Comment on: Weight loss during medical weight management does not predict weight loss after bariatric surgery: a retrospective cohort study

Abstract Objectives Obesity prevalence is estimated at 34% in U.S. military retirees and 28% in beneficiaries of military healthcare, with common comorbidities being type 2 diabetes (T2D), hypertension, and hyperlipidemia. Stressors experienced during active duty service result in higher risk for disabling musculoskeletal injuries, psychological trauma, and alcohol abuse; all of which debilitate healthy weight loss efforts. No literature exists on the demographics and clinical outcomes of military retirees who elect bariatric surgery. The purpose of this study was to assess demographics and determine clinical outcomes of retirees and beneficiaries following bariatric surgery. It was hypothesized that pre-operative weights and comorbidity remission would be higher in the military retiree group. Methods A retrospective cohort study assessed military retirees and beneficiaries who underwent sleeve gastrectomy or gastric bypass surgery at a military treatment facility in 2014. Percent total weight loss (%TWL) and remission of pre-existing comorbidities (T2D, hypertension, and hyperlipidemia) at one year follow-up were primary outcomes and compared using Student's T tests and chi-squared contingency analysis. Additional statistical analyses included a Wilcoxon-Mann-Whitney test and backwards stepwise regression. Results Ninety-eight patients (64 beneficiaries and 34 retirees) were included with mean ages of 48 and 52 years, respectively. Student's T test and Wilcoxon-Mann-Whitney test confirmed that beneficiaries achieved greater %TWL at one year follow-up, 30.2% vs. 25.8% (p < 0.05) and 55.5 vs. 38.2 mean rank (p < 0.01), respectively. Beneficiaries and retirees achieved similar remission of T2D, hypertension, and hyperlipidemia. Patient's sex and surgery type were significant predictors of %TWL variation between groups at one year follow-up. These variables accounted for 9% of the %TWL variance. Conclusions Retirees who elect bariatric surgery lose less weight than their beneficiary counterparts. Etiology of this poorer outcome remains unclear, but further research may demonstrate need for improving healthcare resources provided to military retirees. Funding Sources No funding was received to support this study.

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Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.2020.20.03.015 ◽

2020 ◽

Vol 20 (3) ◽

pp. 344

Author(s):

Nawal A. Hasan ◽

Afnan Freije ◽

Abdulmenem Abualsel ◽

Hani Al-Saati ◽

Simone Perna

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Cohort Study ◽

Postoperative Complications ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Nutritional Deficiencies ◽

Deficiency Anemia ◽

Lifestyle Recommendations ◽

Type Of Surgery

Objectives: This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. Methods: This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012–2017 were included. Sociodemographic and clinical information was collected from the patients’ medical records and during phone interviews. Results: A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. Conclusion: Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.Keywords: Bariatric Surgery; Obesity Management; Weight Loss; Gastric Bypass; Biliopancreatic Diversion; Avitaminosis; Iron-Deficiency Anemia; Bahrain.

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Estimation Of Excessive Weight Loss In Bariatric Surgery Patients: A Prediction Model Retrospective Cohort Study

10.21203/rs.3.rs-572974/v1 ◽

2021 ◽

Author(s):

Mahsa Hatami ◽

Abdolreza Pazouki ◽

Ali Kabir

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Excess Weight Loss ◽

Adverse Consequence ◽

Excessive Weight Loss ◽

Excessive Weight

Abstract Background and Objective: Bariatric surgery has been recognized as the most effective long-term treatment for morbid obesity. Despite the considerable positive results, adverse consequence can develop. Excessive Weight Loss (EXWL), a rare consequence of bariatric surgery, can lead to a broad adverse consequence. The aim of this study was determining of prevalence and the predicting model of EXWL in patient underwent bariatric surgery until 24 months after surgery.Material and Methods: Data have been extracted from the National Obesity Surgery Database in obesity clinic of * University of Medical Sciences. The subjects of this retrospective cohort study were morbid obese individuals who underwent three various types of bariatric surgery (One Anastomosis Gastric Bypass (OAGB), Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG)) in period of 24 months ago. EXWL has been defined as excess weight loss more than 100% at any time until 24 months after surgery. SPSS (version 23) was used in data analysis.Results: Among 4214 subjects of this study, most excess weight loss after surgery has taken place in 18 months after surgery. 18.5% (n=407) of patients experienced EXWL with highest percentage among OAGB patients (22.6%). The females (20.4% vs.9.9%) and younger persons (35.45 ± 10.25 vs. 39.06 ± 10.76) were more susceptible to EXWL. patients with EXWL had significantly lower BMI (body mass index) (41.11± 4.51 vs. 46.73±6.26) (Kg/m2), and were less probable to had emotional eating. Visceral fat level, fat percentage and BMI were the best predictor of EXWL (P-value for all <0.05).Conclusions: Surgery should be adjusted in younger females with a lower BMI and healthy metabolic status who are more prone to EXWL. In such a way that minimize weight loss speed/value. It may be possible by selection of other surgery procedures, rather than OAGB, tighter follow ups and consultations of patients after surgery is emphasized for more EXWL vulnerable patients.

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Association between antidepressants and reduced weight loss following bariatric surgery – A retrospective cohort study

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2019.03.157 ◽

2019 ◽

Vol 121 ◽

pp. 152

Author(s):

Philip Plaeke ◽

Filip Van Den Eede ◽

Ben Gys ◽

Anthony Beunis ◽

Martin Ruppert ◽

...

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Key Time Points After Bariatric Surgery, From Weight Loss To Weight Regain: Long-Term Retrospective Cohort Study

10.21203/rs.3.rs-1064596/v1 ◽

2021 ◽

Author(s):

Mahsa Hatami ◽

Abdolreza Pazouki ◽

Fatemeh Sadat Hosseini-Baharanchi ◽

Ali Kabir

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Weight Regain ◽

Long Term Results ◽

Time Points

Abstract Background and Objective: Bariatric surgery may lead to an unsuccessful weight loss, weight loss plateau, and even weight regain in different time points after various types of surgery. Despite the numerous studies investigated bariatric surgery-induced weight loss, the long-term results of surgery, after repetitive weight fluctuations, is not really clear and remains as one of the most important concerns. The aim of the present study was to determine the key time points of weight changes after three types of bariatric surgery, and the estimation of five-year weight loss after surgery. Setting: This is a retrospective cohort study including patients with morbid obesity conducted in the obesity clinic of Minimally Invasive Surgery Research Center of Iran University of Medical Sciences. Methods The subjects underwent one of the three types of bariatric surgeries including laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB) which had been followed up to five years after surgery. The percentage lost to follow-up was 34% until five-year after surgery. Results The mean %EWL a total of 2567 morbid obese participants (mean age=39.03, mean BMI=45.67) in the first six months after surgery was independent of the type of surgery. Ninth and 24th month after surgery were the times that OAGB and then RYGB induced weight loss sped up rather than LSG, respectively. Weight plateau and weight regain were initiated earlier (at 18th month) and more (18.23% of maximum EWL %) in LSG in the period of five years. The %EWL in time intervals of 3-6, 6-9, and 9-12 months after LSG, RYGB, and OAGB, respectively; could estimate the long-term five years %EWL after surgery. Conclusion OAGB provides the fastest and highest %EWL, and LSG induced the earliest and most weight plateau and weight regain during five years interval post-surgery. The pattern of early weight loss could predict the long-term outcome of bariatric surgery. So early identification of suboptimal weight loss could allow consideration of earlier postoperative intervention to enhance long-term weight loss.

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