scholarly journals Obesity, bariatric surgery, and weight regain parameters: a concise systematic review

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Sibelle Grätsch
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Excess Weight Loss ◽  
Total Weight Loss ◽  
Surgical Success ◽  
The Subject ◽  
Treatment Of Obesity

Introduction: Obesity, an easily diagnosed disease, is multifactorial, chronic, and difficult to manage. It has increased alarmingly and is now one of the main public health problems. It is associated with several comorbidities and poorer quality of life. Bariatric surgery is currently widely accepted and described in the literature as the most effective method for the treatment of obesity. Even though this is the best method, weight regain (WR) is also checked. In the literature, there are several parameters used to configure WR, and with that, several results are presented. Objective: This paper aims to review the parameters used to assess WR after bariatric surgery. Method: A bibliographic review of the last 5 years was carried out in the PubMed and Scielo virtual databases with the following keywords: bariatric surgery, obesity, and weight regain, in October and November 2019. Result: Lack of unanimity in the definition and parameters for WR is still a reason for further studies. And with that, the results are also presented in a varied way, depending on the parameter used. Conclusion: The subject is relatively new and there is a need for more studies to define and quantify the meaning of WR, to also improve the approach and management of the patient with weight regain. But there seems to be a tendency to adapt itself as a favorable response to surgical success when at least 50% excess weight loss (%EWL) and > 20% total weight loss is achieved, and that any regain should not be used. as a parameter to define it.

A298 Long-Term Weight Regain After Bariatric Surgery: Does Postoperative Percent Excess Weight Loss Matter?

2019 ◽  
Vol 15 (10) ◽  
pp. S118-S119
Author(s):  
Laura Flores ◽  
Priscila Rodrigues-Armijo ◽  
Mark Ringle ◽  
Salim Hosein ◽  
Vishal Kothari
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Percent Excess Weight Loss

scholarly journals MON-590 Presence of Diabetes Diminishes the Ultimate Weight Loss After Bariatric Surgery

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Yingying Luo ◽  
Abdel Wahab Jalal Eldin ◽  
Raad Haddad ◽  
Nahid Keshavarzi ◽  
Shokoufeh Khalatbari ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Total Weight ◽  
Total Weight Loss ◽  
Obesity And Diabetes ◽  
Weight Loss Outcomes

Abstract Background Obesity and diabetes as well as their related complications result in both individual and global health burdens. Among patients who present with both obesity and diabetes, bariatric surgery can lead to remission of both these diseases. However, the possible impact of diabetes on the magnitude of weight loss outcomes after bariatric surgery has not been quantified. Methods To address this question, we extracted data from Michigan Bariatric Surgery Cohort (MI-BASiC) to see whether diabetes at baseline could be a predictor of weight loss outcomes. Consecutive patients 18 years of age or older undergoing gastric bypass (GB) or sleeve gastrectomy (SG) for obesity at the University of Michigan between January 2008 and November 2013 were included in our retrospective cohort. All patients had either body mass index (BMI) > 40 kg/m2 or BMI 35 – 39.9 kg/m2 with comorbid condition. Firstly, we performed Generalized Linear Mixed Model (GLMM) analysis to compare the probability of achieving BMI under 30kg/m2 or achieving excess body weight loss (EBWL) 50% or more for patients with or without diabetes. We then further tested the effect of presence of diabetes for the BMI outcomes across time using Linear Mixed Model (LMM) analysis. Finally, we conducted a LMM analysis to determine if diabetes is a predictor of the future weight loss, percentage of total weight loss or percentage of excess weight loss over 5 years of follow up. Results Based on our criteria, 380 patients were included for GB [female 305 (80.3%), mean age 43.6±0.6 years, mean BMI 47.3±0.4kg/m2, diabetes 149 (39.2%), on insulin 45 (11.8%)] and 334 for SG [female 259 (77.5%), mean age 45.3±0.6 years, mean BMI 49.9±0.5kg/m2, diabetes 108 (32.3%), on insulin 29(8.7%)]. From GLMM analysis, the presence of diabetes at baseline did not impact the probability of achieving BMI under 30kg/m2 (p=0.0848), but substantially impacted the probability of achieving 50% or more EBWL (p=0.0021) with individuals without diabetes having a 1.6 (odds ratio 1.56, 95% CL [1.18-2.08]) times higher chance to achieve this threshold. We also showed that individuals with diabetes at baseline had a significant effect to modify BMI points lost, regardless of the surgery type (p=0.0178). The presence of diabetes at baseline diminished weight loss by 1.2 BMI points (95% CL [0.21- 2.20]) which is roughly 10 to 15% of the total BMI points to be lost. LMM analysis further confirmed that after adjusting the time, surgery type, age, gender and baseline weight, there was still a significant difference of absolute weight loss (p=0.0110), percentage of total weight loss (p=0.0089) and percentage of excess weight loss (p=0.0365) between individuals with diabetes versus individuals without diabetes. Conclusion In conclusion, our data demonstrate that diabetes diminishes the ultimate weight loss effect of bariatric surgery. Further research is needed to understand why this is the case.

scholarly journals The safety and efficacy of bariatric surgery for obese, wheelchair bound patients

2014 ◽  
Vol 96 (5) ◽  
pp. 373-376 ◽  
Author(s):  
GJ Williams ◽  
PA Georgiou ◽  
DM Cocker ◽  
G Bonanomi ◽  
J Smellie ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight Loss ◽  
Length Of Hospital Stay ◽  
Mobility Limitations ◽  
Mobility Impairment ◽  
The Mean ◽  
Lost To Follow Up

Introduction The aim of this study was to evaluate outcomes of bariatric surgery performed in order to improve mobility in patients with severe mobility limitations. Methods Patients with severe mobility impairment (wheelchair bound) who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic adjustable gastric banding (LAGB) surgery to improve their mobility were included in this study. Patients were identified between July 2009 and October 2011 using an electronic prospective bariatric database. Mobility was assessed by questionnaire during clinic follow-up appointments. Results Fifteen patients (11 female, 4 male) with a mean age of 48 years (range: 26–71 years) and a mean body mass index of 46kg/m2 (range: 33–54kg/m2) were included. Seven patients (47%) underwent LAGB and eight (53%) LRYGB. The aetiologies of mobility impairment included advanced osteoarthritis (n=6), spinal conditions (n=4), severe bilateral leg oedema and ulceration (n=2), advanced rheumatoid arthritis (n=2) and traumatic paraplegia (n=1). The mean length of hospital stay was 3.8 days. There was no mortality. One patient was lost to follow-up. Of the remaining 14 patients, the mean excess weight loss percentage at a mean of 18.5 months postoperatively was 48% (68% for LRYGB, 20 months; 29% for LAGB, 17 months). Ten patients reported improved mobility. Reduced pain, improved independence and ability to transfer were most commonly cited. Four patients reported no improvement in mobility (three LAGB patients, one LRYGB patient). Conclusions Bariatric surgery can safely improve mobility and quality of life in obese patients with severe mobility impairment. Our paper supports the idea that severe mobility impairment should be considered an indication for bariatric surgery in selected patients. LRYGB demonstrated better weight loss and mobility improvement than LAGB. Larger studies are required to establish robust selection criteria for surgery in this group.

scholarly journals Single Anastomosis Duodenoileal Bypass or Roux-en-Y Gastric Bypass After Failed Sleeve Gastrectomy: Medium-Term Outcomes

2021 ◽  
Author(s):  
Phillip J. Dijkhorst ◽  
May Al Nawas ◽  
Laura Heusschen ◽  
Eric J. Hazebroek ◽  
Dingeman J. Swank ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Complication Rates ◽  
Total Weight Loss ◽  
Micronutrient Deficiencies ◽  
Single Anastomosis

Abstract Background Although the sleeve gastrectomy (SG) has good short-term results, it comes with a significant number of patients requiring revisional surgery because of insufficient weight loss or functional complications. Objective To investigate the effectiveness of the single anastomosis duodenoileal bypass (SADI-S) versus the Roux-en-Y gastric bypass (RYGB) on health outcomes in (morbidly) obese patients who had previously undergone SG, with up to 5 years of follow-up. Methods Data from patients who underwent revisional SADI-S or RYGB after SG were retrospectively compared on indication of surgery, weight loss, quality of life, micronutrient deficiencies, and complications. Results From 2007 to 2017, 141 patients received revisional laparoscopic surgery after SG in three specialized Dutch bariatric hospitals (SADI-S n=63, RYGB n=78). Percentage total weight loss following revisional surgery at 1, 2, 3, 4, and 5 years was 22%, 24%, 22%, 18%, and 15% for SADI-S and 10%, 9%, 7%, 8%, and 2% for RYGB (P<.05 for 1–4 years). Patients who underwent RYGB surgery for functional complications experienced no persistent symptoms of GERD or dysphagia in 88% of cases. No statistical difference was found in longitudinal analysis of change in quality of life scores or cross-sectional analysis of complication rates and micronutrient deficiencies. Conclusion Conversion of SG to SADI-S leads to significantly more total weight loss compared to RYGB surgery with no difference in quality of life scores, complication rates, or micronutrient deficiencies. When GERD in sleeve patients has to be resolved, RYGB provides adequate outcomes. Graphical abstract

scholarly journals Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies

2017 ◽  
Vol 76 (11) ◽  
pp. 1870-1882 ◽  
Author(s):  
Sabrina M Nielsen ◽  
Else M Bartels ◽  
Marius Henriksen ◽  
Eva E Wæhrens ◽  
Henrik Gudbergsen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Longitudinal Studies ◽  
Randomised Trial ◽  
Risk Of Bias ◽  
Current Evidence ◽  
Short Term ◽  
Quality Of Evidence

ObjectivesWeight loss is commonly recommended for gout, but the magnitude of the effect has not been evaluated in a systematic review. The aim of this systematic review was to determine benefits and harms associated with weight loss in overweight and obese patients with gout.MethodsWe searched six databases for longitudinal studies, reporting the effect of weight loss in overweight/obese gout patients. Risk of bias was assessed using the tool Risk of Bias in Non-Randomised Studies of Interventions. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation.ResultsFrom 3991 potentially eligible studies, 10 were included (including one randomised trial). Interventions included diet with/without physical activity, bariatric surgery, diuretics, metformin or no intervention. Mean weight losses ranged from 3 kg to 34 kg. Clinical heterogeneity in study characteristics precluded meta-analysis. The effect on serum uric acid (sUA) ranged from −168 to 30 μmol/L, and 0%–60% patients achieving sUA target (<360 μmol/L). Six out of eight studies (75%) showed beneficial effects on gout attacks. Two studies indicated dose–response relationship for sUA, achieving sUA target and gout attacks. At short term, temporary increased sUA and gout attacks tended to occur after bariatric surgery.ConclusionsThe available evidence is in favour of weight loss for overweight/obese gout patients, with low, moderate and low quality of evidence for effects on sUA, achieving sUA target and gout attacks, respectively. At short term, unfavourable effects may occur. Since the current evidence consists of a few studies (mostly observational) of low methodological quality, there is an urgent need to initiate rigorous prospective studies (preferably randomised controlled trials).Systematic review registrationPROSPERO, CRD42016037937.

Endoscopic Approaches to Obesity Management

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Russell D. Dolan ◽  
Allison R. Schulman
Keyword(s):  
Metabolic Disease ◽  
Weight Loss ◽  
Small Bowel ◽  
Weight Regain ◽  
Caloric Intake ◽  
Annual Review ◽  
Publication Date ◽  
Obesity Management ◽  
Surgical Interventions ◽  
Treatment Of Obesity

The field of endoscopic bariatric and metabolic therapy has rapidly evolved from offering endoscopic treatment of weight regain following bariatric surgery to providing primary weight loss options as alternatives to pharmacologic and surgical interventions. Gastric devices and remodeling procedures were initially designed to work through a mechanism of volume restriction, leading to earlier satiety and reduced caloric intake. As the field continues to grow, small bowel interventions are evolving that may have some effect on weight loss but focus on the treatment of obesity-related comorbidities. Future implementation of combination therapy that utilizes both gastric and small bowel interventions offers an exciting option to further augment weight loss and alleviate metabolic disease. This review considers gastric devices and techniques including space-occupying intragastric balloons, aspiration therapy, endoscopic tissue suturing, and plication interventions, followed by a review of small bowel interventions including endoluminal bypass liners, duodenal mucosal resurfacing, and endoscopically delivered devices to create incisionless anastomoses. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Preoperative Weight Loss as a Predictor of Percentage Excess Weight Loss after Bariatric Surgery

2018 ◽  
Vol 227 (4) ◽  
pp. e75
Author(s):  
Mario A. Masrur ◽  
Luis Fernando Gonzalez Ciccarelli ◽  
Roberto Bustos ◽  
Ronak A. Patel ◽  
Kirstie K. Danielson ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Preoperative Weight Loss ◽  
Preoperative Weight ◽  
Percentage Excess Weight Loss
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