Weight Loss and Comorbidity Outcomes After Revisional Bariatric Surgery

Some people who have had weight-loss (bariatric) surgery do not lose enough weight, regain much of the weight they lost, see obesity-related diseases such as diabetes or high blood pressure return, or develop complications of the first operation. Many of them need a second, revisional operation. This study reviews the medical records of adults who had revisional bariatric surgery between 2017 and 2025 at a single surgical centre. It describes which revisional operations were performed after each type of first operation and measures how much weight patients lost 6 months, 12 months and up to 3 years after the revision. It also records whether obesity-related diseases and quality of life improved after the revision, and looks at patient factors linked to better weight loss.

Inclusion Criteria: * Age 25 to 65 years. * One or more previous bariatric operations. * Revisional bariatric surgery performed at the study centre between 2017 and 2025. * Revision performed for at least one of the following: * Insufficient weight loss: %EWL below 50% or BMI above 35 kg/m2 at least 18 months after the primary operation. * Weight regain: BMI rising to 35 kg/m2 or more after successful weight loss, a gain of more than 10 kg from the lowest weight, or an increase of 5 kg/m2 from the lowest BMI. * Recurrence of obesity-related comorbidities. * Complications of the primary operation requiring revision. Exclusion Criteria: * Uncontrolled psychiatric illness. * Substance abuse. * Severe hepatic or renal dysfunction. * Non-compliance with long-term follow-up.