One-year weight-loss trajectories and associated baseline factors after laparoscopic sleeve gastrectomy: a retrospective cohort study

Abstract This retrospective cohort study evaluated one-year weight-loss trajectories after laparoscopic sleeve gastrectomy and explored baseline factors associated with postoperative outcomes. Adult patients who underwent surgery between January 2021 and June 2024 were identified from an institutional bariatric surgery database. Body weight was assessed at 1, 3, 6, and 12 months after surgery. Generalized linear mixed-effects models were used to characterize longitudinal changes in body weight, body mass index, percentage total weight loss, and percentage excess weight loss, and multivariable linear regression was performed to identify baseline factors associated with percentage total weight loss at 12 months. A total of 489 patients were included, with a mean age of 32.5 ± 9.5 years and a mean body mass index of 36.7 ± 5.6 kg/m 2 . All weight-related indicators showed significant nonlinear trajectories characterized by rapid early change followed by gradual deceleration. At 12 months, mean percentage total weight loss was 30.2%, and 73.6% of patients achieved at least 20% total weight loss. Age, ethnicity, baseline body mass index, and visceral fat area were independently associated with postoperative weight-loss outcomes. These findings support trajectory-based monitoring after sleeve gastrectomy and may help identify patients at risk of suboptimal early weight loss.