Diabetics Less Likely to Lose Weight After Gastric Bypass

Study finds change in med use, improper stomach pouch size are likely causes

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MONDAY, Sept. 15 (HealthDay News) -- People with diabetes and those with larger stomach pouches are less likely than others to have good weight loss after gastric bypass surgery, according to University of California, San Francisco, researchers.

In this procedure, surgeons restrict food intake by creating a smaller stomach pouch that bypasses large sections of the digestive system.

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"When performed in high-volume centers and with a low rate of complications, gastric bypass provides sustained and meaningful weight loss, significant improvements in quality of life, improvement or resolution of obesity-associated co-morbidities, and extended life span. However, 5 percent to 15 percent of patients do not lose weight successfully, despite perceived precise surgical technique and regular follow-up," the researchers wrote.

The researchers, who analyzed data from more than 300 gastric bypass patients, defined poor weight loss as losing 40 percent or less of excess body weight after one year and good weight loss as losing more than 40 percent of excess body weight.

Before gastric bypass surgery, the 310 patients had an average body mass index (BMI) of 52. One year after surgery, the patients had an average BMI of 34 and had lost an average of 60 percent of excess body weight. However, 38 patients (12.3 percent) had poor weight loss.

After they adjusted for different factors, the researchers concluded that diabetes and having a larger size of stomach pouch after surgery were independently associated with poor weight loss.

The study authors noted that people with diabetes take insulin or other drugs that stimulate the production of fat and cholesterol.

"Other factors that may lead to weight gain in patients with diabetes include a 'protective' increase in caloric intake to treat episodes of hypoglycemia (low blood sugar), reduction of urinary glucose losses, and sodium and water retention that are a direct effect of insulin on the distal tubule in the kidney," they wrote.

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-- Robert Preidt