We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Commentary |

The Difficulty of Predicting Long-term Weight Loss After Gastric Bypass ONLINE FIRST

Amy Neville, MD, MSc, FRCSC1,2
[+] Author Affiliations
1Bariatric Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada
2Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
JAMA Surg. Published online August 10, 2016. doi:10.1001/jamasurg.2016.2302
Text Size: A A A
Published online


Weight regain occurs in a significant number of patients following gastric bypass1 and continues to be a potential Achilles heel of the gastric bypass procedure. In this issue of JAMA Surgery, Wood et al2 provide an extensive case series with admirable follow-up to examine clinical factors associated with weight regain. Beyond the usual suspects (baseline body mass index [calculated as weight in kilograms divided by height in meters squared] and age3), the study suggests an association between insulin use and better long-term weight loss. This is counterintuitive, as diabetes and insulin use are associated with weight gain4 and poorer surgical outcomes.5 Wood et al2 found no increase in health care visits for insulin-dependent patients postoperatively in the study to account for these findings, and there was similarly no increased use of diabetes medications with weight loss effects. Interestingly, the study also found that patients receiving more than 12 medications were more likely to be successful in long-term weight loss.2 Combined, this appears to suggest that some of the sickest patients have the best outcomes after surgical procedures, a finding that would be new to the literature.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections

Care at the Close of Life: Evidence and Experience
Weight Loss

Care at the Close of Life: Evidence and Experience
Weight Loss Contributing to Fatigue