828-P: The Impact of Diabetes and Depression Status on Weight Loss Outcomes in Mexican Patients with Severe Obesity

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 828-P
Author(s):  
MARCELA RODRIGUEZ FLORES ◽  
SYLVANA STEPHANO Z. ◽  
MARÍA RABASA ◽  
JUANA MONTOYA ◽  
CLAUDIA VELEZ ◽  
...  
2018 ◽  
Vol 315 (1) ◽  
pp. E91-E98 ◽  
Author(s):  
S. R. Coutinho ◽  
J. F. Rehfeld ◽  
J. J. Holst ◽  
B. Kulseng ◽  
C. Martins

The impact of lifestyle-induced weight loss (WL) on appetite in patients with obesity remains controversial. This study aimed to assess the short- and long-term impact of WL achieved by diet and exercise on appetite in patients with obesity. Thirty-five (22 females) adults with severe obesity (body mass index: 42.5 ± 5.0 kg/m2) underwent a 2-yr WL program focusing on diet and exercise. Body weight (BW), cardiovascular fitness (V̇o2max), appetite feelings, and plasma concentrations of insulin, active ghrelin (AG), glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and cholecystokinin (CCK), in the fasting and postprandial states, were measured at baseline (B), week 4 (W4), and 1 and 2 yr (and average values for all fasting and postprandial time points computed). BW was significantly reduced and V̇o2max(ml·kg−1·min−1) increased at all time points compared with B (3.5, 8.1, and 8.4% WL and 7, 11, and 8% increase at W4 and 1 and 2 yr, respectively). Basal hunger and average hunger and desire to eat were significantly increased at 1 and 2 yr. Basal fullness was significantly increased at W4, and average ratings were reduced at 1 yr. Average AG and PYY were significantly increased, and insulin was reduced, at all time points compared with B. Average GLP-1 was reduced at W4, and CCK was increased at 2 yr. After lifestyle-induced WL, patients with severe obesity will, therefore, have to deal with increased hunger in the long term. In conclusion, sustained WL at 2 yr achieved with diet and exercise is associated with increased hunger feelings and ghrelin concentration but also increased postprandial concentrations of satiety hormones.


SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A334-A334
Author(s):  
J L Kaar ◽  
L Patten ◽  
A Kaizer ◽  
S M Hawkins ◽  
J M Moore ◽  
...  

Abstract Introduction Significant weight loss is seen following bariatric surgery, leading to an ameliorative effect on obesity-related comorbidities such as OSA. Weight loss maintenance is a priority, and identifying factors that may be associated with weight loss outcomes following bariatric surgery is of high importance. The current study examined whether OSA symptoms and PAP therapy were associated with weight outcomes following bariatric surgery in adolescents. Methods Participants from the Teen-LABS Study, which follows adolescents undergoing bariatric surgery were examined. Demographic and anthropometric data, OSA diagnosis, and PAP prescription and self-reported usage information were assessed 6 months before surgery. Pediatric Sleep Questionnaire (PSQ) responses were utilized from baseline to 48 months post-surgery. All analyses were adjusted for time, age, sex, surgery type, and ethnicity. Results 242 adolescents (76% female, 72% White, age at surgery = 16.6 [1.6] years) were included. 57% had a diagnosis of OSA at pre-surgical baseline, and 56% of adolescents with OSA reported PAP use at pre-surgery. BMI increase over time from year 1-4 post-surgery was 11% more for those with high PSQ severity compared to those with low PSQ severity (p = 0.01). Those with pre-surgical OSA that reported using PAP “often” or “always” at baseline had an 8% lower increase in BMI from year 1-4 post-surgery compared to those that reported using PAP “rarely” or “sometimes” at baseline (p = 0.004). Finally, endorsing daytime sleepiness on the PSQ was associated with a 11% greater increase in BMI during years 1-4 post-surgery (p = 0.01). Conclusion OSA and daytime sleepiness may be associated with greater weight regain following bariatric surgery in adolescents. Adherence to PAP therapy pre-surgery may be a protective factor in preventing or reducing weight regain following surgery. Daytime sleepiness may be an effect of OSA, or due to the insufficient sleep that is prevalent among adolescents. Research is needed to examine the impact of additional aspects of sleep health such as duration, timing, and quality on health outcomes, as well as the impact of PAP adherence and sleep interventions on weight regain following bariatric surgery in adolescents with severe obesity. Support None.


2021 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Marlies Bongers ◽  
Daniëlle D.B. Holthuijsen ◽  
Loes Janssen ◽  
François M.H. van Dielen ◽  
...  

AbstractDespite the initial successful weight loss after bariatric surgery, a significant amount of patients experience weight loss failure and weight regain. Several factors are known to contribute to this, though the impact of employment status is unknown. The objective of this systematic review was to examine the impact of employment status on post-surgical weight loss outcomes. Eight studies were included with a follow-up ranging between 2 and 10 years. Employed patients seemed to present more weight loss (9.0–11.0% EWL, 1.3–1.6% BMI loss) compared to unemployed patients, but none of these numbers were statistically significant. Moreover, there were contrasting findings in terms of weight regain. This review may highlight the importance of working status after bariatric surgery and warrants further investigation on this topic. Graphical abstract


2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Amy S Shah ◽  
Thomas Inge ◽  
Hannah Sexmith ◽  
Anna Heink ◽  
W S Davidson

Severe obesity is a major problem among US adolescents and traditional weight loss strategies, including lifestyle intervention, have had limited efficacy. Bariatric surgery has grown in popularity because it results in rapid weight loss while improving cardiovascular disease risk factors, including raising high density lipoprotein cholesterol (HDL-C). Whether this rise in HDL-C translates into improved HDL cardioprotective function is not clear, particularly in adolescents. We studied the impact of weight loss surgery (vertical sleeve gastrectomy) in adolescents with severe obesity on HDL function pre and one year post operatively. Adolescents underwent laparoscopic vertical sleeve gastrectomy between in 2008-2011. HDL function (cholesterol efflux, HDL oxidation, and HDL inflammatory index) was measured pre and post-surgery on stored serum (-80°C) after apolipoprotein B depletion with polyethylene glycol. Only males were studied in this pilot study to minimize the known effects of sex and the menstrual cycle on lipoproteins. Changes pre and post-surgery were evaluated using paired t-tests. Participants (n=10, 90% Caucasian) were a mean±SD age of 17.4±1.6 years at baseline and 18.4 ±1.5 years at follow-up. After vertical sleeve gastrectomy, BMI was 32% lower than baseline (p<0.01). All lipid measurements improved and HDL-C increased by 23%. HDL function significantly improved post vertical sleeve gastrectomy compared to baseline, all p<0.01 (cholesterol efflux by 12%, HDL oxidation potential by 30%, and HDL inflammatory index by 25%). We conclude that vertical sleeve gastrectomy results in a significant improvement in HDL cholesterol levels and HDL function in adolescents with severe obesity. Whether these changes result in long term improvement in cardiovascular health remains to be determined.


2021 ◽  
Author(s):  
Enzamaria Fidilio ◽  
Marta Comas ◽  
Miguel Giribés ◽  
Guillermo Cárdenas ◽  
Ramón Vilallonga ◽  
...  

Abstract Purpose One major determinant of weight loss is resting energy expenditure (REE). However, data regarding REE is scarce in patients with severe obesity (SO)—BMI>50kg/m2. Most studies used equation in order to estimate REE and not indirect calorimetry (IC) (gold standard). Additionally, there is no reliable data on the impact of bariatric surgery (BS) on REE. Objectives (a) To evaluate the REE in patients with SO; (b) to compare REE measured by IC (mREE) to that calculated by Mifflin St-Jeor equation (eREE); (c) to evaluate the impact of BS on REE and the relationship with evolution post-BS. Material and Methods Single-center observational study including consecutive patients with SO between January 2010 and December 2015, candidates for BS. mREE was determined at baseline, and 1 and 12 months post-BS by IC, using a Vmax metabolic monitor. Results Thirty-nine patients were included: mean age 46.5±11.77 years, 64.1%women. Preoperative mREE was 2320.38±750.81 kcal/day. One month post-BS, the mREE significantly decreased (1537.6 ± 117.46 kcal/day, p = 0.023) and remained unchanged at 12 months (1526.00 ± 123.35 kcal/day; p =0.682). Reduction in mREE after the BS was a predictor of reaching successful weight loss (nadir) and weight regain (5 years follow-up) (AUCROC of 0.841 (95%CI [0.655–0.909], p=0.032) and AUCROC of 0.855 (95% CI [0.639–0.901]), p= 0.027, respectively). eREE was not valid to identify these changes. Conclusion In patients with SO, a significant reduction of mREE occurs 1 month post-BS, unchanged at 12 months, representing the major conditioning of successful weight loss and maintenance post-BS. Graphical abstract


2021 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Stijn van Hoef ◽  
Loes Janssen ◽  
Kelly G. H. van de Pas ◽  
François M. H. van Dielen ◽  
...  

Abstract Background When performing a Roux-en-Y gastric bypass (RYGB), the gastroenterostomy can be constructed with a circular stapled or linear stapled technique. The size of the gastroenterostomy depends on the stapling method and this may affect weight loss outcomes. The aim of this study was to examine the impact of the stapling technique on weight loss outcomes after RYGB. Methods This is a nationwide population-based cohort study of patients that received a RYGB. Data were derived from the Dutch Audit of Treatment of Obesity. Primary outcome was the impact of stapling technique on the rate of non-response defined as significant weight regain (≥20% of a patients’ lost weight) 2–4 years post-surgery, after initial successful weight loss (≥20% total weight loss, TWL). Secondary outcomes were the rate of response, defined as successful weight loss (≥20% TWL) within 1.5 years post-surgery, the incidence of complications and the progression of comorbidities. Results In a cohort of 12,468 patients, non-response was equally distributed between both groups (circular 18.0% vs. linear 17.6%). No differences in response rate (circular 97.0% vs. linear 96.5%) or %TWL were observed up to 4 years post-surgery. Patients in the circular stapled group experienced more complications, specifically major bleedings (2.4% vs. 1.2%; p=0.002) within 30 days postoperatively. No differences were found in deteriorated comorbidities, neither in de novo developed comorbidities. Conclusion When comparing stapling technique in RYGB, weight loss outcomes did not differ during a 4-year follow-up period. The linear stapled gastroenterostomy could pose an advantage due to its lower complication rate. Graphical abstract


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