their surgeons and finding out why they are away: weight loss, insurance, embarrassment over weight regain, can't be bothered, moved away, did well, etc.

The surgery is new, everything is new and exciting. Once the honeymoon has passed ...

[2goldengirl 2,076]

It would actually make a big difference if people could self-report their results over time; an online database you could register for when you have your surgery, maybe you'd have to get a code from your surgeon or something to activate it (to avoid bogus entries).

[OutsideMatchInside 10,166]

You realize a lot of the people that are very successful with weight loss surgery go on to live their life and are not even active in the weight loss communities or care any thing about WLS etc. At 7.5 months out, I doubt I will even be involved in WLS communities 6 months from now. Mainly because so many people are so full of self hatred and low self esteem, I find it too negative of an environment.

A lot of people want to just forget about their former selves. They aren't going to respond to surveys especially a lot of the longer ones.

[swimbikerun 1,041]

It would actually make a big difference if people could self-report their results over time; an online database you could register for when you have your surgery, maybe you'd have to get a code from your surgeon or something to activate it (to avoid bogus entries).

Americans are not known for truthful reporting. So ... even the health apps are starting to get flagged because the data in them is not always trustable. It was one of the issues that came up when the ideas of taking the health apps people use and putting them in their medical records. It seemed to work for healthy, educated, and higher educated people.

If you aren't with your surgeon any longer or don't want to be, or your surgeon wants to hide your results, you won't get a code. My surgeon definitely doesn't want a number of "whoops" on his record (with me or any one else).

Possibly a regular doctor could, but the problem is, what happens for those uninsured? What do you define as success? Weight loss is the major item tracked, but I don't see where they're separating out true resolution of diabetes. There is a Swedish study that showed 30% resolution of diabetes 10 years out, and a bit more at a 5 year rate. The issue was the longer you had diabetes before the surgery, the greater the chance of it returning. If you were just prediabetic, you had the best chance for resolution. Why they aren't following that up is beyond me because that is a big issue: equal to weight.

[swimbikerun 1,041]

You realize a lot of the people that are very successful with weight loss surgery go on to live their life and are not even active in the weight loss communities or care any thing about WLS etc. At 7.5 months out, I doubt I will even be involved in WLS communities 6 months from now. Mainly because so many people are so full of self hatred and low self esteem, I find it too negative of an environment.

A lot of people want to just forget about their former selves. They aren't going to respond to surveys especially a lot of the longer ones.

No we don't know that. How success is defined in a study and what it means to people are 2 different things. By my *surgeons* criteria, I am a success. By other doctors, insurance, etc. I am not because of the health problems I have after.

As I said: honeymoon phase. Its all new and exciting, and I've lost this much by the 1 year time. Visiting at the 3, 5, 7, 10 year out, big difference. We still come back to the same questions.

http://www.ncbi.nlm.nih.gov/pubmed/24915261%C2'> might help. You can also check for the Swedish Obese Subjects. Granted it is not a lot of people but it is more than Italy. This is where I get the stats. They have socialized medicine in Sweden. Its a lot easier to follow people when they don't have to pay, like in America, and they have a one stop shop to go to, in terms of things following them around.