First Month and Fifth Year: Critical Time Points for Long-Term Sleeve Gastrectomy Outcomes, 13-Year Study Reveals

"We found that those with the best responses showed the highest percentage of excess body weight loss (%EWL) within the first month. After the fifth postoperative year, %EWL declined in partial responders, while it remained relatively stable in good responders," the researchers reported in the journal Obesity Surgery.

The researchers note that weight loss after sleeve gastrectomy shows considerable long-term variation, with the mechanisms behind suboptimal clinical response (SCR) and recurrent weight gain (RWG) requiring further investigation. Dimitrios Kehagias, Department of Surgery, University General Hospital of Patras, Patras, Greece, and colleagues retrospectively analyzed weight-loss trajectories to identify key time points, aiming to optimize follow-up strategies and inform future prospective research.

For this purpose, the researchers conducted a single-center, retrospective study involving 104 patients who underwent sleeve gastrectomy (SG). Excess body weight loss was measured at multiple time points: 1, 3, 6, 12, 24, 60 months, and 160.4 ± 16 months. Recurrent weight gain was defined as the difference between the current body mass index (BMI) and the minimum BMI achieved postoperatively. Based on clinical response, patients were categorized into three groups: good responders (Group A: %EWL ≥ 50 and RWG < 5 kg/m²), partial responders (Group B: %EWL ≥ 50 and RWG ≥ 5 kg/m²), and weak responders (Group C: %EWL < 50).

The study revealed the following findings:

• In the first postoperative month, good responders achieved the highest %EWL of 24.4 ± 6.5, significantly higher than the other two groups.
• After 24 months, all patients exhibited a decrease in %EWL.
• Good and partial responders followed a similar pattern of weight loss until the fifth year.
• After the fifth year, %EWL significantly decreased in partial responders.
• In contrast, %EWL remained relatively stable in good responders.

The study showed the importance of targeted follow-up and intervention during these key time points to maximize the long-term success of sleeve gastrectomy.

The findings highlight that the first postoperative month and the fifth postoperative year are critical time points for evaluating long-term clinical outcomes following sleeve gastrectomy.

"Healthcare providers can improve patient outcomes and support sustained weight management by focusing on these critical periods," the researchers concluded.

Reference:

Lampropoulos, C., Kehagias, D., Bellou, A. et al. Critical Time Points for Assessing Long-Term Clinical Response After Sleeve Gastrectomy—A Retrospective Study of Patients with 13-Year Follow-Up. OBES SURG (2025). https://doi.org/10.1007/s11695-024-07659-7