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.

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.

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 OP0106 THE ASSOCIATIONS BETWEEN BARIATRIC SURGERY AND HIP OR KNEE ARTHROPLASTY, AND HIP OR KNEE OSTEOARTHRITIS: A COHORT STUDY FROM SWEDISH NATIONWIDE HEALTHCARE REGISTRIES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 59.2-59
Author(s):  
T. Burkard ◽  
D. Holmberg ◽  
T. Hügle ◽  
A. M. Burden
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Weight ◽  
Knee Arthroplasty ◽  
Secondary Care ◽  
Obese Patients ◽  
Knee Oa ◽  
Hip And Knee Arthroplasty ◽  
Post Bariatric Surgery

Background:Osteoarthritis (OA) is a slowly developing chronic joint disease mainly characterized by joint pain which may lead to physical disability. OA in weight bearing joints, such as the hip and knee, was suggested to be susceptible to high body weight. In end-stage disease, hip and knee OA are often treated with arthroplasty. The impact of weight loss among obese patients on hip and knee arthroplasty has not been assessed to date.Objectives:To assess the association between bariatric surgery and hip or knee arthroplasty. As a secondary aim, we assessed the association between bariatric surgery and hip or knee OA in a secondary care setting.Methods:We performed a propensity score (PS)-matched cohort study using data from Swedish nationwide healthcare registries (patient registry [secondary care], causes of death registry, prescribed drug registry). Patients aged 18-79 years who underwent bariatric surgery between 2006 and 2019 were matched to up to 2 obese bariatric surgery free patients (called unexposed patients) based on their PS. PS-matching was carried out in risk set sampling to reduce selection bias, within 4 sequential cohort entry blocks to account for time trend biases. The primary outcome was hip or knee arthroplasty. The secondary outcome was a diagnosis of hip or knee OA in secondary care. We excluded patients with differential indications for arthroplasty or OA (e.g. rheumatoid arthritis, septic arthritis). After a 1-year run-in period, patients were followed in an “as-treated” approach until the outcome or censoring due to onset of an exclusion criterion, change of exposure status, or end of study period. We applied Cox proportional hazard regression to calculate hazard ratios (HR) with 95% confidence intervals (CIs) of hip or knee arthroplasty, and separately of hip or knee OA, among bariatric surgery patients when compared to obese unexposed patients. Additionally, we performed analyses in subgroups of age, sex, joint location, bariatric surgery type, and by duration of follow-up.Results:A total of 39 392 bariatric surgery patients were PS-matched to 61 085 obese unexposed patients. The study population had a mean age of 42 years, a mean follow-up of 6.5 years, and 72.5% of patients were women. We observed 1138 and 1108 hip or knee arthroplasties among bariatric surgery and obese unexposed patients, respectively. We observed an overall increased risk of hip or knee arthroplasty among bariatric surgery patients (HR of 1.43, 95% CI 1.32-1.55), compared to obese unexposed patients. The risk for knee arthroplasty was higher than that for hip arthroplasty among bariatric surgery patients (HR of 1.58, 95% CI 1.42-1.76, and HR of 1.21, 95% CI 1.06-1.39, respectively). Patients who underwent combined malabsorptive and restrictive bariatric surgery yielded highest risks of hip or knee arthroplasty (HR of 3.58, 95% CI 1.34-9.54). Risks of hip or knee arthroplasty decreased with duration of follow-up (highest risks 1-3 years post-bariatric surgery, HR of 1.79, 95% CI 1.56-2.07). In secondary analyses, risks of secondary care hip or knee OA were decreased among bariatric surgery versus obese unexposed patients (HR of 0.84, 95% CI 0.79-0.90). We observed lower risks for knee OA (HR of 0.82, 95% CI 0.76-0.88) than for hip OA (HR of 0.90, 95% CI 0.79-1.01) and observed lowest risks of hip or knee OA in early follow-up (1-3 years post-bariatric surgery) with a HR of 0.79, 95% CI 0.71-0.88, stable thereafter at a HR of 0.87, 95% CI 0.78-0.97.Conclusion:Our results suggest that substantial weight loss among obese patients is associated with decreased risks of secondary care hip and knee OA. Increased risks of hip and knee arthroplasty after bariatric surgery are likely the result of increased operability of patients who have lost a substantial amount of excess body weight. Stronger associations for the knee than for the hip in both arthroplasty and OA are consistent with existing literature suggesting a stronger impact of body weight on knee than on hip joints.Acknowledgements:We thank Prof. Dr. Jesper Lagergren (Karolinksa Institutet, Stockholm, Sweden) for hosting Dr. Theresa Burkard for a research stay at the Upper Gastrointestinal Surgery Group and making the data available for use. Furthermore, we thank Dr. Giola Santoni (Karolinksa Institutet, Stockholm, Sweden) for her technical support.Disclosure of Interests:Theresa Burkard: None declared, Dag Holmberg: None declared, Thomas Hügle Consultant of: Pfizer, Abbvie, Novartis, Grant/research support from: GSK, Jansen, Pfizer, Abbvie, Novartis, Roche, MSD, Sanofi, BMS, Eli Lilly, UCB, Andrea Michelle Burden: None declared

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.

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.

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.

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.

scholarly journals Altered GH-IGF-1 Axis in Severe Obese Subjects is Reversed after Bariatric Surgery-Induced Weight Loss and Related with Low-Grade Chronic Inflammation

2020 ◽  
Vol 9 (8) ◽  
pp. 2614
Author(s):  
Paula Juiz-Valiña ◽  
Lara Pena-Bello ◽  
Maria Cordido ◽  
Elena Outeiriño-Blanco ◽  
Sonia Pértega ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Chronic Inflammation ◽  
Morbidly Obese ◽  
Endocrine Disorders ◽  
Low Grade ◽  
Obese Patients ◽  
Free T4 ◽  
Preoperative Body Mass Index ◽  
Post Surgery

Endocrine disorders are common in obesity, including altered somatotropic axis. Obesity is characterized by reduced growth hormone (GH) secretion, although the insulin-like growth factor-1 (IGF-1) values are controversial. The aim of this study was to evaluate the effect of weight loss after bariatric surgery in the GH–IGF-1 axis in extreme obesity, in order to investigate IGF-1 values and the mechanism responsible for the alteration of the GH–IGF-1 axis in obesity. We performed an interventional trial in morbidly obese patients who underwent bariatric surgery. We included 116 patients (97 women) and 41 controls (30 women). The primary endpoint was circulating GH and IGF-1 values. Circulating IGF-1 values were lower in the obese patients than in the controls. Circulating GH and IGF-1 values increased significantly over time after surgery. Post-surgery changes in IGF-1 and GH values were significantly negatively correlated with changes in C-reactive protein (CRP) and free T4 values. After adjusting for preoperative body mass index (BMI), free T4 and CRP in a multivariate model, only CRP was independently associated with IGF-1 values in the follow-up. In summary, severe obesity is characterized by a functional hyposomatotropism at central and peripheral level that is progressively reversible with weight loss, and low-grade chronic inflammation could be the principal mediator.

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