scholarly journals Nutrition Care for Patients with Weight Regain after Bariatric Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Carlene Johnson Stoklossa ◽  
Suneet Atwal
Keyword(s):  
Bariatric Surgery ◽  
Weight Status ◽  
Weight Regain ◽  
Multidisciplinary Approach ◽  
Registered Dietitian ◽  
Weight Losses ◽  
Nutrition Care ◽  
Efficacious Treatment ◽  
Food And Beverage ◽  
Weight Outcomes

Achieving optimal weight outcomes for patients with obesity is important to the management of their chronic disease. All interventions present risks for weight regain. Bariatric surgery is the most efficacious treatment, producing greater weight losses that are sustained over more time compared to lifestyle interventions. However, approximately 20–30% of patients do not achieve successful weight outcomes, and patients may experience a regain of 20–25% of their lost weight. This paper reviews several factors that influence weight regain after bariatric surgery, including type of surgery, food tolerance, energy requirements, drivers to eat, errors in estimating intake, adherence, food and beverage choices, and patient knowledge. A comprehensive multidisciplinary approach can provide the best care for patients with weight regain. Nutrition care by a registered dietitian is recommended for all bariatric surgery patients. Nutrition diagnoses and interventions are discussed. Regular monitoring of weight status and early intervention may help prevent significant weight regain.

scholarly journals Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience

2021 ◽  
Vol 10 (21) ◽  
pp. 4922
Author(s):  
Assim A. Alfadda ◽  
Mohammed Y. Al-Naami ◽  
Afshan Masood ◽  
Ruba Elawad ◽  
Arthur Isnani ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Saudi Arabia ◽  
Weight Regain ◽  
Severe Obesity ◽  
Successful Outcome ◽  
Post Surgery ◽  
Weight Outcomes

Background: Obesity is considered a global chronic disease requiring weight management through lifestyle modification, pharmacotherapy, or weight loss surgery. The dramatic increase in patients with severe obesity in Saudi Arabia is paralleled with those undergoing bariatric surgery. Although known to be beneficial in the short term, the long-term impacts of surgery within this group and the sustainability of weight loss after surgery remains unclear. Objectives: We aimed to assess the long-term weight outcomes after bariatric surgery. Setting: The study was conducted at King Khalid University Hospital (KKUH), King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. Methods: An observational prospective cohort study on adult patients with severe obesity undergoing bariatric surgery (sleeve gastrectomy (SG) or Roux-en Y gastric bypass (RYGB)) during the period between 2009 and 2015 was conducted. Weight loss patterns were evaluated pre- and post-surgery through clinical and anthropometric assessments. Absolute weight loss was determined, and outcome variables: percent excess weight loss (%EWL), percent total weight loss (%TWL), and percent weight regain (%WR), were calculated. Statistical analysis using univariate and multivariate general linear modelling was carried out. Results: A total of 91 (46 males and 45 females) patients were included in the study, with the majority belonging to the SG group. Significant weight reductions were observed at 1 and 3 years of follow-up (p < 0.001) from baseline. The %EWL and %TWL were at their maximum at 3 years (72.4% and 75.8%) and were comparable between the SG and RYGB. Decrements in %EWL and %TWL and increases in %WR were seen from 3 years onwards from bariatric surgery until the study period ended. The yearly follow-up attrition rate was 20.8% at 1 year post-surgery, 26.4% at year 2, 31.8% at year 3, 47.3% at year 4, 62.6% at year 5, and 79.1% at end of study period (at year 6). Conclusion: The major challenge to the successful outcome of bariatric surgery is in maintaining weight loss in the long-term and minimizing weight regain. Factors such as the type of surgery and gender need to be considered before and after surgery, with an emphasis on the need for long-term follow-up to enssure the optimal benefits from this intervention.

scholarly journals Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

2020 ◽  
Author(s):  
Marleen Romeijn ◽  
Martine Uittenbogaart ◽  
François M. H. van Dielen ◽  
Arijan A. P. M. Luijten ◽  
Loes Janssen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Retrospective Cohort ◽  
Weight Regain ◽  
Multidisciplinary Approach ◽  
Physical Therapist ◽  
Revisional Surgery ◽  
Behavioral Changes ◽  
Selection Of Patients ◽  
Selection Of

Abstract Background 20–30% of patients show a lack of response after bariatric surgery (BS). These non-responders may experience insufficient weight loss or significant weight regain. Based on previous research in our center, it has been identified that before the introduction of a multidisciplinary team (MDT), 68% of the non-responders underwent revisional surgery. This study describes the effect of an MDT on treatment strategy in non-responders after BS. Methods this retrospective study included non-responders that were reviewed in an MDT meeting. Patients were categorized as primary non- responders (1NR) or as secondary non-responders (2NR). Outcomes assessed were: I. MDT-based treatment (conservative versus operative), II. Weight loss, III. Complications after revisional surgery. Results a total of 104 patients were included (n = 15 1NR, n = 89 2NR). In 73 patients, lifestyle and/or behavioral changes were indicated. Only eleven patients (13%) were re-operated in which one complication occurred. Twenty patients did not show up at their appointment with the dietician, physical therapist and/or medical psychologist and were excluded from further analysis. Conservatively treated patients lost 2.1 kg < 12 months (SD = 7.29) and 0.8 kg < 24 months (SD = 5.08). Surgically treated patients lost 12.0 kg < 12 months (SD = 4.29) and 26.3 kg < 24 months (SD = 2.75). Conclusions the rate of revisional surgery decreased after the introduction of an MDT. An explanation for this could be that an MDT drives more patients towards a conservative treatment since it identifies modifiable lifestyle and/or behavioral factors contributing to non-response. Incorporation of an MDT may contribute to the selection of patients who might benefit from revisional surgery.

scholarly journals A multidisciplinary approach for non-responders after bariatric surgery: why does it matter?

2020 ◽  
Author(s):  
Marleen Romeijn ◽  
Martine Uittenbogaart ◽  
François M. H. van Dielen ◽  
Arijan A. P. M. Luijten ◽  
Loes Janssen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Conservative Treatment ◽  
Multidisciplinary Team ◽  
Weight Regain ◽  
Multidisciplinary Approach ◽  
Physical Therapist ◽  
Revisional Surgery ◽  
Multidisciplinary Team Meeting ◽  
Behavioural Factors

Abstract Background: 20-30% of patients show a lack of response after bariatric surgery. These non-responders may experience insufficient weight loss or significant weight regain. While ongoing studies about the beneficial effect of revisional surgery on non-response are being reported, studies about the contributiveness of a multidisciplinary approach fall behind. The aim of this study was to describe the effect of a multidisciplinary approach on treatment strategy in non-responders after gastric bypass and sleeve gastrectomy.Methods: this retrospective study included non-responders that were reviewed in a multidisciplinary team meeting. Outcomes assessed were: given treatment (conservative versus operative), weight loss and complications after operative treatment. Outcomes were described separately for primary non- responders and secondary non-responders.Results: a total of 104 patients were included (n=15 primary, n=89 secondary non-response). Eleven patients underwent revisional surgery (13%), while 73 patients received conservative treatment as they were not eligible for surgery due to lifestyle and/or behavioural factors. Twenty patients did not show up at their appointment with the dietician, physical therapist and/or medical psychologist and were excluded from further analysis. Conservatively treated patients lost 2.1kg <12 months (SD=7.29) and 0.8kg <24 months (SD=5.08). Surgically treated patients lost 12.0kg <12 months (SD=4.29) and 26.3kg <24 months (SD=2.75). One complication occurred in a patient that underwent revisional surgery.Conclusions: a conservative treatment was more frequently proposed by the multidisciplinary team than a surgical treatment. A multidisciplinary approach can be beneficial for the identification of lifestyle and/or behavioural factors contributing to the development of non-response. More studies would help to establish the position of a multidisciplinary approach in the treatment of non-responders in future practices.

scholarly journals Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Elham Abbas Aljaaly
Keyword(s):  
Bariatric Surgery ◽  
Saudi Arabia ◽  
Care Process ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Nutrition Risk ◽  
Nutrition Care ◽  
Management Protocol ◽  
Perioperative Nutrition

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.

scholarly journals Nutritional Optic Neuropathies: State of the Art and Emerging Evidences

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2653
Author(s):  
Matilde Roda ◽  
Natalie di Geronimo ◽  
Marco Pellegrini ◽  
Costantino Schiavi
Keyword(s):  
Bariatric Surgery ◽  
Optic Neuropathy ◽  
Multidisciplinary Approach ◽  
State Of The Art ◽  
Signs And Symptoms ◽  
Therapeutic Strategies ◽  
Scientific Interest ◽  
Optic Nerve Atrophy ◽  
Prompt Diagnosis

Nutritional optic neuropathy is a cause of bilateral, symmetrical, and progressive visual impairment with loss of central visual acuity and contrast sensitivity, dyschromatopsia, and a central or centrocecal scotoma. The clinical features are not pathognomonic, since hereditary and toxic forms share similar signs and symptoms. It is becoming increasingly common due to the widespread of bariatric surgery and strict vegetarian or vegan diets, so even the scientific interest has recently increased. In particular, recent studies have focused on possible pathogenetic mechanisms, and on novel diagnostic and therapeutic strategies in order to prevent the onset, make a prompt diagnosis and an accurate nutritional supplementation, and to avoid irreversible optic nerve atrophy. Nowadays, there is clear evidence of the role of cobalamin, folic acid, thiamine, and copper, whereas further studies are needed to define the role of niacin, riboflavin, and pyridoxine. This review aims to summarize the etiology, diagnosis, and treatment of nutritional optic neuropathy, and it is addressed not only to ophthalmologists, but to all physicians who could come in contact with a patient with a possible nutritional optic neuropathy, being a fundamental multidisciplinary approach.

scholarly journals Emotional Eating and Weight Status in Adolescents: A Systematic Review

2021 ◽  
Vol 18 (3) ◽  
pp. 991
Author(s):  
Christine A. Limbers ◽  
Emma Summers
Keyword(s):  
Systematic Review ◽  
Weight Loss ◽  
Emotional Eating ◽  
Weight Status ◽  
English Language ◽  
Gastric Bypass Surgery ◽  
Study Results ◽  
Weight Outcomes ◽  
Prospective Association ◽  
The One

Background: Despite evidence that emotional eating is associated with weight gain in adults, less is known about this association in adolescents. The purpose of the current study was to conduct a systematic review to assess the association between emotional eating and weight status in adolescents. This study also sought to describe existing measures of emotional eating in adolescents and explore weight-loss interventions that assessed emotional eating in relation to weight status in this population. Methods: Two independent reviewers searched the database PubMed for published or in press peer-reviewed studies that assessed the association between emotional eating and weight status in adolescents aged 12 to 19 years. Studies were excluded from this review if they were not written in the English language, did not include a measure of emotional eating, or were a dissertation study. Results: A total of 13 studies met full inclusion criteria and were included in the systematic review. Of the six longitudinal studies in the review, only one found a prospective association between emotional eating and weight status. The Dutch Eating Behavior Questionnaire was the most widely used measure of emotional eating in the systematic review (n = 6; 46.2%). The one intervention study included in this review found that baseline emotional eating was not associated with weight outcomes 2 years following gastric bypass surgery in obese Swedish adolescents (13–18 years). Conclusions: While there were some inconsistent findings across the studies included in this review, taken as a whole, the results largely do not support an association between emotional eating and elevated weight status or reduced weight loss in adolescents.

Multidisciplinary Approach for Weight Regain—how to Manage this Challenging Condition: an Expert Review

2021 ◽  
Author(s):  
Maria Paula Carlin Cambi ◽  
Giorgio Alfredo Pedroso Baretta ◽  
Daniéla De Oliveira Magro ◽  
Cesar Luiz Boguszewski ◽  
Igor Braga Ribeiro ◽  
...  
Keyword(s):  
Weight Regain ◽  
Multidisciplinary Approach ◽  
Expert Review

scholarly journals Weight regain among women after metabolic and bariatric surgery: a qualitative study in Brazil

2014 ◽  
Vol 36 (3) ◽  
pp. 140-146 ◽  
Author(s):  
Ataliba de Carvalho Jr. ◽  
Egberto Ribeiro Turato ◽  
Elinton Adami Chaim ◽  
Ronis Magdaleno Jr.
Keyword(s):  
Bariatric Surgery ◽  
Psychological Factors ◽  
Qualitative Method ◽  
Weight Regain ◽  
Structured Interview ◽  
Qualitative Investigation ◽  
Health Team ◽  
Open Questions ◽  
Metabolic And Bariatric Surgery ◽  
Degree Of Participation

INTRODUCTION: Due to the increased number of bariatric surgeries over the years, aspects contributing or hindering the achievement of outcomes, among them weight regain, have acquired increased significance. Psychological factors directly influence on this unwanted situation, but there are few studies and controversies about the degree of participation of these factors. We propose a qualitative investigation to analyze the meanings of weight regain after surgery among women and how these factors influence this outcome.METHOD: This study uses the clinical-qualitative method, by means of a semi-structured interview with open questions in an intentional sample, closed by saturation, with eight women who underwent surgery at the Bariatric Surgery Outpatient Clinic of Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP), in the state of São Paulo, Brazil.RESULTS: A feeling of defeat and failure emerges with weight regain, which contributes to social isolation; there is no regret, but gratitude for the surgery; among patients, there is a sense of feeling rejected greater than a rejection that actually exists.CONCLUSION: We found out the need for further qualitative studies that help the health team to better understand the dynamic psychological factors involved in the meaning of weight regain after bariatric surgery among women, in order to adopt appropriate conducts to deal with this problem.

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