Optimising Weight Loss Outcomes after Sleeve Gastrectomy: A Preoperative Risk Model from a Team-based Single-Centre Study

Abstract

Objective This study examined the association between preoperative parameters and weight loss outcomes at 12 months after laparoscopic sleeve gastrectomy (LSG). Materials and Methods We retrospectively reviewed 93 patients who underwent laparoscopic sleeve gastrectomy (LSG); the 68 with complete 12-month data formed the analytic cohort. Success was defined as a total weight loss (TWL) of at least 25% at 12 months. Eating behaviour was classified as “healthy” or “risky” using the validated Three-Factor Eating Questionnaire. Logistic regression, ROC analysis, and bootstrap internal validation were used to identify predictors and assess model performance. Results Of the 68 patients in the analytic cohort, 54.4% (n = 37) achieved successful weight loss. Risky eating behaviour was the only independent predictor of lower success (adjusted OR = 0.03, 95% CI: 0.01–0.14, p < 0.001); female sex was not significant after adjustment (OR = 0.40, p = 0.23). The final model (risky eating behaviour, baseline BMI, diabetes) showed an AUC of 0.89 (optimism-corrected 0.88), with sensitivity 86.5%, specificity 80.6%, and accuracy 83.8%. Conclusion Preoperative risky eating behaviour is a strong independent predictor of weight loss success after LSG, and early postoperative weight loss further identifies patients at risk of failure. Identifying patients with risky eating behaviour could help tailor preoperative counselling and postoperative support.