Bariatric Surgery for Morbid Obesity (original) (raw)
Related papers
Impact of Bariatric Surgery on Comorbidities
Surgical Clinics of North America, 2011
The challenges of the obesity epidemic are not limited to concerns about bulk and weight but also to the associated physiologic, psychosocial, and economic disabilities. 1 A small amount of weight loss, approximately 10 kg, carries significant benefits. including resolution of comorbid conditions, 2 and 10% of initial weight loss has been shown to improve long-term comorbidity control. 3 The likelihood of comorbidity resolution depends on many factors, including the length and severity of disease, the amount of weight loss attained, and the contribution of obesity to the severity of the disease. Bariatric surgery (BS) can significantly reduce body weight, resolve obesity-related comorbidities, and improve long-term survival. 4,5 Overall mortality of BS in a meta-analysis was 0.28%, 6 placing these procedures in the lowest category of mortality for elective operations performed in the United States. 7,8 An observational cohort study based on submitted claims for reimbursement of services or medication showed that, after a mean of 5.3 years, BS was associated with a mean excess weight loss (EWL) of 67.1%; produced significant relative risk reductions in cardiovascular, endocrine, respiratory, infectious, and psychiatric diseases, as well as cancers; and was associated with an 89% reduction in the relative risk of mortality. 9 These benefits improved patients' quality of life and significantly decreased (71.6%) obesity-related claims to insurance companies as early as 4 months following BS. 10 The impact on comorbidities depends on the type of procedure, amount of weight loss achieved, alterations in hormones and incretins, degree of malabsorption, change in motility, and effect on eating habits. This article reviews published literature on the impact of BS on some major obesityassociated comorbidities. The authors gratefully acknowledge the help of Mr Donald A. Risucci PhD in editing this manuscript.
Clinical Outcomes and Weight Loss Trend After Bariatric Surgery in a Population of Obese Patients
Purpose Bariatric Surgery (BS) is a therapeutic option in patients with severe obesity whosenon-surgical techniques have failed. No work has previously explored trajectories of weight loss and how long this was maintained. Aim of study is to describe effect of BS and nutritional intervention on body weight trend in patients with obesity. Subjects/Methods: 792 patients who underwent BS from 1996 to 2021 were included. The Protocol provides Laparoscopic Sleeve Gastrectomy (LSG), Vertical Gastroplasty (VBG) and Roux-en-Y Gastric Bypass (GB%). %Total Weight Loss (%TWL) and %Excess Weight Loss (%EWL) were evaluated in three cohort of patients. Cumulative incidence of clinical goal after surgery was calculated at two and five years after BS. Results At two years of follow-up, average %TWL and %EWL were 31.2% (95% CI = 29.0–33.4%) and 71% (95% CI = 65.4–76.5%) for VBG, 34.7% (95% CI = 33.8–35.6%) and 78.0% (95% CI = 75.9–89.1%) for GB and 33.8% (95% CI = 32.5–35.1%) and 68.8% (95% CI = 66....
Bariatric surgery versus non-surgical treatment for obesity: a
Objective To quantify the overall effects of bariatric surgery compared with non-surgical treatment for obesity. Design Systematic review and meta-analysis based on a random effects model. Data sources Searches of Medline, Embase, and the Cochrane Library from their inception to December 2012 regardless of language or publication status. Eligibility criteria Eligible studies were randomised controlled trials with ≥6 months of follow-up that included individuals with a body mass index ≥30, compared current bariatric surgery techniques with non-surgical treatment, and reported on body weight, cardiovascular risk factors, quality of life, or adverse events. Results The meta-analysis included 11 studies with 796 individuals (range of mean body mass index at baseline 30-52). Individuals allocated to bariatric surgery lost more body weight (mean difference −26 kg (95% confidence interval −31 to −21)) compared with non-surgical treatment, had a higher remission rate of type 2 diabetes (relative risk 22.1 (3.2 to 154.3) in a complete case analysis; 5.3 (1.8 to 15.8) in a conservative analysis assuming diabetes remission in all non-surgically treated individuals with missing data) and metabolic syndrome (relative risk 2.4 (1.6 to 3.6) in complete case analysis; 1.5 (0.9 to 2.3) in conservative analysis), greater improvements in quality of life and reductions in medicine use (no pooled data). Plasma triglyceride concentrations decreased more (mean difference −0.7 mmol/L (−1.0 to −0.4) and high density lipoprotein cholesterol concentrations increased more (mean difference 0.21 mmol/L (0.1 to 0.3)). Changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different. There were no cardiovascular events or deaths reported after bariatric surgery. The most common adverse events after bariatric surgery were iron deficiency anaemia (15% of individuals undergoing malabsorptive bariatric surgery) and reoperations (8%). Conclusions Compared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome. However, results are limited to two years of follow-up and based on a small number of studies and individuals. Systematic review registration PROSPERO CRD42012003317 (www. crd.york.ac.uk/PROSPERO).
Obesity Surgery, 2011
Background Few studies have looked at non-surgical alternatives for morbid obese patients. This study aims to compare 1-year weight loss and changes in risk factors and comorbidities after bariatric surgery and three conservative treatments. Methods Patients with morbid obesity (BMI > 40 or BMI > 35 kg/m2 plus comorbidities) on waiting list for bariatric surgery, were non-randomly allocated to (A) bariatric surgery or to one of three conservative treatments; (B) residential intermittent program; (C) commercial weight loss camp and (D) hospital outpatient program. Body weight, risk factors and comorbidities were assessed at baseline and 1 year. Results Of 206 participants, 179 completed the study. All treatments resulted in significant weight loss, but bariatric surgery (40 ± 14 kg, 31 ± 9%) led to the largest weight loss (P < 0.0001). There were no differences in weight loss between B and C (22 ± 13 kg, 15 ± 8% vs. 18 ± 12 kg, 13 ± 8%), but these resulted in larger weight loss compared with D (7 ± 10 kg, 5 ± 8%). There were no differences in changes in total or LDL cholesterol, triacylglycerols or glucose between groups; however, the increase in HDL cholesterol was significantly larger in groups A and C. There were no differences in comorbidities resolution between groups A and B, C and D combined (except hypertension, which was better in group A). Conclusion In conclusion, although bariatric surgery leads to a greater weight loss at 1 year compared with conservative treatment, in patients with morbid obesity, clinical significant weight loss and similar improvements in risk factors and comorbidities resolution can also be achieved with lifestyle interventions.
SYSTEMATIC REVIEW OF SUCCESSFUL RATE OF BODY WEIGHT LOSS AFTER BARIATRIC SURGERY
Background: Bariatric surgery is an accepted treatment for obesity. And only a limited studies which were concerned with the outcome of significant weight loss following the surgery procedures. Objective: the aim of this systematic review was to evaluate and demonstrate the comprehensive data about the significant loss of body weight of obese patients after appropriate techniques oaBackground:- Bariatric surgery is an accepted treatment for obesity. And only a limited studies which were concerned with the outcome of significant weight loss following the surgery procedures. Objective:- The aim of this systematicreview was to evaluate and demonstrate the comprehensive data about the significant loss of body weight of obese patients after appropriate techniques of different bariatric surgeries procedures and todetermine the impact of bariatric surgery on weight loss, Methodology:- MEDLINE and Cochrane databases were searched from 1989 through July15, 2016. Search terms included bariatric surgery, individual bariatric procedures, and obesity significant body weight loss. Studies were included if they described outcomes of interest which was significant body weight loss after gastric bypass, gastric band, or sleeve gastrectomy performed on Obese patients Conclusion:- Significant body weight loss was achieved in most of obese patients after undergoing bariatric surgery; most of the studies that were included in this review showed that all current bariatric operations lead to major weight loss. f different bariatric surgeries procedures and to determine the impact of bariatric surgery on weight loss, Methodology: MEDLINE and Cochrane databases were searched from 1989 through July15, 2016. Search terms included bariatric surgery, individual bariatric procedures, and obesity significant body weight loss. Studies were included if they described outcomes of interest which was significant body weight loss after gastric bypass, gastric band, or sleeve gastrectomy performed on Obese patients Conclusion: Significant body weight loss was achieved in most of obese patients after undergoing bariatric surgery; most of the studies that were included in this review showed that all current bariatric operations lead to major weight loss.
JAMA, 2013
Severe obesity (body mass index [BMI] ≥35) is associated with a broad range of health risks. Bariatric surgery induces weight loss and short-term health improvements, but little is known about long-term outcomes of these operations. To report 3-year change in weight and select health parameters after common bariatric surgical procedures. The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium is a multicenter observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers. PARTICIPANTS AND EXPOSURE: Adults undergoing first-time bariatric surgical procedures as part of routine clinical care by participating surgeons were recruited between 2006 and 2009 and followed up until September 2012. Participants completed research assessments prior to surgery and 6 months, 12 months, and then annually after surgery. Three years after Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB), we assessed percent weight change from ba...