Abstract 16717: My Unlimited Health Potential: 12 Month Effect of Participation in a Worksite Lifestyle Intervention Program on Significant Weight Loss and Eligibility Criteria for Bariatric Surgery Among High Risk Individuals

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Sameer Shaharyar ◽  
Lara Roberson ◽  
Ehimen Aneni ◽  
Maribeth Rouseff ◽  
Thinh Tran ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Weight ◽  
High Risk ◽  
Intervention Program ◽  
South Florida ◽  
Morbidly Obese ◽  
Worksite Wellness ◽  
Wellness Program

BACKGROUND: Bariatric surgery among the morbidly obese is recommended as an option to mitigate future risk of cardiovascular disease, diabetes and hypertension. To date there is little evidence on the effect of extensive lifestyle interventions among these high-risk groups in reducing the need for such procedures in extended periods. METHODS: The purpose of the present study is assess efficacy of an intensive lifestyle workplace intervention on significant body weight across the spectrum of obesity in a worksite wellness program, called “My Unlimited Potential (MyUP)” conducted at Baptist Health South Florida. Changes in BMI are being measured from baseline to 12 months follow up, along with corresponding improvements in cardio-metabolic risk. In addition, the decrease in participants meeting criteria for bariatric surgery over the study period is examined at 6 and 12 months. Bariatric surgery criteria were defined as BMI≥40 or BMI between 35 and 40 and at least one of the following co-morbidities: diabetes, hypertension, or high cholesterol. RESULTS: The study population consisted of 272 individuals (48±9 years, 78% female) with BMI≥27 at baseline. Complete data at 12-month follow up was available for 141 individuals (52%). A total of 21(14%) and 14 (10%) participants had lost at least 10 % of their body weight by 6 months and 12 months respectively. Forty-six participants (32%) initially met criteria for bariatric surgery. At six month follow-up 43% (20 of 46, p<0.001) of these candidates no longer needed bariatric surgery. Of these, 80% (16 out of 20) retained their weight loss at 12 months. CONCLUSIONS: This worksite wellness program effectively obviated the need for bariatric surgery in approximately half of those who were initially eligible at 1 year of follow up. Replication of this program with a larger cohort with stricter attention to attrition is needed to asses the utility of our program and its implications as a larger corporate wellness strategy.

Abstract P385: My Unlimited Health Potential: Short term Effect of Participation in a Worksite Lifestyle Intervention Program on Significant Weight Loss and Eligibility Criteria for Bariatric Surgery Among High Risk Individuals

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lara L Roberson ◽  
Ehimen Aneni ◽  
Sameer Shaharyar ◽  
Ebenezer Oni ◽  
Maribeth Rouseff ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Weight ◽  
High Risk ◽  
Disease Risk ◽  
Morbidly Obese ◽  
Metabolic Risk ◽  
Short Term

Background: Current recommendations support bariatric surgery among the morbidly obese as an option to mitigate future risk of cardiovascular disease, diabetes and hypertension. To date, there is little evidence on the effect of extensive lifestyle interventions among those high-risk individuals in reducing the need for such procedures. Methods: The purpose of the present study was to examine the efficacy of an intensive lifestyle workplace intervention on significant body weight and cardiovascular disease risk factors across the spectrum of obesity. Changes in BMI were measured from baseline to 12 week follow up, along with corresponding improvements in cardio-metabolic risk. In addition, the decrease in participants meeting criteria for bariatric surgery over the study period was examined. Bariatric surgery criteria were defined as BMI≥40 or BMI between 35 and 40 and at least one of the following co-morbidities: diabetes, hypertension, or high cholesterol. Results: The study population consisted of 169 individuals (49±10 years, 77% female) with BMI≥27 at baseline and complete data at follow-up. A total of 65 (39%) participants lost at least 5% of both their initial BMI and body weight. Additionally, 32% dropped an entire BMI category. Of note, 38%(18 of 48) who were classified as BMI>40 were in BMI 35-39 at follow-up, respectively 37%(13 of 55) of individuals in the BMI category 35-39 successfully moved to the BMI category 30-34 at 3 months follow-up. Sixty-three participants (37% of total) initially met criteria for bariatric surgery. At 12 weeks follow-up 35% (22 of 63) of these candidates no longer qualified. Conclusions: Worksites can be effective for achieving clinically important reductions in body weight and diminish the potential need for procedures among a small proportion of morbidly obese individuals. Further follow-up is needed to ascertain whether weight loss can be sustained long-term, and if the short term gains will translate to significant improvements in cardio-metabolic risk profile.

Abstract P199: Keep Moving, Your Health Depends On It: Impact Of Improved Physical Activity And Weight Loss In A Wellness Program

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ebenezer T Oni ◽  
Ehimen Aneni ◽  
Maribeth Rouseff ◽  
Thinh Tran ◽  
Henry Guzman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Weight Loss ◽  
Intervention Program ◽  
South Florida ◽  
Metabolic Equivalents ◽  
Baseline Weight ◽  
The Mean ◽  
The Difference

Negative impact of CVD as the leading cause of death in the US is worsened by the significant burden of obesity and associated morbidity and concerns about the growing population inactivity. The American Heart Association has emphasized worksite-based interventions to improve CV health. We evaluated the benefits of improved physical activity(PA) and weight loss(WL) among employees of the Baptist Health South Florida enrolled in a wellness intervention program. Methods: Employees with two or more Cardio-metabolic risk factors , such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were enrolled in an intervention program themed “My unlimited potential”. Interventions were focused on diet and PA modifications. We defined improved physical activity as the difference in the metabolic equivalents (METs) at 12 weeks follow-up and at baseline. WL (lbs) was the difference in weight at follow-up. The relationship between WL and changes in METs was explored in an ordered logistic regression. Results: Overall 203 (48±10 years, 78% females) employees were enrolled with a retention rate of 89% (n=181) at 12 weeks follow-up. At baseline the median weights was 211 lbs., and mean METs- 8.6, while at follow-up the median weight was 200 lbs, and the mean METs 11. At 12 weeks follow up 38% had significant WL (lost >5% of baseline weight). The median WL was 8.4 (IQR 4.8-13.0) lbs and the mean change in METs was 2.4±1.8. Median WL increased with increasing tertiles of METs change; tertile1- 6.5(4-11) lbs., tertile2- 9(6-13)lbs. tertile3- 11(7-15)lbs. Increased PA was related to increased WL across BMI categories adjusting for age, gender and baseline weight. Conclusion: This study points strongly toward the benefit of increasing PA among other lifestyle modification interventions in controlling weight. Although further follow-up of this population to evaluate sustainability of change is needed, our results clearly relate improved PA and health.

scholarly journals MON-LB101 5-Year Data of an Aggressive Pharmacological Approach to Moderate and Morbid Obesity: Is Prevention of Bariatric Surgery Feasible in the Long Run?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Flavio Cadegiani
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Body Weight ◽  
Weight Regain ◽  
Morbidly Obese ◽  
Biochemical Profile ◽  
Initial Weight ◽  
Initial Weight Loss

Abstract Background: Maintenance of weight loss in patients that undergo weight loss interventions is highly challenging, irrespective of the type of approach to obesity (whether surgical, pharmacological, or non-pharmacological). We proposed a protocol of an aggressive clinical treatment for obesity aiming to prevent the need of bariatric surgery, in patients unwilling to undergo this procedure, by proposing a protocol that included the combination of different anti-obesity medications and non-pharmacological modalities, for longer duration, and with an active approach to prevent weight regain. Our initial 2-year data showed that 93% (40 of 43 patients) with moderate and morbid obesity were able to avoid the need of bariatric surgery, with concomitant improvements of the biochemical profile. However, whether these patients would maintain their successful rates after five years was uncertain. Our objective is to describe the efficacy and safety of a long term (5-year data) pharmacological and multi-modal treatment for moderate and severe obesity. Methods: The 40 patients that were successful in the two-year approach in our obesity center (Corpometria Institute, Brasilia, DF, Brazil) were enrolled. A long-term anti-obesity protocol was employed, with continuous or intermittent use of anti-obesity drugs, trimestral body composition analysis, psychotherapy, visit to a nutritionist every four months, and both resistance and endurance exercises at least four times a week. Body weight (BW), total weight excess (TWE), body fat, markers of lipid and glucose metabolism, liver function, and inflammation were analyzed. Subjects that dropped out were considered as weight regain. Therapeutic success for the 5-year follow-up included as the maintenance of &gt;20% loss of the initial BW loss, and no weight regain (or &lt; 20% of the initial weight loss). Results: A total of 27 patients (67.5%) were able to maintain the body weight, seven dropped out, and six regained more than 20% of the initial weight loss. Of these, 21 (77.8%) had significant further increase of muscle mass and decrease of fat loss, while 17 (63.0%) had further weight loss (p &lt; 0.05), compared to the 2-year data. Improvements on the biochemical profile persisted in all 27 patients, and had significant further improvements in 24 (88.9%) of these patients. Conclusion: The risk of weight regain five years after a weight loss treatment for obesity was significantly lower compared to previous literature, and comparable to the long-term outcomes of bariatric procedures. An aggressive, structured, and long-term clinical weight loss approach has been shown to be feasible, even for morbidly obese patients.

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 Obese patients lose weight independently of nutritional follow-up after bariatric surgery

2015 ◽  
Vol 61 (2) ◽  
pp. 139-143 ◽  
Author(s):  
Beatriz Helena Tess ◽  
Veruska Magalhães Scabim ◽  
Marco Aurélio Santo ◽  
Júlio César R. Pereira
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Weight ◽  
Postoperative Period ◽  
Weight Reduction ◽  
Intervention Strategies ◽  
Obese Patients ◽  
Preoperative Body Mass Index ◽  
Preoperative Weight

Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP) from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil). Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195) of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%). Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18). Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00). Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

Effect on Liver Enzymes of Biliopancreatic Diversion: 4 Years of Follow-Up

2015 ◽  
Vol 66 (2-3) ◽  
pp. 132-136 ◽  
Author(s):  
Rocio Aller ◽  
David Pacheco ◽  
Olatz Izaola ◽  
David Primo ◽  
Daniel A. de Luis
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Weight ◽  
Biliopancreatic Diversion ◽  
Liver Enzymes ◽  
Elevated Serum ◽  
Obese Patients ◽  
Serum Aminotransferase ◽  
Morbid Obese

Background: Elevated serum aminotransferase levels are commonly associated with obesity and with a progression to chronic liver disease. Bariatric surgery is the most effective strategy to achieve weight loss. Methods: We conducted the present study with the aim of evaluating the influence of biliopancreatic diversion (BPD) on liver enzymes levels during 4 years in morbid obese patients with normal aminotransferase (n = 65) and in morbid obese patients with high aminotransferase basal levels (n = 50). Results: A decrease in alanine aminotransferase and aspartate aminotransferase activities was significant after biliopancreatic diversion. The basal percentage of high aminotransferase levels and percentage of ratio ALT/AST <1 also decreased significantly at 1-, 2-, 3- and 4-years of follow-up in both groups. ALT (52 to 20%), AST (42 to 10%) and ALT/AST (80 to 22%) in patients with normal aminotransferase. ALT (82 to 20%), AST (70 to 6%) and ALT/AST (90 to 20%) in patients with elevated transaminase basal levels. Bariatric surgery was associated with a significant and sustained decrease in body weight in both groups. Serum trasnaminases level changes were positively correlated to body weight changes during follow-up. Conclusion: BPD is an effective method of achieving sustainable weight loss and reduced aminotransferase levels and enzyme ratios of liver damage.

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 Ten Years After Bariatric Surgery: A Review of the Literature

2020 ◽  
Vol 13 (1) ◽  
pp. 19-27
Author(s):  
Toni I. Stoyanov ◽  
Pedro Cascales-Sanchez ◽  
Kaloyan T. Ivanov ◽  
Agustina Martinez-Moreno ◽  
Servando Usero-Rebollo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Vertical Band Gastroplasty ◽  
Surgical Techniques ◽  
Morbidly Obese ◽  
Operation Rate

Summary Introduction: Bariatric surgery has amply demonstrated its benefit in the treatment of morbidly obese patients. After surgery, there is a progressive and significant decrease in weight in a high percentage of patients. Most comorbidities resolve, improving quality of life and increasing life expectancy. Methods and Objective: The literature review is based on a 10-year or longer follow-up of patients who underwent various bariatric surgery procedures. The long-term weight loss results and the clinical impact were evaluated. Results: The applied surgical techniques, including Rouxen-Y gastric Bypass (RYBG), Biliopancreatic Diversion, Scopinaro type (BPD), and Duodenal Switch (DS), have contributed to achieving very satisfactory long-term and sustainable weight loss results. According to the reviewed literature, the percentage of excessive BMI Loss (%EBMIL) for the various techniques was 67.9%, 70.7%, and 71.5% for RYGB, BPD, and DS, respectively. Patients undergoing BGYR have lost much more weight than non-surgical patients and can maintain long-term weight loss, reaching a Percentage of Excessive Weight Loss (%EWL) as high as 56.4% in 10 years. Patients who underwent Adjustable Gastric Band (AGB) presented with a %EWL of 45.9% in 10 years, but with very high re-operation rate range (8-78%). There are few studies in the literature on Laparoscopic Sleeve Gastrectomy, reporting weight loss results over ten years. According to the study carried out by Arman G. A., Himpens J., et al. isolated Laparoscopic Sleeve Gastrectomy (LGS) produced a satisfactory weight loss over ten years, reachingEBMIL of 62.5%. Amending LSG with a new surgical design with malabsorbtive component (in 25% of patients) increased the weight loss, achieving %EBMIL of 81.7%.The Vertical Band Gastroplasty technique resulted in EWL of 38.1 ± 28.8%, as shown by a mean follow-up of 17.3 years, with a high rate of re-operations and conversions.

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.

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