Metabolic and psychological features are associated with weight loss 12 months after sleeve gastrectomy.

CONTEXT Laparoscopic sleeve gastrectomy (LSG) is a recognized effective procedure of bariatric surgery but a poor response in weight loss may still represent a clinical problem. To date there are no validated predictors useful to better perform patient selection. OBJECTIVE to establish the association of baseline anthropometric, metabolic and psychologic features with the percent total (%TWL) and excess (%EWL) weight loss 12 months after surgery. DESIGN retrospective longitudinal analysis of a set of data about obese attending the outpatients service of a single obesity center from June 2016 to June 2019. PATIENTS 106 obese patients underwent LSG with pre-surgery evaluation and follow-up at 12 months after surgery. MAIN OUTCOME weight loss 12 months after LSG. RESULTS patients who achieved a %TWL higher than the observed median (≥34%) were younger, with a lower fasting plasma glucose and HbA1c, with a lower prevalence of hypertension and with a lower score in the impulsiveness scale, compared to the patients with a %TWL <34%. Similar findings were found when was considered %EWL. Multivariable stepwise regression analysis showed that younger age, lower impulsiveness, higher than normal urinary free cortisol and lower HbA1c were associates with higher %TWL, explaining about 31.5% of the outcome. CONCLUSION metabolic and psychologic features at baseline were independently associated with weight loss and explained a non-negligible effect on the response to LSG. These data suggest that careful metabolic and psychologic profiling could help in sharper indications and personalized pre- and post-surgical follow-up protocols in candidates for LSG.