{
  "abstract": "BackgroundEarly postoperative weight loss may help predict later outcomes, but its reliability for longer-term weight loss and regain remains unclear. We assessed whether the percentage total weight loss (%TWL) 3 months after metabolic/bariatric surgery predicted later %TWL weight change/regain.\n\nMethodsThis retrospective observational cohort study included 216 patients from the Personalised Medicine for Morbid Obesity cohort who underwent sleeve gastrectomy or Roux-en-Y gastric bypass and had 3-month %TWL and at least one later outcome. Linear regression assessed associations between 3-month %TWL and later %TWL plus weight change/regain outcomes. Adjusted incremental R2 quantified the additional variance explained by 3-month %TWL. Secondary procedure-stratified, diabetes-stratified, and baseline BMI comparator analyses are reported in the Supplementary Material.\n\nResultsGreater 3-month %TWL was associated with higher 1-year and 2-year %TWL in adjusted models (both p < 0.001) but not longer-term %TWL (p = 0.078). Incremental R2 was 38.23% for 1- year, 11.75% for 2-year %TWL and 2.25% for long-term %TWL. Greater 3-month %TWL was also associated with greater recurrent weight gain from 1 to 2 years and from 1 year to long-term follow-up. In secondary analyses, findings were broadly consistent across procedure and diabetes subgroups, while 3-month %TWL explained more additional variance in 1-year %TWL than baseline BMI\n\nConclusion3-month %TWL predicted 1-year and 2-year outcomes but not longer-term %TWL, supporting its value as an early marker of postoperative weight trajectory. Heterogeneity in recurrent weight stability may contribute to weaker long-term prediction and warrants further study to determine whether early weight-loss patterns can identify patients requiring closer long-term weight management support.\n\nKey pointsO_LIThree-month %TWL predicted 1-year and 2-year %TWL. C_LIO_LIGreater early %TWL was associated with greater recurrent weight gain. C_LIO_LIThree-month %TWL explained more additional variance in 1-year %TWL than baseline BMI. C_LI",
  "abstract_shown": true,
  "affiliations": [
    "Imperial College London"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "K. Pushparajah"
    },
    {
      "name": "D. Handley"
    },
    {
      "name": "A. Lobo"
    },
    {
      "name": "S. Almansoori"
    },
    {
      "name": "S. I. Alsters"
    },
    {
      "name": "S. Purkayastha"
    },
    {
      "name": "H. S. Chahal"
    },
    {
      "name": "M. v. Haelst"
    },
    {
      "name": "R. G. Walters"
    },
    {
      "name": "F. Drenos"
    },
    {
      "name": "A. I. F. Blakemore"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/38gq534ag3aph.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.07.26364977",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.07.26364977v1.full",
  "id": "38gq534ag3aph",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.07.26364977v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "endocrinology"
    ],
    [
      "openalex",
      "2746|Bariatric Surgery and Outcomes"
    ]
  ],
  "openalex": "W7221143779",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.07.26364977v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/38gq534ag3aph.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:34Z",
      "native_id": "10.64898/2026.10.07.26364977",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.07.26364977v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:endocrinology",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Greater early weight loss after metabolic/bariatric surgery predicts greater loss up to 2 years but is also associated with weight regain in the longer term.",
  "title_text": "Greater early weight loss after metabolic/bariatric surgery predicts greater loss up to 2 years but is also associated with weight regain in the longer term.",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:34Z",
  "url": "https://research.draconitic.com/paper/38gq534ag3aph",
  "venue": "medRxiv",
  "versions": []
}