scholarly journals The association between socioeconomic factors and weight loss 5 years after gastric bypass surgery

2020 ◽  
Vol 44 (11) ◽  
pp. 2279-2290
Author(s):  
Erik Stenberg ◽  
Ingmar Näslund ◽  
Carina Persson ◽  
Eva Szabo ◽  
Magnus Sundbom ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Socioeconomic Status ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Socioeconomic Factors ◽  
First Generation ◽  
First Generation Immigrants ◽  
Preoperative Body Mass Index ◽  
Postoperative Weight Loss ◽  
The Mean

Abstract Introduction Patients with low socioeconomic status have been reported to have poorer outcome than those with a high socioeconomic status after several types of surgery. The influence of socioeconomic factors on weight loss after bariatric surgery remains unclear. The aim of the present study was to evaluate the association between socioeconomic factors and postoperative weight loss. Materials and methods This was a retrospective, nationwide cohort study with 5-year follow-up data for 13,275 patients operated with primary gastric bypass in Sweden between January 2007 and December 2012 (n = 13,275), linking data from the Scandinavian Obesity Surgery Registry, Statistics Sweden, the Swedish National Patient Register, and the Swedish Prescribed Drugs Register. The assessed socioeconomic variables were education, profession, disposable income, place of residence, marital status, financial aid and heritage. The main outcome was weight loss 5 years after surgery, measured as total weight loss (TWL). Linear regression models, adjusted for age, preoperative body mass index (BMI), sex and comorbid diseases were constructed. Results The mean TWL 5 years after surgery was 28.3 ± 9.86%. In the adjusted model, first-generation immigrants (%TWL, B −2.4 [95% CI −2.9 to −1.9], p < 0.0001) lost significantly less weight than the mean, while residents in medium-sized (B 0.8 [95% CI 0.4–1.2], p = 0.0001) or small towns (B 0.8 [95% CI 0.4–1.2], p < 0.0001) lost significantly more weight. Conclusions All socioeconomic groups experienced improvements in weight after bariatric surgery. However, as first-generation immigrants and patients residing in larger towns (>200,000 inhabitants) tend to have inferior weight loss compared to other groups, increased support in the pre- and postoperative setting for these two groups could be of value. The remaining socioeconomic factors appear to have a weaker association with postoperative weight loss.

What Happens to Patients who Do Not Follow-Up after Bariatric Surgery?

2007 ◽  
Vol 73 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Jason Harper ◽  
Atul K. Madan ◽  
Craig A. Ternovits ◽  
David S. Tichansky
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Laparoscopic Gastric Bypass ◽  
Excess Body Weight ◽  
Preoperative Body Mass Index ◽  
Number Of Patients ◽  
Group B

Loss of follow-up is a concern when tracking long-term clinical outcomes after bariatric surgery. The results of patients who are “lost to follow-up” are not known. After bariatric surgery, the lack of follow-up may result in less weight loss for patients. This study investigated the hypothesis that there are differences between patients who do not automatically return for their annual follow-up and those that do return. Patients who were greater than 14 months postoperative after laparoscopic gastric bypass were contacted if they had not returned for their annual appointment. They were seen in clinic and/or a phone interview was performed for follow-up. These patients (Group A) were compared with patients who returned to see us for their annual appointment (Group B) without us having to notify them. There were 105 consecutive patients, with 48 patients who did not automatically return for their annual appointment. Only six of these patients could not ultimately be contacted. There was no difference in preoperative body mass index between the two groups. Percentage excess body weight loss was greater in Group B (76 vs 65%; P < 0.003). More patients had successful weight loss (defined as within 50% of ideal body weight) in Group B (50 [88%] vs 28 [67%]; P < 0.02). We found that a significant number of patients will not comply with regular follow-up care after laparoscopic gastric bypass unless they are prompted to do so by their bariatric clinic. These patients have worse clinical outcome ( i.e., less weight loss). Caution should be taken when examining the results of any bariatric study where there is a significant loss to follow-up.

scholarly journals Does Preoperative Weight Change Predict Postoperative Weight Loss after Laparoscopic Roux-en-Y Gastric Bypass in the Short Term?

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Dan Eisenberg ◽  
Andrew J. Duffy ◽  
Robert L. Bell
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Change ◽  
Regression Analyses ◽  
Short Term ◽  
Postoperative Weight Loss ◽  
Significant Difference ◽  
Preoperative Weight ◽  
One Way Anova

Background. Many institutions mandate preoperative weight loss prior to bariatric surgery. This study examines the correlation between preoperative weight change and postoperative success following laparoscopic Roux-en-Y gastric bypass.Methods. We retrospectively studied the correlation between change in BMI before surgery and change in BMI postoperatively, using linear regression analyses and one-way ANOVA, in 256 consecutive gastric bypass patients with 1-year followup.Results. Of 256 patients, 125 lost weight preoperatively (mean % BMI), while 131 maintained or gained weight (mean +1.2% BMI). Postoperatively, there was no significant difference in percent BMI loss between the two groups (34.6% and 34.5%). The percent change in BMI preoperatively did not predict postoperative BMI change after 1 year ().Conclusions. Our study did not show any correlation between preoperative weight change and postoperative weight loss after Roux-en-Y gastric bypass. Therefore, we do not believe that potential patients should be denied bariatric surgery on the basis of their inability to lose weight preoperatively.

scholarly journals Association between weight loss and reduced use of antihypertensive, hypoglycemic, psychotropic, and lipid-lowering drugs in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
pp. 6-13
Author(s):  
Mariana Mendes Pereira Gonçalves ◽  
Frederico Daldegan ◽  
Gabriel Correia Iannuzzi ◽  
Marcelo Mendonça Rodrigues ◽  
Seleno Glauber de Jesus-Silva
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Psychotropic Drugs ◽  
Antihypertensive Drugs ◽  
Lipid Lowering ◽  
Hypoglycemic Agents ◽  
Temporary Reduction ◽  
The Mean

Objectives: To analyze whether the weight reduction observed in bariatric surgery (Roux-en-Y gastric bypass; BGYR) is accompanied by a reduction in the use of antihypertensive, hypoglycemic, antilipidemic, and psychotropic drugs after 6 and 12 months. Methods: Longitudinal, retrospective study of 100 adult patients undergoing RYGB from May 2015 to January 2019, by laparotomy or laparoscopy. Data on age, body mass index (BMI), and the number of drugs used were recorded 6 and 12 months after surgery. Results: The mean age was 39.7 ± 9.7 years, and the majority were female (n = 78). The mean preoperative BMI was 43.7 ± 5.1 kg/m2, and the mean reduction in BMI after 6 months was 12.1 kg/m2 and 14.9 kg/m2 after 12 months. The reduction in antihypertensive drugs was 65.2% after 6 months and 96% after 12 months. The reduction in 6 months of hypoglycemic agents was 84.3%, and in 12 months, 98.3%. The average reduction in antidyslipidemic drugs was 86.7% in 6 months, and there was no record of using this medication after 12 months. Psychotropics showed a temporary reduction in use after 6 months with a return to levels close to the baseline after 1 year.There was no correlation between the variation in BMI and the use of drugs. Conclusions: there was a significant reduction in the use of drugs after 6 and 12 m, except for psychotropic drugs. The reduction in the use of drugs was not correlated with a reduction in BMI.

Behavioral Factors Associated with Successful Weight Loss after Gastric Bypass

2010 ◽  
Vol 76 (10) ◽  
pp. 1139-1142 ◽  
Author(s):  
Masha Livhits ◽  
Cheryl Mercado ◽  
Irina Yermilov ◽  
Janak A. Parikh ◽  
Erik Dutson ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Support Groups ◽  
Preoperative Body Mass Index ◽  
Patients At Risk ◽  
Successful Weight Loss ◽  
Predictors Of Weight Loss ◽  
Weight Loss Success

Patients undergoing bariatric surgery lose substantial weight (≥50% excess weight loss [EWL]), but an estimated 20 per cent fail to achieve this goal. Our objective was to identify behavioral predictors of weight loss after laparoscopic Roux-en-Y gastric bypass. We retrospectively surveyed 148 patients using validated instruments for factors predictive of weight loss. Success was defined as ≥50 per cent EWL and failure as <50 per cent EWL. Mean follow-up after laparoscopic Roux-en-Y gastric bypass was 40.1 ± 15.3 months, with 52.7 per cent of patients achieving successful weight loss. After controlling for age, gender, and preoperative body mass index, predictors of successful weight loss included surgeon follow-up (odds ratio [OR] 8.2, P < 0.01), attendance of postoperative support groups (OR 3.7, P = 0.02), physical activity (OR 3.5, P < 0.01), single or divorced marital status (OR 3.2, P = 0.03), self-esteem (OR 0.3, P = 0.02), and binge eating (OR 0.9, P < 0.01). These factors should be addressed in prospective studies of weight loss after bariatric surgery, as they may identify patients at risk for weight loss failure who may benefit from early tailored interventions.

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

scholarly journals Is One Anastomosis Gastric Bypass with a Biliopancreatic Limb of 150 cm Effective in the Treatment of People with Severe Obesity with BMI > 50?

2021 ◽  
Author(s):  
Arnaud Liagre ◽  
Francesco Martini ◽  
Radwan Kassir ◽  
Gildas Juglard ◽  
Celine Hamid ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Severe Obesity ◽  
Postoperative Mortality ◽  
One Anastomosis Gastric Bypass ◽  
Sustained Weight Loss ◽  
Biliopancreatic Limb ◽  
Percentage Excess Weight Loss

Abstract Purpose The treatment of people with severe obesity and BMI > 50 kg/m2 is challenging. The present study aims to evaluate the short and mid-term outcomes of one anastomosis gastric bypass (OAGB) with a biliopancreatic limb of 150 cm as a primary bariatric procedure to treat those people in a referral center for bariatric surgery. Material and Methods Data of patients who underwent OAGB for severe obesity with BMI > 50 kg/m2 between 2010 and 2017 were collected prospectively and analyzed retrospectively. Follow-up comprised clinical and biochemical assessment at 1, 3, 6, 12, 18, and 24 months postoperatively, and once a year thereafter. Results Overall, 245 patients underwent OAGB. Postoperative mortality was null, and early morbidity was observed in 14 (5.7%) patients. At 24 months, the percentage total weight loss (%TWL) was 43.2 ± 9, and percentage excess weight loss (%EWL) was 80 ± 15.7 (184 patients). At 60 months, %TWL was 41.9 ± 10.2, and %EWL was 78.1 ± 18.3 (79 patients). Conversion to Roux-en-Y gastric bypass was needed in three (1.2%) patients for reflux resistant to medical treatment. Six patients (2.4%) had reoperation for an internal hernia during follow-up. Anastomotic ulcers occurred in three (1.2%) patients. Only two patients (0.8%) underwent a second bariatric surgery for insufficient weight loss. Conclusion OAGB with a biliopancreatic limb of 150 cm is feasible and associated with sustained weight loss in the treatment of severe obesity with BMI > 50 kg/m2. Further randomized studies are needed to compare OAGB with other bariatric procedures in this setting. Graphical abstract

Responsiveness of virtual beverage portion size tasks and prediction of postoperative weight loss in bariatric surgery patients.

Appetite ◽  
2021 ◽  
pp. 105574
Author(s):  
Tamima Sultana ◽  
Jeon D. Hamm ◽  
Jany Dotel ◽  
Jeanine Albu ◽  
Subhash Kini ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Portion Size ◽  
Postoperative Weight Loss

scholarly journals Evaluation of the Effects of Bariatric Surgery in Terms of Weight Loss and Diabetes Remission in the Indian Population

2021 ◽  
pp. 1-7
Author(s):  
Manish Khaitan ◽  
Riddhish Gadani ◽  
Koshish Nandan Pokharel
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Complete Remission ◽  
Predictive Factors ◽  
Indian Population ◽  
Diabetes Remission ◽  
Obese Patients ◽  
Sustained Weight Loss

<b><i>Objectives:</i></b> The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. <b><i>Methods:</i></b> Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s <i>t</i> test and ANOVA and McNemar’s test were applied. <b><i>Results:</i></b> Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (<i>n</i> = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (<i>p</i> = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. <b><i>Conclusion:</i></b> Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.

Abstract 15673: Racial Disparities in Referral for Pre-operative Cardiovascular Evaluation, Surgical Wait Time, and Weight Loss in Patients Undergoing Bariatric Surgery

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Lauren Tragesser ◽  
Kaitlyn Ibrahim ◽  
Rohit Soans ◽  
Abdullah Haddad ◽  
Raj K Dalsania ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Racial Disparities ◽  
Wait Time ◽  
Similar Proportion ◽  
Postoperative Weight Loss ◽  
Cardiovascular Evaluation ◽  
Cardiac Testing ◽  
Surgical Wait Time ◽  
White Patients

Introduction: White patients undergo bariatric surgery more frequently and with fewer complications compared to non-white patients. Yet, racial disparities in referral pattern for preoperative cardiovascular evaluation (CVE) are unexplored. We hypothesized that racial disparities exist in preoperative CVE in white vs. non-white patients undergoing bariatric surgery. Methods: We identified consecutive patients undergoing bariatric surgery at our institution from 2014-2018. The association of white vs. non-white race with referral for CVE, cardiac testing, surgical wait time, and postoperative weight loss was determined in a multivariate model adjusting for baseline demographic comorbidities and income. Additional adjustment for insurance provider was made for surgical wait time. Results: Of the 797 patients undergoing bariatric surgery during the study period, 86% (n=682) were non-white. White vs. non-white patients had similar age, gender distribution, and prevalence of hypertension, hyperlipidemia, Type 2 diabetes, and heart failure. A similar proportion of whites vs. non-whites were referred to cardiology for pre-operative evaluation (65% vs. 68%, p=0.52), while whites were more likely to undergo further preoperative cardiac testing after adjustment (68% vs. 55%, p=0.04; adjusted, OR 0.6, 95%CI 0.35-1.0, p=0.05). Despite less cardiac testing, non-white patients referred to cardiology waited longer for surgery (9.9 months vs. 12.1 months, p=0.008), including after adjustment (HR 0.7, 95%CI 0.53-0.91, p= 0.008. Weight loss at 6 months was higher in whites (12.9 kg/m 2 vs. 11.95 kg/m 2 , p=0.03), but equivalent at 1 year (whites 14.9 kg/m 2 vs. non-whites 14.3 kg/m 2 , p=0.33). Conclusions: In a bariatric surgery population, white vs. non-white patients were referred for CVE in similar proportion. However, white patients underwent more subsequent cardiac testing pre-operatively when compared to non-whites yet had a shorter wait time for surgery. Early weight loss was greater in whites, but equivalent between groups at 1 year.

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