S2164 Sociodemographic Determinants of Weight Loss Outcomes Following Transoral Outlet Reduction

Introduction: Transoral outlet reduction (TORe) is an endoscopic procedure for weight recurrence after Roux-en-Y gastric bypass (RYGB). While studies have evaluated its long-term efficacy and safety, many have lacked racially and socioeconomically diverse populations. In this study, we assess factors associated with outcomes following TORe in a racially and socioeconomically diverse cohort. Methods: We conducted a retrospective cohort study to include patients who underwent TORe due to insufficient weight loss or weight recurrence after RYGB from 2019 to 2025. Patients were identified from a prospectively managed registry of patients who underwent TORe. TORe were all performed under general anesthesia by a single endoscopist at an academic medical center. Clinical and anthropometric data was collected retrospectively up to 24 months after TORe from the electronic medical record. The primary outcome was the total body weight loss percentage (TBWL%) at 12-months by race/ethnicity. Results: A total of 72 patients (95.8% woman, 58.3% African American (AA), 29.2% Non-Hispanic Whites (NHW), 12.5% Hispanic, mean age 53 ± 10.2 years, mean body mass index (BMI) 40.8 ± 9.5) completed TORe. The mean time from primary bariatric procedure to TORe was 169.7 ± 93.4 months and patients experienced mean weight recurrence of 40.7% ± 37.5. Hispanic patients had a trend towards higher weight recurrence percentage from nadir post-RYGB to pre-TORE weight (59.3% ± 66.3) than AA (43.6% ± 35.6) and NHW (27.7% ± 21.8; P = 0.13). Hispanic patients also had a higher BMI at time of TORe (47.8 ± 3.1) than AA (42.1 ± 8.6) and NHW (35.3 ± 7.8; P = 0.002). At 12-months after TORe (n = 52), TBWL for AA was -9.4% ± 7.9, followed by NHW at -8.1% ± 10.2 and Hispanic patients at -7.5% ± 11.9; (P = 0.84). Conclusion: Hispanic patients had higher weight recurrence and BMI at time of TORe, suggesting delayed access to revisional procedures. Further research is needed to identify potential disparities in timely access to revisional bariatric endoscopic procedures and weight-loss outcomes.