scholarly journals Chew and spit (CHSP) in bariatric patients: a case series

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Phillip Aouad ◽  
Kristin Stedal ◽  
Gro Walø-Syversen ◽  
Phillipa Hay ◽  
Camilla Lindvall Dahlgren
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Disordered Eating ◽  
Weight Loss Surgery ◽  
Eating Pathology ◽  
Post Surgery ◽  
Significant Depression ◽  
Bariatric Patients ◽  
Clinically Significant

Abstract Background Studies into the disordered eating behaviour of chew and spit have alluded to several cohorts more likely to engage in the behaviour, one such group being bariatric surgery candidates and patients. Weight-loss surgery candidates have received little to no attention regarding engaging in chew and spit behaviour. Changes in pre- and post- surgery eating pathology related to chew and spit behaviour has yet to be explored and described in academic literature. Case presentation The current study reports on three cases of individual women, aged 30, 35, and 62 respectively, who indicated engagement in chew and spit. All three cases underwent bariatric surgery (two underwent gastric bypass, one underwent vertical sleeve gastrectomy). Eating pathology—including chew and spit behaviour, anxiety and depression, and adherence to the Norwegian nutritional guidelines were examined pre-operatively and post-operatively (one and two-year follow-up). At baseline (pre-surgery), two participants reported that they engaged in chew and spit, compared to one patient post-surgery. All three cases reported that they, to at least some extent, adhered to dietary guidelines post-surgery. Subjective bingeing frequency appeared to be relatively low for all three cases, further declining in frequency at one-year follow-up. At baseline, one participant reported clinically significant depression and anxiety, with no clinically significant depression or anxiety reported at follow-ups in participants that chew and spit. Conclusions The current study provides a starting point for the exploration of chew and spit as a pathological symptom of disordered eating in bariatric patients. It highlights the need to further explore chew and spit before and after weight-loss surgery.

scholarly journals The Work behind Weight-Loss Surgery: A Qualitative Analysis of Food Intake after the First Two Years Post-Op

ISRN Obesity ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Angela A. Geraci ◽  
Ardith Brunt ◽  
Cindy Marihart
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Food Intake ◽  
Weight Loss Surgery ◽  
Exercise Adherence ◽  
Phenomenological Approach ◽  
First Year ◽  
Structured Interviews ◽  
Post Surgery ◽  
Bariatric Patients

Purpose. Obesity has reached epidemic proportions in the U.S. and has nearly doubled worldwide since 1980. Bariatric surgery is on the rise, but little focus has been placed on the psychosocial impacts of surgery. The purpose of this study was to explore experiences of patients who have undergone bariatric surgery at least two years before to gain an understanding of the successes and challenges they have faced since surgery. Methods. This study used a phenomenological approach, to investigate the meaning and essence of bariatric patients with food after surgery. Semi-structured interviews were conducted on a sample of nine participants who had undergone surgery at least two years prior. Findings. Two main themes regarding food intake emerged from the data: (a) food after the first year post-surgery and (b) bariatric surgery is not a magic pill. Upon further analysis, food after the first year post-surgery had four subthemes emerge: diet adherence after the first year post-surgery, food intolerances, amount of food, and tendencies toward coping with food do not magically disappear. Conclusion. Findings revealed that post-operative diet and exercise adherence becomes increasingly difficult as weight loss slows. Many participants find that only after the first year after surgery the work really begins.

scholarly journals Utility of Fibroscan XL to assess the severity of non-alcoholic fatty liver disease in patients undergoing bariatric surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Andrew Yang ◽  
Melinda Nguyen ◽  
Irene Ju ◽  
Anthony Brancatisano ◽  
Brendan Ryan ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Stiffness ◽  
Convincing Evidence ◽  
Alcoholic Fatty Liver ◽  
Post Surgery

AbstractSignificant weight loss can modify the progression of Nonalcoholic fatty liver disease (NAFLD) with the most convincing evidence coming from bariatric surgery cohorts. Effective ways to non-invasively characterise NAFLD in these patients has been lacking, with high Fibroscan failure rates reported. We prospectively evaluated the utility of Fibroscan using XL-probe over a two-year period. 190 consecutive patients undergoing bariatric surgery were followed as part of their routine care. All patients had Fibroscan performed on the day of surgery and at follow-up a mean of 13 months (± 6.3) later. The majority of patients were female (82%) with mean age of 42. Fibroscan was successful in 167 (88%) at baseline and 100% at follow up. Patients with a failed Fibroscan had higher body mass index (BMI) and alanine transaminase (ALT), but no difference in FIB-4/NAFLD score. Mean baseline Liver stiffness measurement was 5.1 kPa, with 87% of patients classified as no fibrosis and 4% as advanced fibrosis. Mean baseline controlled attenuation parameter was 291, with 78% having significant steatosis, 56% of which was moderate-severe. Significant fibrosis was associated with higher BMI and HbA1c. Significant steatosis was associated with higher BMI, ALT, triglycerides and insulin resistance. Mean follow up time was 12 months with weight loss of 25.7% and BMI reduction of 10.4 kg/m2. Seventy patients had repeat fibroscan with reductions in steatosis seen in 90% and fibrosis in 67%. Sixty-four percent had complete resolution of steatosis. Fibroscan can be performed reliably in bariatric cohorts and is useful at baseline and follow-up. Significant steatosis, but not fibrosis was seen in this cohort with substantial improvements post-surgery.

scholarly journals Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up

2016 ◽  
Vol 49 (12) ◽  
pp. 1058-1067 ◽  
Author(s):  
Michael J. Devlin ◽  
Wendy C. King ◽  
Melissa A. Kalarchian ◽  
Gretchen E. White ◽  
Marsha D. Marcus ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Prospective Study ◽  
Eating Pathology ◽  
A Prospective Study

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 All in the Family: Child and Adolescent Weight Loss Surgery in the Context of Parental Weight Loss Surgery

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 990
Author(s):  
Eleanor R. Mackey ◽  
Megan M. York ◽  
Evan P. Nadler
Keyword(s):  
Social Support ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Children And Adolescents ◽  
Family Support ◽  
Psychosocial Factors ◽  
Emotional Eating ◽  
Weight Loss Surgery ◽  
Food Addiction ◽  
Post Surgery

Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their surgical status as having had surgery or not. Results: There were no differences in perceived family support, emotional eating, or food addiction symptoms between those whose parents had bariatric surgery and those whose parents did not. There were some moderating effects of parent surgery status on the relationship between social support, emotional eating/food addiction, and weight loss following surgery. Specifically, at 3 months post-surgery, higher change in BMI was associated with lower perceived family support only in those whose parents had not had surgery. More pre-surgical food addiction symptoms were associated with greater weight loss at 3 months for those whose parents had not had surgery, whereas this finding was true only for those whose parents had surgery at 12 months post-surgery. Conclusions: Children and adolescents whose parents have had bariatric surgery may have unique associations of psychosocial factors and weight loss. More research is needed to determine mechanisms of these relationships.

Abstract P203: Demographic Predictors of Long-term Weight Loss Beginning One-Year After Bariatric Surgery at Two Medical Centers

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Laura Rasmussen-Torvik ◽  
Abigail Baldridge ◽  
Jennifer Pacheco ◽  
Sharon Aufox ◽  
Kwang-Young Kim ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Mixed Effects ◽  
Mixed Effects Models ◽  
Linear Mixed Effects ◽  
Post Surgery ◽  
Percentage Weight

Objective: Existing studies of predictors of weight loss after bariatric surgery suffer from simplistic statistical methods and relatively short follow-up. We sought to determine predictors of long-term weight loss up to 9.6 years after bariatric surgery using data extracted from two electronic health records (EHR) systems and linear mixed effects models. Methods: Participants were selected from patients enrolled in the NUgene biorepository at either Northwestern Memorial HealthCare or NorthShore University HealthSystem. Individuals who had undergone Roux-en-Y gastric bypass (RNY) were identified through billing or surgical history procedure codes in the electronic health records (EHRs). All available weight measurements and dates were extracted from the EHR as well as surgery date. Sex, race/ethnicity, education, marital status, and height were taken from the NUgene intake questionnaire. SAS PROC MIXED was used to create linear mixed effects models to examine weight loss from 1- 9.6 years post-surgery. To examine overall weight loss and slope of weight regain, covariates and covariate interactions with time post-surgery were included in the mixed effects models. Results: 119 individuals from Northwestern and 43 individuals from NorthShore had undergone gastric bypass and had at least 1 weight measurement 1 year post-surgery. There were 3071 weight measurements which occurred at least 1 year post-surgery in the dataset; the median number of observations per person was 10 and the median weight loss represented by these measurements was 32.7% from pre-surgical weight. The regression model indicated that, on average, individuals experienced slight weight regain of about 0.8% of pre-surgical weight per year after their first year post-surgery. Over the 1- 10 years of follow up African Americans lost nearly 5 percentage points less weight than whites ( p =.0025) . People who were older and taller also experienced less percentage weight loss, and people with higher initial weights experienced a higher percentage weight loss (all p <.05), Older age was associated with significantly (p<0.05) slower weight regain after 1 year post-surgery. Discussion: EHR records from multiple institutions can be integrated to study outcomes after bariatric surgery. Demographic factors predict overall weight loss and a rate of weight regain after 1 year post RNY surgery. This information may be useful for both surgeons and prospective patients.

The influence of preoperative psychological factors on weight loss after bariatric surgery: A preliminary report

2016 ◽  
Vol 24 (4) ◽  
pp. 518-525 ◽  
Author(s):  
Carlo Lai ◽  
Paola Aceto ◽  
Ilaria Petrucci ◽  
Gianluca Castelnuovo ◽  
Cosimo Callari ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Psychological Factors ◽  
Preliminary Report ◽  
Total Weight ◽  
Anxiety And Depression ◽  
Total Weight Loss ◽  
Depressed Patients ◽  
Bariatric Patients

Aim of this study was to investigate relationship between preoperative psychological factors and % total weight loss after gastric bypass. 76 adult patients scheduled for bariatric surgery were preoperatively asked to complete anxiety and depression Hamilton scales and Toronto Alexithymia Scale. At 3- and 6-month follow-up, body weight was assessed. At 6-month follow-up, alexithymic patients showed a poorer % total weight loss compared with non-alexithymic patients ( p = .017), and moderately depressed patients showed a lower % total weight loss compared with non-depressed patients ( p = .011). Focused pre- and postoperative psychological support could be useful in bariatric patients in order to improve surgical outcome.

Abstract P342: Associations Between Sleep Duration and Sleep Quality and Long-Term Weight Status in Post-Bariatric Surgery Patients

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Elsa Thomas ◽  
Devon Roeshot ◽  
Dympna Gallagher ◽  
Marie-Pierre St-Onge
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Weight Change ◽  
Weight Status ◽  
Post Surgery ◽  
Post Bariatric Surgery

Introduction: The prevalence of obesity continues to rise since 1980. This obesity epidemic has been paralleled by a trend of reduced sleep duration and sleep quality throughout the years. However, there is limited research on the relation between sleep duration and quality and its association with weight loss maintenance. The purpose of this study was to examine the association between sleep duration and quality and weight status in post-bariatric surgery patients at 9-y post-surgery. We tested the hypothesis that participants’ post-surgical weight change would be related to sleep duration and quality at 9-y. Methods: Sleep data were collected on a subset of participants (mean body weight = 94.1 kg ± 18.9) enrolled in an ancillary study to the Longitudinal Assessment for Bariatric Surgery trial. Self-reported hours of sleep per night and overall sleep quality were assessed once, at the 9-y visit using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Results: Complete data were available on 14 participants (10 females and 4 males, age 52.1 ± 15.6 y), current weight 94 kg ± 18.9. Average total weight loss from pre-surgery was 28.5% ± 10.6, with an average weight gain of 0.3 ± 6.2 % over the last 2 y of follow-up. Participants reported average sleep duration of 6.8 ± 2.0 h/night at the 9-y evaluation visit and an average score of 7.9 ± 3.7 on the PSQI. There was no relation between sleep duration and current weight or percent weight change after maximum weight loss, which occurred around 2-y post-surgery. However, there were trends for an association between sleep quality and percent weight change after maximum weight loss (p=0.057) and percent weight change in the last 2-y of follow-up (p=0.066). In general, participants who lost more weight over the last 2 y of the study had lower scores on the PSQI, indicating better quality of sleep. Conclusion: Our results showed no association between sleep quality or duration and long-term changes in weight for patients who underwent bariatric surgery. However, those with better sleep quality tended to have more beneficial changes in weight over the latest 2-y. It is important to note that this study cannot address causality and whether improved weight influenced sleep quality or whether sleep quality influenced weight change. Further studies should examine the temporality of these association. Sleep quality may be an important sleep metric to consider for long-term weight loss maintenance.

scholarly journals 0884 The Effect of Bariatric Surgery on Sleep Disordered Breathing in Adolescents and Young Adults

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A336-A337
Author(s):  
A Koirala
Keyword(s):  
Bariatric Surgery ◽  
Heart Rate ◽  
Weight Loss ◽  
Young Adults ◽  
Sleep Disordered Breathing ◽  
Weight Loss Surgery ◽  
Sleep Architecture ◽  
Adolescents And Young Adults ◽  
Post Surgery ◽  
Children And Young Adults

Abstract Introduction Childhood obesity is the major risk factor sleep disordered breathing (SDB). Severely obese young people may require bariatric surgery for correction of obesity, if other methods of weight loss have failed. We aim to assess the effect of bariatric surgery on SDB, in adolescents and young adults. Methods We conducted a retrospective chart review study of patients who underwent bariatric surgery between January 1, 2006 and August 31, 2019 at Cincinnati Children’s Hospital. Only patients who had pre-operative and post-operative polysomnograms were included in the study. Results Twenty-seven children and young adults (female: 59.2%) met the criteria for entry into analysis. The mean age of subjects at the time of weight loss surgery was 17.9 years (range: 12.9 to 32.5). Majority of the patients underwent laparoscopic partial gastrectomy (85.2%) and the remaining underwent laparoscopic gastric bypass surgery (14.8%). The average duration of follow up for post study measurements after the surgery was 10.4 months (Range: 0.4 to 57.5). The median Body Mass Index (BMI) was significantly lower at post-surgery (49.9 kg/m2[IQR: 45.4-55.9][pre] vs 39.3 kg/m2[IQR: 33.9-46][post], P&lt;0.001). The median obstructive AHI was significantly reduced at post-surgery (6.7/hr[IQR: 3.1-16.4][pre] vs 2.6/hr[IQR: 1.6-6][post], P= 0.03). Median heart rate (HR) during REM (79 bpm[IQR:67-90][pre] vs 67 bpm[IQR: 59.7-72][post], P&lt;0.0001) and NREM (81 bpm[IQR:65-91][pre] vs 65 bpm[IQR: 58-73][post], P&lt;0.0001) sleep were significantly lower at post-surgery. There was no statistically significant difference in sleep architecture (sleep latency, arousal index and percentage of REM, N1 and N3 sleep, P&gt; 0.05) except N2 sleep (53.1% [IQR:47.7-57.3] [pre] vs 55.7% [IQR:51.4-63.7] [post], P= 0.03) which was significantly increased at post-surgery. Conclusion There was significant improvement in BMI and SDB after weight loss surgery in children and young adults. Interestingly, there was a decrease in heart rate during both REM and NREM sleep after surgery which may suggest a decrease in sympathetic activation due to improvement if SDB. The sleep architecture remained unchanged after surgery, except the percentage of N2 sleep. Support Cincinnati Children’s Hospital Research Foundation

scholarly journals Are the Results of a Combined Behavioural and Surgical Treatment of Morbid Obesity Satisfactory and Predictable?

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1997
Author(s):  
Per G Farup
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Weight Reduction ◽  
Treatment Success ◽  
Behavioural Therapy ◽  
Behavioural Treatment ◽  
Alternative Interventions ◽  
Clinically Significant

Treatment of subjects with morbid obesity (Body Mass Index (BMI) > 40 kg/m2 or > 35 kg/m2 with obesity-related complications) often fails. This study explored the biopsychosocial predictors of dropout and weight loss during a combined behavioural and surgical weight-reduction program. Behavioural treatment for six months was followed by bariatric surgery and a visit six months after surgery. The success criterion was the loss of ≥50% of excess BMI above 25 kg/m2 (%EBMIL). Thirty-one men and 113 women with BMI 43.5 kg/m2 (SD 4.3) and 41.8 kg/m2 (SD 3.6), respectively, were included; 115 underwent bariatric surgery (Gastric sleeve: 23; Roux-en-Y gastric bypass: 92), and 98 had a follow-up visit six months after surgery. The mean %EBMIL at follow-up was 71.2% (SD 18.5). Treatment success was achieved in 86 subjects. Assuming success in 17 subjects who did not attend the follow-up visit (best possible outcome), 103 out of 144 subjects (72%) achieved successful weight reduction. Cohabitation was the only predictor of accomplishing surgery. Neither weight loss during behavioural therapy nor biopsychosocial factors were found to be clinically significant predictors of weight loss after surgery. The success rate of less than three in four subjects was unsatisfactory. There is a need to improve the regimen and to determine effective alternative interventions.

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