scholarly journals Weight Regain and Insufficient Weight Loss after Bariatric Surgery: A Call for Action

2020 ◽  
Author(s):  
Wahiba Elhag ◽  
Walid El Ansari
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Management Strategies ◽  
Surgical Approaches ◽  
Target Weight ◽  
Insufficient Weight Loss ◽  
Important Health ◽  
Successful Weight Loss ◽  
The Individual

Despite successful weight loss after bariatric surgery (BS), weight regain (WR) may occur on long term following most bariatric procedures, with 20–30% of patients either failing to reach their target weight goals or failing to maintain the achieved weight loss. Significant WR has important health consequences, including the reversal of the improved obesity-related comorbidities and psychological function leading to decreased quality of life. Given the challenges faced by these patients, there is a need for multidisciplinary approaches to deal with WR. This chapter addresses the issue of WR among bariatric patients. It starts with the various definitions of insufficient weight loss and WR and the prevalence of weight regain by type of bariatric procedure. The chapter then explores the underlying causes as well as the predictors of WR. It will also outline the behavioral and psychotherapeutic, dietary and exercise strategies employed in the prevention of post-surgery WR. The chapter will then highlight the non-surgical and surgical approaches used in the management of WR. The chapter will conclude with a summary of the findings emphasizing that WR is complex and multifactorial, requiring multidisciplinary and multimodal dietary, behavioral, pharmacological, and surgical management strategies tailored to meet the individual needs of each patient.

scholarly journals Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps—a Scoping Review

2021 ◽  
Author(s):  
Walid El Ansari ◽  
Wahiba Elhag
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Scoping Review ◽  
Weight Regain ◽  
Current Knowledge ◽  
Management Strategies ◽  
Patient Counseling ◽  
Knowledge Gaps ◽  
Insufficient Weight Loss ◽  
Preoperative Predictors

AbstractSome patients experience weight regain (WR) or insufficient weight loss (IWL) after bariatric surgery (BS). We undertook a scoping review of WR and IWL after BS. We searched electronic databases for studies addressing the definitions, prevalence, mechanisms, clinical significance, preoperative predictors, and preventive and treatment approaches including behavioral, pharmacological, and surgical management strategies of WR and IWL. Many definitions exist for WR, less so for IWL, resulting in inconsistencies in the reported prevalence of these two conditions. Mechanisms and preoperative predictors contributing to WR are complex and multifactorial. A range of the current knowledge gaps are identified and questions that need to be addressed are outlined. Therefore, there is an urgent need to address these knowledge gaps for a better evidence base that would guide patient counseling, selection, and lead to improved outcomes.

scholarly journals Correction to: One anastomosis gastric bypass vs. Roux-en-Y gastric bypass, remedy for insufficient weight loss and weight regain after failed restrictive bariatric surgery

2020 ◽  
Vol 30 (9) ◽  
pp. 3295-3295
Author(s):  
Nathan Poublon ◽  
Ibtissam Chidi ◽  
Martijn Bethlehem ◽  
Ellen Kuipers ◽  
Ralph Gadiot ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Weight Regain ◽  
One Anastomosis Gastric Bypass ◽  
Insufficient Weight Loss ◽  
Restrictive Bariatric Surgery

Weight Regain after Bariatric Surgery

2018 ◽  
Author(s):  
Bartolome Burguera ◽  
Amani Mohamed Hag ◽  
Leslie J. Heinberg
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Behavioral Factors ◽  
Number Of Patients ◽  
Medical Therapies ◽  
Successful Weight Loss ◽  
Definition Of

Bariatric surgery is the most effective therapy for morbid obesity. Unfortunately, a significant number of patients experience significant postoperative weight regain, which undermines the metabolic and cardiovascular benefits of weight loss associated with surgery. When revisional procedures are not indicated and/or when behavioral factors are present (e.g., nonadherence, eating pathology), bariatric programs currently do not have any empirically evaluated treatment options to offer those burdened with less favorable outcomes. This chapter reviews the definition of successful weight loss after bariatric surgery, as well as some biologic and behavioral factors that could be implicated in weight regain after surgery. Finally, we outline the scientific evidence supporting the use of behavioral and medical therapies to prevent weight regain after surgery. Bariatric programs need to determine from clinical experience, as well as through clinical trials, what behavioral/medical therapies are the most effective for managing weight gain after bariatric surgery.

scholarly journals Liraglutide 3.0 mg for the management of insufficient weight loss or excessive weight regain post‐bariatric surgery

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Sean Wharton ◽  
Jennifer L. Kuk ◽  
Magdalena Luszczynski ◽  
Elham Kamran ◽  
Rebecca A. G. Christensen
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Insufficient Weight Loss ◽  
Excessive Weight ◽  
Post Bariatric Surgery

scholarly journals Use of Pharmacotherapy in Obesity Management

2021 ◽  
Vol 47 (5) ◽  
Author(s):  
Kwang Wei Tham
Keyword(s):  
Bariatric Surgery ◽  
Body Mass Index ◽  
Weight Loss ◽  
Weight Regain ◽  
Energy Homeostasis ◽  
Weight Maintenance ◽  
High Body Mass Index ◽  
Obesity Management ◽  
Behavioural Modification ◽  
Successful Weight Loss

Obesity is a chronic disease which is often relapsing and progressive due in part to the physiology of energy homeostasis in people with obesity, rendering them with the challenge of attaining adequate weight loss and weight maintenance after successful weight loss. Depending on the presence, types and severity of the obesity-related comorbidities (ORCs), some patients will require an amount of weight loss beyond what lifestyle and behavioural modification can achieve. Even after bariatric surgery, patients may not lose the expected amount of weight or experience weight regain. Anti-obesity medications may be required to support them further. Hence, the use of pharmacotherapy in obesity management remains an important adjunct to lifestyle and behavioural modifications and even to bariatric surgery, particularly in those with more severe ORCs and with a high body mass index. This article discusses the general approach to the use of pharmacotherapy in obesity management and the various anti-obesity medications currently approved.

scholarly journals Place Work on a Scale: What Do We Know About the Association Between Employment Status and Weight Loss Outcomes After Bariatric Surgery?

2021 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Marlies Bongers ◽  
Daniëlle D.B. Holthuijsen ◽  
Loes Janssen ◽  
François M.H. van Dielen ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Employment Status ◽  
Weight Regain ◽  
Weight Loss Outcomes ◽  
Working Status ◽  
Successful Weight Loss ◽  
Patients Experience ◽  
The Impact

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

Weight Regain and Insufficient Weight Loss after Bariatric Surgery: a Survey to identify current practices and attitudes amongst ASMBS members

2018 ◽  
Vol 14 (11) ◽  
pp. S148-S149
Author(s):  
Saniea F Majid ◽  
Anthony Gonzalez ◽  
Brandon T Grover ◽  
Michael C Morell ◽  
David Podkameni ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Insufficient Weight Loss ◽  
Current Practices

Interventions for Weight Regain after Bariatric Surgery

2021 ◽  
Author(s):  
Rodrigo Muñoz ◽  
Pedro Soto
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Current Evidence ◽  
Revisional Procedure ◽  
Insufficient Weight Loss ◽  
Associated Diseases ◽  
Number Of Patients ◽  
Increased Risk ◽  
Nutritional Complications

AbstractBariatric surgery is the most effective available treatment for obesity, inducing a significant and durable weight loss, and improving several obesity-associated diseases. However, as the number of bariatric surgeries performed increases, so does the prevalence of patients who experience either insufficient weight loss or weight regain, accompanied by relapse or the emergence of new obesity-related diseases. Endoscopic and surgical bariatric revisional procedures are used to promote weight loss and improve metabolic function to address these problems. After a psychological, nutritional, medical, and anatomical evaluation of the gastrointestinal anatomy has been completed, patient candidacy to a revisional procedure must be defined. In those patients with insufficient weight loss or weight regain associated with relapse, the emergence of new obesity-related diseases, or quality-of-life deterioration, a revisional procedure must be selected. Although current evidence comes mainly from observational and retrospective studies, with a limited number of patients and short follow-up times, the available data indicate that revisional procedures are useful to induce a significant weight loss and/or promote remission of obesity-associated diseases, albeit an increased risk of surgical and/or nutritional complications. Thus, careful selection of patients is needed to minimize risk and maximize the benefit of these procedures.

scholarly journals Weighing in on heart failure: the potential impact of bariatric surgery

2021 ◽  
Author(s):  
Tanuka Datta ◽  
Andrew J. Lee ◽  
Rachel Cain ◽  
Melissa McCarey ◽  
David J. Whellan
Keyword(s):  
Heart Failure ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Cardiovascular System ◽  
Economic Burden ◽  
Treatment Strategies ◽  
It Impacts ◽  
Potential Impact ◽  
The Individual ◽  
Physiologic System

AbstractObesity is a growing worldwide epidemic with significant economic burden that carries with it impacts on every physiologic system including the cardiovascular system. Specifically, the risk of heart failure has been shown to increase dramatically in obese individuals. The purpose of this review is to provide background on the individual burdens of heart failure and obesity, followed by exploring proposed physiologic mechanisms that interconnect these conditions, and furthermore introduce treatment strategies for weight loss focusing on bariatric surgery. Review of the existing literature on patients with obesity and heart failure who have undergone bariatric surgery is presented, compared, and contrasted.

scholarly journals Dietary and Lifestyle Factors Serve as Predictors of Successful Weight Loss Maintenance Postbariatric Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Afshan Masood ◽  
Lujain Alsheddi ◽  
Loura Alfayadh ◽  
Bushra Bukhari ◽  
Ruba Elawad ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Regain ◽  
Dietary Habits ◽  
Weight Maintenance ◽  
Dietary Counseling ◽  
Beneficial Effects ◽  
Predicting Factors ◽  
Lifestyle Practices ◽  
Fiber Consumption

Bariatric surgery is considered to be an effective treatment for the resolution of severe obesity; however, in more than half of the bariatric surgery patients, weight reacquisition occurs as early as 18 months postsurgery, compromising the surgery’s beneficial effects. Maintaining weight loss after surgery poses a great challenge, necessitating the identification of predicting factors. In the present study, we explored the association between weight regain and dietary habits and behavioral lifestyle practices in patients following bariatric surgery. Fifty patients who underwent bariatric surgery with ≥18-month postoperative period of follow-up were included. They were classified into two groups: weight maintainers (n = 29) were patients who regained <15% of their weight, and weight regainers (n = 21) were patients who regained ≥15% of their weight compared to their lowest postoperative weight. The mean age of the study participants was 41.4 ± 8.9 years, and twenty-eight patients (56%) of the total, were females. A detailed analysis of dietary and lifestyle habits was performed by questionnaire-based interviews. Significant weight regain was noted in the regainers compared to the maintainers (19.6 ± 8.4 kg vs. 4.5 ± 3.5 kg, respectively, P≤0.001), which was attributed to their following of unhealthy dietary habits and behavioral lifestyle practices. The dietary and behavioral lifestyle practices adopted by the maintainers were higher fiber consumption and water intake, monitored pace of eating, evasion of emotional binge, and distracted eating and following of self-assessment behaviors. Additionally, regular nutritional follow-ups and compliance with postoperative dietary counseling significantly helped to improve weight maintenance. In conclusion, the effectiveness of weight loss postbariatric surgery was compromised by weight regain due to unhealthy dietary and behavioral lifestyle practices stemming from a lack of nutritional guidance and knowledge. The implementation of comprehensive nutritional counseling and advice on behavioral changes before and after surgery will help achieve optimal weight results.

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