scholarly journals Baseline serum folate level may be a predictive factor of weight loss in a morbid-obesity-management programme

2006 ◽  
Vol 96 (5) ◽  
pp. 956-964 ◽  
Author(s):  
J. J. Gorgojo Martínez ◽  
F. Almodóvar Ruiz ◽  
S. Donnay Candil
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Medical Management ◽  
Management Programme ◽  
Serum Folate ◽  
Successful Outcome ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obesity Management

Prompt identification of responders to non-surgical therapy is of utmost importance in attempting medical treatment in patients with clinically severe obesity before indication of bariatric surgery. The objectives of the present study were to assess the outcome at 1 year of morbidly obese patients undergoing a weight-loss medical programme and to detect baseline predictors of a loss ≥10 % of initial weight at the end of the follow-up. A longitudinal, prospective study of a cohort of morbidly obese patients (n 182; females 78 %; age 40·5 (sd 11·5) years; BMI 45·4 (sd 6·0) kg/m2) enrolled in a 1-year obesity-management programme based on lifestyle changes and pharmacological therapy. Significant laboratory and clinical variables were included in a binary logistic regression model in order to identify baseline independent factors for the prediction of a successful outcome in the programme. At 12 months of follow-up, twenty-one subjects (11·5 % of the initial cohort) had lost ≥10 % of baseline weight. A high serum folic acid level was the only independent predictor of weight loss at 1 year. A rise of 1 ng/ml in serum folate increased the chance of success by 28 % (adjusted odds ratio 1·28; 95 % CI 1·04, 1·58). We concluded that a medical-management programme of morbid obesity obtained limited results at 1 year, in agreement with other intervention studies. Serum folate may be useful as a pre-treatment predictor of response to a medical-management programme in patients with morbid obesity. Patients with low basal serum folate levels probably should be urged to change unhealthy eating patterns.

scholarly journals Outcomes of Biliointestinal Bypass among Iranian Obese Patients

2018 ◽  
Vol 04 (04) ◽  
pp. e197-e200
Author(s):  
Seyed Naeini ◽  
Alireza Khalaj ◽  
Ali Abbaszadeh-Kasbi ◽  
Seyed Miri
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Surgical Approaches ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Liver Transaminases ◽  
Biliointestinal Bypass ◽  
A Prospective Study

Background There are several surgical approaches to treat obesity not cured with medical approaches. Each method has its advantages and complications. In here, we have conducted a study to evaluate complications of biliointestinal bypass surgery (BIBP). Methods A prospective study was conducted in a private hospital from 2002 to 2016. Those patients, not previously operated for morbid obesity, were eligible. Mean follow-up period was 89 months ( ± 54 months; range: 73–108 months). Main outcome measures were weight, BMI (body mass index), concentrations of blood lipids and glucose, liver transaminases, and obesity-related comorbidities and complications. Results Twenty-three consecutive patients with morbid obesity, including 16 women (69.7%) and seven men (31.3%) with mean age 38.47 ± 10 years (range: 26–57 years) underwent surgery. At the end of follow-up period, a mean BMI reduction of 12.2 kg/m2 kg/m2 (p < 0.001)] was observed. An excess weight loss (EWL) of 63% ( ± 34) was achieved at the end of the study. Additionally, total cholesterol and triglyceride levels decreased postoperative significantly. The main long-term complications were flatulence (60%), borborygmus (47.8%), mal odorous stool (30.4%), and diarrhea (21.7%). Revision rate was 4.34%. There were no cases with irreversible hepatic injury, deaths due to the surgery, or progressive renal failure. Conclusion BIBP seems to be a safe, easily reversible, and one of valid therapeutic approaches in morbidly obese patients. BIBP has the potential to achieve durable weight loss and offers an improved quality of life.

A Preliminary Study of the Relationship between Preoperative Depression and Weight Loss following Surgery for Morbid Obesity

1986 ◽  
Vol 15 (2) ◽  
pp. 185-196 ◽  
Author(s):  
Steven L. Dubovsky ◽  
Ann Haddenhorst ◽  
James Murphy ◽  
R. Dale Liechty ◽  
Deborah A. CoyLe
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Body Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Postoperative Weight Loss ◽  
Preliminary Study ◽  
Preoperative Weight ◽  
The Relationship

Fifty-two consecutive morbidly obese patients were evaluated psychiatrically before they were scheduled to undergo gastroplasty and again an average of twenty-six months later. Ten patients did not undergo surgery; six patients who did undergo gastroplasty were unavailable for follow up. In the remaining thirty-six patients, there was a statistically significant correlation between the degree of clinically estimated preoperative depression and the percent of body weight lost following surgery. Amount of preoperative weight was also correlated with postoperative weight loss, but depression before surgery was a more significant predictor of postoperative weight loss. Patients who expressed less distress prior to surgery tended to lose less weight after surgery and were more likely to manifest increased psychiatric distress postoperatively.

scholarly journals Towards Precision Health in Weight Reduction: Thematic Content Analysis of an Open-Ended Survey on Reasons Why Morbidly Obese Patients Want to Lose Weight.

2020 ◽  
Author(s):  
Mazapuspavina Md-Ya ◽  
Ilham Ameera Ismail ◽  
Khasnur Abd Malek ◽  
Khalid Yusoff ◽  
Awang Bulgiba
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Content Analysis ◽  
Weight Reduction ◽  
Extensive Study ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Thematic Content Analysis ◽  
Thematic Content ◽  
The Impact

Abstract Background: Addressing individuals’ motivation to lose weight among patients with morbid obesity is an essential entity in weight reduction. Failures to shift motivation into weight loss actions are common. These could be contributed by the inadequacy to identify and subsequently address the key reasons, that are of particular concern to the patient' individual needs. We aimed to understand the motivations better and identify the reasons why morbidly obese patients attending hospital-based weight management programmes (WMP) wanted to lose weight. Methods: The study used a qualitative approach to analyze part of a quantitative questionnaire of a more extensive study to understand factors influencing weight loss among morbidly obese patients. We used thematic content analysis to analyze responses from a self-administered open-ended question "What is the main factor why you want to lose your weight?”. A total of 225 new patients attending obesity clinics in two tertiary hospitals responded to the questionnaire. Results: Patients’ mean BMI was 45.6±8.05 kg/m2. Four themes emerged for the reasons why morbidly obese patients wanted to lose weight. Health was the most commonly inferred theme (84%). Patients were concerned about the impact obesity had on their health. Overcoming obesity was seen as a reward not just for physical health, but also for their psychological wellbeing. Patients regard being functional to care for themselves, their family members, as well as their religious and career needs as the next most crucial theme (25.8%). Patients raised the theme appearance (12.9%), especially with regards to wanting to look and feel beautiful. The last theme was perceived stigmatization for being morbidly obese as they were mocked and laughed at for their appearance (3.1%).Conclusion: Patients with morbid obesity in this study had expressed their main personal motivational reasons to lose weight. Concerns about the impact of morbid obesity on health, physical, social and obligatory function, appearance and perceived stigma warrant detailed exploration by the managing health professionals. Identifying and addressing these unique personal motivations in a focused approach is vital at the beginning and throughout a weight reduction program in this unique group.

scholarly journals Application of BAROS’ questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution

2017 ◽  
Vol 54 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Caetano de QUEIROZ ◽  
José Afonso SALLET ◽  
Pedro Gabriel Melo DE BARROS E SILVA ◽  
Luzia da Gloria Pereira de Sousa QUEIROZ ◽  
Jélis Arenas PIMENTEL ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Long Term Results ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Index Reduction ◽  
Clinical Complications ◽  
Number Of Patients ◽  
Prevalence Of Obesity

ABSTRACT BACKGROUND -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric operations have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery. OBJECTIVE To investigate results concerning a casuistic of morbidly obese patients undergoing bariatric surgery over a 2-year follow-up in terms of weight loss, related medical conditions, safety and changes in quality of life. METHODS A total of 120 obese (17 male and 103 female) patients, who underwent bariatric surgery, were assessed and investigated using the BAROS system after a 2- year follow-up. RESULTS Patients obtained a mean excess weight loss of 74.6 (±15.9) % and mean body mass index reduction of 15.6 (±4.4) Kg/m2. Pre-surgical comorbidities were present in 71 (59%) subjects and they were totally (86%) or partially (14%) resolved. Complications resulting specifically from the surgical procedure were observed in 4.2% of cases (two bowel obstructions requiring re-operation, and three stomal stenosis treated with endoscopic dilation). Sixteen subjects (13% of total number of patients) presented minor clinical complications managed through outpatient care. The final scores for the BAROS questionnaire showcased excellent to good results in 99% of cases (excellent 44%, very good 38%, good 23%, acceptable 1%). CONCLUSION According to the BAROS questionnaire, bariatric surgery is a safe and effective method for managing obesity and associated clinical comorbidities, allowing for satisfactory results after a 2-year follow-up. Future studies should address other clinical and psychosocial variables that impact outcome as well as allow for longer follow-ups.

scholarly journals Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Kalman Bencsath ◽  
Adham Jammoul ◽  
Ali Aminian ◽  
Hideharu Shimizu ◽  
Carolyn J. Fisher ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight ◽  
Control Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Percent Excess Weight Loss ◽  
Severely Obese

Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypass n=19, sleeve gastrectomy n=3), preoperative BMI was 46.5 ± 7.2 Kg/m2 and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population.

Weight loss and improvement of lipid profiles in morbidly obese patients after laparoscopic one-anastomosis gastric bypass: 2-year follow-up

2016 ◽  
Vol 31 (1) ◽  
pp. 416-421 ◽  
Author(s):  
Miguel A. Carbajo ◽  
Arlett Fong-Hirales ◽  
Enrique Luque-de-León ◽  
Juan Francisco Molina-Lopez ◽  
Javier Ortiz-de-Solórzano
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Lipid Profiles ◽  
One Anastomosis Gastric Bypass ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Lifestyle intervention for morbid obesity: effects on liver steatosis, inflammation, and fibrosis

2018 ◽  
Vol 315 (3) ◽  
pp. G329-G338 ◽  
Author(s):  
Simon Hohenester ◽  
Simon Christiansen ◽  
Jutta Nagel ◽  
Ralf Wimmer ◽  
Renate Artmann ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Liver Fibrosis ◽  
Lifestyle Intervention ◽  
Liver Damage ◽  
Liver Steatosis ◽  
Real Life ◽  
Serum Levels ◽  
Morbidly Obese ◽  
Obese Patients

The prevalence of obesity-related nonalcoholic fatty liver disease (NAFLD) is rising. NAFLD may result in nonalcoholic steatohepatitis (NASH), progressing to liver cirrhosis. Weight loss is recommended to treat obesity-related NASH. Lifestyle intervention may improve NASH; however, pertinent trials have so far focused on overweight patients, whereas patients with obesity are at highest risk of developing NAFLD. Furthermore, reports of effects on liver fibrosis are scarce. We evaluated the effect of lifestyle intervention on NAFLD in a real-life cohort of morbidly obese patients. In our observational study, 152 patients underwent lifestyle intervention, with a follow-up of 52 weeks. Noninvasive measures of obesity, metabolic syndrome, liver steatosis, liver damage, and liver fibrosis were analyzed. Treatment response in terms of weight loss was achieved in 85.1% of patients. Dysglycemia and dyslipidemia improved. The proportion of patients with fatty liver dropped from 98.1 to 54.3% ( P < 0.001). Weight loss >10% was associated with better treatment response ( P = 0.0009). Prevalence of abnormal serum transaminases fell from 81.0 to 50.5% ( P < 0.001). The proportion fibrotic patients, as determined by the NAFLD fibrosis score, dropped from 11.8 to 0% ( P < 0.05). Low serum levels of adiponectin correlated with degree of liver damage, i.e., serum liver transaminases ( r = −0,32, P < 0.05). Serum levels of adiponectin improved with intervention. In conclusion, lifestyle intervention effectively targeted obesity and the metabolic syndrome. Liver steatosis, damage and fibrosis were ameliorated in this real-life cohort of morbidly obese patients, mediated in part by changes in the adipokine profile. Patients with weight loss of >10% seemed to benefit most. NEW & NOTEWORTHY We demonstrate new evidence that lifestyle intervention is effective in treating NAFLD in the important group of patients with (morbid) obesity. Although current guidelines on the therapy of NASH recommend weight loss of 5–7%, weight reduction >10% may be favorable in morbid obesity. Serum levels of adipokines correlate with liver damage, which is indicative of their pathogenetic importance in human NASH. Our study adds to the limited body of evidence that NAFLD-associated liver fibrosis may resolve with lifestyle intervention.

scholarly journals Self-Reported Psychosocial Health in Obese Patients before and after Weight Loss

2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
G. Osei-Assibey ◽  
I. Kyrou ◽  
S. Kumar ◽  
P. Saravanan ◽  
K. A. Matyka
Keyword(s):  
Weight Loss ◽  
Depressive Disorders ◽  
Emotional Health ◽  
Dietary Treatment ◽  
Psychosocial Health ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Increased Risk ◽  
Before And After

Psychosocial profiles were examined in 255 morbidly obese patients attending a hospital service offering access to standard weight loss therapies. 129 patients were reassessed after at least 6-month follow-up. At baseline, 51.8% and 32.7% of patients, respectively, had evidence of anxiety and depressive disorders, 24% had severe impairments in self esteem, and 29.7% had an increased risk of eating disorders. At follow-up, weight loss from baseline was significant in all 3 therapies: diet only is  kg; pharmacotherapy is  kg; and surgery is  kg. Anxiety scores improved in all three groups (). Patients having pharmacotherapy or surgery had significant improvements in physical and work function and public distress compared to those having dietary treatment only (). Our observational data suggest that weight management services can lead to psychosocial benefit in morbidly obese patients. Well-designed studies are necessary to examine the link between weight loss and emotional health.

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