scholarly journals Modest weight loss improves leptin to adiponectin ratio and induces insulin and leptin resensitivization in individuals with obesity.

2021 ◽  
Author(s):  
Victoria Therese Isaksen ◽  
Maria Arlen Larsen ◽  
Rasmus Goll ◽  
Eyvind J. Paulssen ◽  
Jon Ragnar Florholmen
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Total Body Weight ◽  
Rehabilitation Program ◽  
University Hospital ◽  
Leptin Resistance ◽  
Model Assessment ◽  
Metabolic Complications ◽  
Leptin Sensitivity ◽  
Modest Weight Loss

Abstract Background Weight loss is important to reduce the risk of metabolic complications in obese individuals, in whom dysregulated adipokines play a central role. This study aims to investigate whether dysregulated adipokines and postprandial triglycerides (TG) improve with a modest weight loss. Methods Individuals with obesity were recruited among patients at the University Hospital of North Norway and the Stamina Health weight loss rehabilitation program. We measured resting energy expenditure (REE), and calculated the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), leptin to adiponectin (L:A) ratio, indirect leptin sensitivity (REE:leptin ratio), postprandial TG clearance at 6 h, and TG response before and after weight loss. The goal of the weight loss intervention was a loss of ≥5% of initial total body weight. Results Of the 28 participants who attended two scheduled assessments, 13 lost ≥5% body weight. HOMA-IR (-23.1%), REE:leptin ratio (+80.1%) and L:A ratio (-45.7%) significantly improved with weight loss, whereas there was no improvement of postprandial TG response or clearance. No significant changes were observed in the non-weight loss group. Conclusion Metabolic dysregulation, as insulin and leptin resistance, but not postprandial TG improve with a modest weight loss in individuals with obesity.

scholarly journals Reduction of Cardio-Metabolic Risk and Body Weight through a Multiphasic Very-Low Calorie Ketogenic Diet Program in Women with Overweight/Obesity: A Study in a Real-World Setting

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1804
Author(s):  
Elena Tragni ◽  
Luisella Vigna ◽  
Massimiliano Ruscica ◽  
Chiara Macchi ◽  
Manuela Casula ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Waist Circumference ◽  
Real World ◽  
Metabolic Complications ◽  
Multi Centre Study ◽  
Low Calorie ◽  
Ketogenic Diets ◽  
Real World Setting ◽  
Overweight Or Obesity

Background: The prevention and treatment of obesity and its cardio-metabolic complications are relevant issues worldwide. Among lifestyle approaches, very low-calorie ketogenic diets (VLCKD) have been shown to lead to rapid initial weight loss, resulting in better long-term weight loss maintenance. As no information on VLCKD studies carried on in a real-world setting are available, we conducted this multi-centre study in a real-world setting, aiming at assessing the efficacy and the safety of a specific multiphasic VLCKD program in women with overweight or obesity. Methods: A multi-center, prospective, uncontrolled trial was conducted in 33 outpatient women (age range 27–60 y) with overweight or obesity (BMI: 30.9 ± 2.7 kg/m2; waist circumference: 96.0 ± 9.4 cm) who started a VLCKD dietary program (duration: 24 weeks), divided into four phases. The efficacy of VLCKD was assessed by evaluating anthropometric measures and cardiometabolic markers; liver and kidney function biomarkers were assessed as safety parameters. Results: The VLCKD program resulted in a significant decrease of body weight and BMI (−14.6%) and waist circumference (−12.4%). At the end of the protocol, 33.3% of the participants reached a normal weight and the subjects in the obesity range were reduced from 70% to 16.7%. HOMA-IR was markedly reduced from 3.17 ± 2.67 to 1.73 ± 1.23 already after phase 2 and was unchanged thereafter. Systolic blood pressure decreased after phase 1 (−3.5 mmHg) and remained unchanged until the end of the program. Total and LDL cholesterol and triglycerides were significantly reduced by VLCKD along with a significant HDL cholesterol increase. Liver, kidney and thyroid function markers did not change and remained within the reference range. Conclusions: The findings of a multi-center VLCKD program conducted in a real-world setting in a cohort of overweight/obese women indicate that it is safe and effective, as it results in a major improvement of cardiometabolic parameters, thus leading to benefits that span well beyond the mere body weight/adiposity reduction.

scholarly journals SUN-543 Real World Evidence of Successful Weight Management for the Obese Population: Complete Reversal of Obesity Related Metabolic Co-Morbidities and Weight Loss in Patients Attending a Multidisciplinary Weight Management Clinic in Australia

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Management ◽  
Exercise Physiology ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Management Interventions ◽  
Co Morbidity ◽  
Total Body ◽  
Total Body Weight Loss

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.

scholarly journals Endoscopic sleeve gastroplasty: a modified technique with greater curvature compression sutures

2019 ◽  
Vol 07 (10) ◽  
pp. E1303-E1309 ◽  
Author(s):  
Michael A. Glaysher ◽  
Alma L. Moekotte ◽  
Jamie Kelly
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Effective Means ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Modified Technique ◽  
Longitudinal Compression ◽  
Median Baseline ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty

Abstract Background Endoscopic sleeve gastroplasty (ESG) is rapidly becoming established as a safe and effective means of achieving substantial weight loss via the transoral route. New ESG suture patterns are emerging. Our aim was to investigate whether superior weight loss outcomes can be achieved by using a unique combination of longitudinal compression sutures and “U”-shaped sutures. Methods This is a retrospective review of prospectively collected data of all patients undergoing ESG by a single operator in a single UK center. Results Between January 2016 and December 2017, 32 patients (23 female) underwent ESG; n = 9 cases were completed utilizing a commonly used triangular suture pattern (“no longitudinal compression”) and n = 23 cases were completed using our unique “longitudinal compression” suture pattern. In the no compression and compression groups, the mean ages were 45 ± 12 years and 43 ± 10 years, the median baseline weights were 113.6 kg (range 82.0 – 156.4) and 107 kg (range 74.0 – 136.0), and the median baseline body mass indexes (BMIs) were 35.9 kg/m2 (range 30.9 – 43.8) and 36.5 kg/m2 (range 29.8 – 42.9), respectively. After 6 months, body weight had decreased by 21.1 kg (range, 12.2 – 34.0) in the compression group (n = 7) versus 10.8 kg (range, 7.0 – 25.8) in the no compression group (n = 5) (P = 0.042). Correspondingly, BMI decreased by 7.8 kg/m2 (range, 4.9 – 11.2) and 4.1 kg/m2 (range, 2.6 – 7.2) in each group, respectively (P = 0.019). Total body weight loss (%TBWL) was greater in the compression group at 19.5 % (range, 12.9 – 30.4 %) compared to 13.2 % (range, 6.2 – 17.1 %) in the non-compression group (P = 0.042). No significant adverse events were reported in this series. Conclusion The technique of ESG is evolving and outcomes from endoscopic bariatric therapies continue to improve. We provide preliminary evidence of superior weight loss achieved through a modified gastroplasty suture pattern.

scholarly journals Changes in Resting Energy Expenditure following Gastric Bypass Surgery: Impact on Total Body Weight.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Fathimath Naseer ◽  
Ruth Price ◽  
Adele McElroy ◽  
Carel Le Roux ◽  
Tamsyn Redpath ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Total Body Weight ◽  
Post Surgery ◽  
Significant Difference ◽  
Total Body ◽  
Ree Group

AbstractBariatric surgery, including Gastric Bypass (GBP) Surgery, is the most efficient modality to manage severe obesity. Resting Energy Expenditure (REE) is an area of interest in the context of weight loss (WL) as it has been postulated to be an independent predictor of WL success following GBP. As such, the aim of this study is to investigate the impact of REE on WL following GBP. 31 GBP patients (77.4% females BMI 45.5 ± 7.0kg/m2 ; 47.3 ± 11.6y) and 32 weight-stable controls (46.9% females; BMI 27.0 ± 4.6kg/m2 ; 41.1 ± 13.5y) were assessed at one-month pre-surgery and at 3 and 12-months post-surgery. Fat mass (FM) and fat-free mass (FFM) were measured using dual energy X-ray absorptiometry (Lunar iDXA, GE Healthcare). REE was measured under standardised conditions using indirect calorimetry (ECAL, Metabolic Health Solutions). Statistical analyses were performed with SPSS v24.0, Armonk, NY. Multiple regression analysis showed that FM (P = 0.001), FFM (P < 0.0001) and gender (P = 0.012) significantly predicted the interindividual variability in REE. Total body weight (TBW) was removed from the model due to collinearity. Adjusted-REE values were then generated using the above predictor variables. Low-REE and high-REE groups were created using within-group adjusted-REE split. At both follow-ups (3- and 12-months post-surgery), patients had a greater reduction in TBW, FM, FFM, measured-REE and adjusted-REE values compared with controls (P < 0.0001). There was also no significant difference between measured and adjusted-REE values at all time-points (P > 0.05). Patients with high REEs at baseline lost more TBW than those in the low-REE group at 3-months post-surgery (-24.9 ± 6.5 kg vs. -16.6 ± 7.0 kg; P = 0.005) and 12-months post-surgery (-41.3 ± 12.5 kg vs. -25.8 ± 10.4.0 kg; P = 0.003). There was no significant difference in mean TBW changes for controls in the low-and high-REE groups at both follow-ups. Patients with high REEs at 3-months post-surgery did not lose more TBW than those in the low-REE group at 12-months post-surgery (-30.1 ± 12.8 kg vs. -38.6 ± 14.4 kg; P = 0.155). Similarly, there was no difference in mean TBW reduction between controls in the low- and high-REE groups (P = 0.115). Thus while patients with a high adjusted-REE value at baseline (> 9746.6kJ/day) lost more weight at 3- and 12-months post-GBP, it is plausible that from the third to the 12th month post-surgery, other key drivers of weight loss, particularly the reduction in energy intake are more important in predicting WL. Further research with a larger sample size is required to increase the chances of detecting a true effect.

scholarly journals Long-term consequences of maternal high-fat feeding on hypothalamic leptin sensitivity and diet-induced obesity in the offspring

2007 ◽  
Vol 293 (3) ◽  
pp. R1056-R1062 ◽  
Author(s):  
Jacqueline Férézou-Viala ◽  
Anne-France Roy ◽  
Colette Sérougne ◽  
Daniel Gripois ◽  
Michel Parquet ◽  
...  
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Body Weight Gain ◽  
Maternal Diet ◽  
The Body ◽  
Female Rats ◽  
Leptin Resistance ◽  
High Fat ◽  
Leptin Sensitivity ◽  
The Impact

Epidemiological and animal studies suggest that the alteration of hormonal and metabolic environment during fetal and neonatal development can contribute to development of metabolic syndrome in adulthood. In this paper, we investigated the impact of maternal high-fat (HF) diet on hypothalamic leptin sensitivity and body weight gain of offspring. Adult Wistar female rats received a HF or a control normal-fat (C) diet for 6 wk before gestation until the end of the suckling period. After weaning, pups received either C or HF diet during 6 wk. Body weight gain and metabolic and endocrine parameters were measured in the eight groups of rats formed according to a postweaning diet, maternal diet, and gender. To evaluate hypothalamic leptin sensitivity in each group, STAT-3 phosphorylation was measured in response to leptin or saline intraperitoneal bolus. Pups exhibited similar body weights at birth, but at weaning, those born to HF dams weighed significantly less (−12%) than those born to C dams. When given the HF diet, males and females born to HF dams exhibited smaller body weight and feed efficiency than those born to C dams, suggesting increased energy expenditure programmed by the maternal HF diet. Thus, maternal HF feeding could be protective against adverse effects of the HF diet as observed in male offspring of control dams: overweight (+17%) with hyperleptinemia and hyperinsulinemia. Furthermore, offspring of HF dams fed either C or HF diet exhibited an alteration in hypothalamic leptin-dependent STAT-3 phosphorylation. We conclude that maternal high-fat diet programs a hypothalamic leptin resistance in offspring, which, however, fails to increase the body weight gain until adulthood.

Initial experience with endoscopic sleeve gastroplasty in Poland

2018 ◽  
Vol 90 (2) ◽  
pp. 16-22 ◽  
Author(s):  
Aleksander Sowier ◽  
Przemysław Pyda ◽  
Anna-Maria Borucka ◽  
Sebastian Sowier ◽  
Jacek Białecki ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Sleeve Resection ◽  
Less Invasive ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty

Introduction: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive. Materials and methods: Eight obese patients underwent ESG. Under general anaesthesia, an endoscope was inserted into the stomach, where a row of 4-5 running stitches was placed (from the pyloric part towards the GE junction). Each of the stitches was cinched tight, which resulted in gastric lumen reduction comparable to that achieved with laparoscopic sleeve gastrectomy. Results: The procedures were performed without any severe peri-operative complications. The only adverse event was a minor haemorrhage in one of the patients, which did not require any surgical intervention. After the surgery, the patients reported a substantial weight loss. Mean %TBWL was 8.6%, 15.4% and 19.6% at 1, 2 and 3 months, respectively. Conclusions: Minimally invasive and highly effective in body weight reduction, endoscopic sleeve gastroplasty is a promising method of treating obesity. The procedure requires appropriate tools and equipment. The method guarantees gastric volume reduction comparable to that achieved with sleeve resection. The initial results confirm that the effectiveness of the surgery in terms of body weight loss is similar to that seen in other forms of bariatric treatment. Discussion: Compared to laparoscopic sleeve gastrectomy, endoscopic sleeve gastroplasty is substantially less invasive. Also, it requires shorter procedure time and shorter hospital stay. Data from other medical centres demonstrate somewhat lower dynamics of total body weight loss but these results need to be verified in a long-term follow-up.

Assessment of body composition measure of bioelectrical impedance in patients operated for pancreatic, gastric and colorectal cancer

2020 ◽  
Vol 92 (1) ◽  
pp. 1-5
Author(s):  
Przemysław Dzierżek ◽  
Krzysztof Kurnol ◽  
Wojciech Hap ◽  
Ewelina Frejlich ◽  
Agata Diakun ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Bioelectrical Impedance ◽  
The Body ◽  
Intracellular Water ◽  
University Hospital ◽  
Major Surgery ◽  
Average Weight ◽  
Neoplastic Disease

Introduction An adequate level of nutrition is important in the period of reconvalescence in patients undergoing major surgery, in particular due to neoplastic disease. Bioelectrical impedance (BIA - Bioelectrical Impedance Analysis) is a widely used technique for assessing body composition. BIA measurement is easy, fast, cheap and repeatable. Material and methods The body composition of 56 patients (25 women and 31 men) was assessed with bioelectrical impedance analysys. All patients was hospitalized and operated in the Department of General and Oncological Surgery, Wrocław Clinical University Hospital in 2017-2018. Results The average weight loss on the 4th postoperative day is 1.32%, and at discharge from hospital 4.23% of body weight in relation to body weight at admission to the ward. The percentage of fat tissue (FM-Fatt Mass) in patients admitted to the ward is above the normal range. The change in body weight composition in hospitalized patients is mainly related to the amount of adipose tissue and the amount of extra- and intracellular water (ECW-Extracellular Water, ICW-Intracellular Water). Conclusions Bioelectrical impedance can be an easy and effective method to assess body composition and its change in patients undergoing major surgery. Patients operated on due to pancreatic cancer lose the highest percentage of body weight until discharge from the ward in relation to body weight at the time of admission to the ward from the analyzed groups. Weight loss mainly occurs as fat loss (FM).

Loss of lean body mass within one week as a major determinant for total weight loss at one month after gastrectomy for gastric cancer.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 219-219
Author(s):  
Toru Aoyama ◽  
Takaki Yoshikawa ◽  
Taiichi Kawabe ◽  
Hirohito Fujikawa ◽  
Tsutomu Hayashi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Lean Body Mass ◽  
Body Mass ◽  
Early Period ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Late Period ◽  
Total Body ◽  
Total Body Weight Loss

219 Background: Postoperative changes in body weight and composition during first 1 month after gastrectomy remained unclear. Methods: The patients who underwent gastrectomy for gastric cancer between May 2010 and October 2013 were examined. Body weight and composition were evaluated by bioelectrical impedance analyzer within 1 week before surgery (first measurement), at 1 week after surgery (second measurement), and at 1 month after surgery (third measurement). The changes of the early period were defined as the differences until the second measurement, while those of the late period as the differences from the second to the third measurement. Results: Two-hundred forty four patients were selected for this study. Total body weight loss (BWL) within 1 month was -3.4 kg and the rate of body weight at 1 month to the preoperative body weight was 94.1%. BWL was significantly greater in the early period rather than that of the late period (-2.1 kg vs -1.2 kg, p<0.001). In the early period, loss of lean body mass was significantly greater than loss of fat mass (-1.5 kg vs -0.6 kg, p<0.001). The same trend was observed regardless of type of gastrectomy and surgical approach. Conclusions: Loss of lean body mass within 1 week was a major determinant for total body weight loss at 1 month. To maintain lean body mass within 1 week and total body weight at 1 month, future trial should be focused on not the surgical approach but nutritional intervention within 1 week.

scholarly journals Reduced atherogenic indices in prepubertal girls with precocious adrenarche born appropriate for gestational age in relation to the conundrum of DHEAS

2013 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Ahmet Uçar ◽  
Nurçin Saka ◽  
Firdevs Baş ◽  
Nihal Hatipoğlu ◽  
Rüveyde Bundak ◽  
...  
Keyword(s):  
Gestational Age ◽  
Plasma Lipids ◽  
University Hospital ◽  
Atherogenic Index ◽  
Oral Glucose ◽  
Model Assessment ◽  
Metabolic Complications ◽  
Increased Risk ◽  
Precocious Adrenarche ◽  
Appropriate For Gestational Age

Context An association between low birth weight, insulin resistance (IR), dyslipidemia, and atherogenesis has been shown in girls with precocious adrenarche (PA). Objective To evaluate whether girls with PA born appropriate for gestational age (AGA) have increased risk for metabolic complications at initial evaluation. Design/methods We conducted a cross-sectional study on 69 AGA born girls with PA (mean (±s.d.) age 7.1±1 years) and 45 body mass index (BMI)- and waist circumference (WC)-matched prepubertal peers born AGA (mean (±s.d.) 7.5±1.9 years). A standard 2-h oral glucose tolerance test with insulin sampling was performed. Fasting plasma lipids and high-sensitivity C-reactive protein were analyzed, and blood pressure was recorded. Insulin sensitivity (IS) index (ISIcomp), homeostasis model assessment of IR, and atherogenic index (AI) (triglycerides/high-density lipoprotein cholesterol) were calculated. Setting The study was performed at University Hospital. Results AI was significantly lower in girls with PA than in controls (P<0.001), and it was correlated with BMI SDS (r=0.44, P=0.001) and WC (r=0.39, P=0.001). The significant correlation of AI with ISIcomp (r=−0.38, P=0.001) disappeared after correcting for BMI (r=−0.185, P=0.16). Multivariate regression analysis revealed that DHEAS was the only significant parameter influencing AI in girls with born AGA (R 2=0.475 β=−0.018, P=0.0001). Conclusions Metabolic screening in prepubertal AGA born girls with PA may yield favorable lipid profiles. AI in girls with PA is increased in relation to decreasing IS and increasing BMI and WC. DHEAS seems to have the most significant effect on AI.

scholarly journals Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study

Children ◽  
2018 ◽  
Vol 5 (9) ◽  
pp. 116 ◽  
Author(s):  
Alexander Toth ◽  
Gricelda Gomez ◽  
Alpana Shukla ◽  
Janey Pratt ◽  
Hellas Cena ◽  
...  
Keyword(s):  
Weight Loss ◽  
Young Adults ◽  
Body Weight ◽  
Weight Change ◽  
Weight Regain ◽  
Body Weight Loss ◽  
Total Body Weight ◽  
Percent Weight Loss ◽  
Total Body ◽  
Weight Loss Medications

This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or metformin postoperatively. Percentage of patients achieving ≥5%, ≥10%, or ≥15% weight loss on medications was determined and percent weight change on each medication was compared to percent weight change of the rest of the cohort. Our results showed that 54.1% of study patients lost ≥5% of their postsurgical weight; 34.3% and 22.9% lost ≥10% and ≥15%, respectively. RYGB had higher median percent weight loss (−8.1%) than SG (−3.3%) (p = 0.0515). No difference was found in median percent weight loss with medications started at weight plateau (−6.0%) versus after weight regain (−5.4%) (p = 0.5304). Patients taking medications at weight loss plateau lost 41.2% of total body weight from before surgery versus 27.1% after weight regain (p = 0.076). Median percent weight change on metformin was −2.9% compared to the rest of the cohort at −7.7% (p = 0.0241). No difference from the rest of the cohort was found for phentermine (p = 0.2018) or topiramate (p = 0.3187). Topiramate, phentermine, and metformin are promising weight loss medications for 21 to 30 year olds. RYGB patients achieve more weight loss on medications but both RYGB and SG benefit. Median total body weight loss from pre-surgical weight may be higher in patients that start medication at postsurgical nadir weight. Participants on metformin lost significantly smaller percentages of weight on medications, which could be the result of underlying medical conditions.

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