SYSTEMATIC REVIEW OF SUCCESSFUL RATE OF BODY WEIGHT LOSS AFTER BARIATRIC SURGERY (original) (raw)
Related papers
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....
Factors Related to Weight Loss up to 4 Years after Bariatric Surgery
Obesity Surgery
Background Gastric bypass is the bariatric surgery most frequently performed in the world. It is responsible for sustainable weight loss, resolution of comorbidities, and improvement of quality of life. However, weight loss is not homogeneous, at times being insufficient in some patients. Our objective was to assess which factors were important in influencing this differentiated weight loss over a period of 4 years after surgery. Methods In this retrospective study, we assessed several physical, socioeconomic, behavioral, surgical, and demographic factors in morbidly obese patients submitted to Roux-en-Y gastric bypass that might influence excess weight loss over a period of 4 years after surgery. The same factors were assessed in order to characterize insufficient excess weight loss ( Results Review of the medical records of 149 patients showed that type-2 diabetes mellitus and dyslipidemia were the most important factors related to a lower EWL up to the third year. Preoperative weight loss, lower schooling, and lack of adherence to nutritional guidelines were important after 2 and 3 years. The presence of depression and lack of adherence to nutritional guidelines were the factors related to EWL of less than 50%. Conclusions Special attention and clarification should be provided to patients with diabetes mellitus type 2 and dyslipidemia and to patients with depression and lower schooling, since these patients tend to lose less excess weight after surgery. Multiprofessional care should also be provided so that the patients will follow nutritional guidelines more rigorously after surgery.
The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference
Obesity Facts, 2019
Background: Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become the most frequently used therapy for morbid obesity. Objectives: The aim of this study was to examine the effects of surgically induced weight loss on cardiopulmonary function 6 months after the procedure, as well as the effect of such an intervention on well-known risk factors for cardiovascular diseases. Methods: This is a cross-sectional study on 66 morbidly obese patients (BMI ≥40 or ≥35 kg/m 2 with present comorbidities), comparing their cardiopulmonary function prior to and 6 months after RYGB surgery. Results: The substantial amount of weight loss (29.80 ± 13.27 kg) after RYGB surgery was associated with significant reduction of comorbidities, especially diabetes and sedentary lifestyle (p = 0.005 and p = 0.002, respectively). Regarding functional capacity, there was significant increase in peak oxygen uptake (VO 2 peak, p = 0.003), duration of exercise testing, metabolic equivalents (exercise time and METs, p < 0.001), and in peak O 2 pulse. These findings were particularly pronounced in a group of patients who had lost more than 18% of initial weight. Conclusions: Reduction of body weight after RYGB surgery is associated with significantly improved cardiorespiratory function
Abstract Journal Bariatric Surgery
ANZ Journal of Surgery, 2017
Substantial weight loss in the setting of obesity has considerable metabolic benefits. Yet some studies have shown improvements in obesity-related comorbidities with more modest weight loss. By closely monitoring patients, we aimed to determine the effects of weight loss on the metabolic syndrome, and determine the target weight loss required for its resolution. Methodology: We performed a prospective observational study of obese participants with metabolic syndrome (ATPIII) who underwent gastric banding. Participants were assessed for all criteria of the metabolic syndrome each month for nine months, then three-monthly until 24 months. Results: There were 89 participants recruited, with baseline BMI 42.4AE6.2kg and age 48.2AE10.7years. Resolution of the metabolic syndrome occurred in 60 of 89 participants (67%) at 12 months and 60 of 75 participants (80%) at 24 months. The mean weight loss when metabolic syndrome resolved was 10.9AE7.7% total body weight loss (TBWL). Median weight loss at which prevalence of disease was halved was 7.0% TBWL for hypertriglyceridemia; 11% TBWL for HDL cholesterol and hyperglycaemia; 20% TBWL for hypertension; 29% TBWL for waist circumference. Achieving 10-12.5% TBWL correlated with a 2.09 (p=0.025) odds of resolution of the metabolic syndrome with increasing probability of resolution with more substantial weight loss. Conclusion: In obese participants, a weight loss target of 10-12.5% TBWL (25-30% EWL) is a reasonable initial goal for metabolic benefits. Further metabolic improvement could be expected with additional weight loss. These findings can help inform weight loss efforts, in counselling patients, determining targets and assessing success of weight loss strategy.
Obesity Medicine, 2019
Bariatric surgery is the most effective treatment for obesity. However, less than 1% of eligible patients undergo bariatric surgery annually. Here we evaluated the weight loss effectiveness of an intensive non-surgical weight loss program in patients that would qualify for bariatric surgery. Methods: Patients eligible for bariatric surgery (n = 1460) (BMI≥40 or BMI≥35 kg/m 2 plus comorbidities) who were enrolled in a dietary weight loss intervention, the RNPC® program, were compared to a cohort of bariatric surgery patients in terms of weight loss outcome. Results: The 663 patients completing the RNPC® program (35% dropout and 20% ongoing) lost 20.2 ± 11.8 kg corresponding to a reduction of 47% of the excess weight and a percentage weight loss from the initial weight of 18% after a mean period of 18.6 ± 9.1 months. Weight loss 18 months after bariatric surgery (n = 61) was 42.5 ± 15.8 kg corresponding to a reduction of 74% of excess weight and a percentage weight loss from the initial weight of 32%. Conclusion: Although bariatric surgery results in a more pronounced weight loss, a clinically important weight loss can be obtained in patients that would qualify for bariatric surgery following an intensive non-surgical weight loss program. This retrospective analysis calls for randomized trials that compare the long-term costeffectiveness between the RNPC® program and bariatric surgery.
Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery
Surgical …, 2012
Background Bariatric surgery (BS) is widely accepted for the treatment of patients with morbid obesity (MO). We aimed to determine presurgical predictors of and surgical technique-related differences in excess weight loss (EWL) 1 year after BS. Methods This retrospective study included 407 subjects (F/M 3:1, median age = 44 years) who underwent laparoscopic Roux-en-Y gastric bypass (RYGB, n = 307) or sleeve gastrectomy (SG, n = 100) at our University Hospital and were evaluated 1 year after surgery. Results Baseline median (min-max) body mass index (BMI) was 47 kg/m 2 (range = 36-71). BMI was higher in the SG than in the RYGB group (53 vs. 46 kg/m 2 , p \ 0.0001). Simple correlation analysis showed negative associations between EWL and age, BMI, waist circumference (WC), fasting glucose, HbA1c, triglycerides (TG), blood pressure, and total cholesterol (all p \ 0.01). EWL (mean ± SD) did not differ by gender (p = 0.2), was lower in diabetic than in nondiabetic subjects (71 ± 17% vs. 79 ± 17%, p \ 0.0001), and higher in the RYGB vs. SG group (76 ± 18% vs. 68 ± 15%, p \ 0.0001). However, SG vs. RYGB differences in EWL disappeared (p = 0.4) after taking into account baseline BMI. Multiple regression and logistic analysis showed that younger individuals with lower BMI but higher WC, and lower HbA1c and TG, had higher EWL and a higher rate of successful (EWL C 60%) weight loss. Conclusions Our data indicate that some of the characteristics that would have subjects referred early for BS were associated with higher weight loss. Therefore, the timing of laparoscopic BS might be an important factor for MO individuals in which medical weight loss intervention has failed. Keywords Bariatric surgery Á Morbid obesity Á Weight loss Á Predictors Obesity, particularly morbid obesity, is a major health problem due to its associated comorbidities and complications, including cancer, cardiovascular disease, type 2 diabetes, and osteoarthritis, and the increased risk in mortality and medical expenditures. Bariatric surgery (BS) is a very effective and long-lasting treatment alternative for those patients with morbid obesity in whom efforts at medical therapy have failed [1, 2]. Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are currently among the most effective and widely used surgical techniques [3-6]. SG, a purely restrictive technique, was initially conceived as the
ANALYSIS OF APPROACHES, COMPLICATIONS AND LONG-TERM RESULTS OF BARIATRIC SURGERY: AN INTEGRATIVE REVIEW (Atena Editora), 2023
Bariatric surgery has emerged as an effective intervention to address severe and morbid obesity, resulting not only in sustained weight loss but also in improvements in associated health conditions. In this integrative review, we explore a comprehensive analysis of the various surgical approaches, related complications, and long-term outcomes linked to bariatric surgery. The period of analysis covers studies published between 2013 and 2023, with the aim of providing a comprehensive and up-to-date overview of the subject. The research addressed clinical and observational studies that analyzed bariatric surgery procedures in the context of the approaches employed, resulting complications and long-term outcomes. We examined studies that compared different surgical techniques, including multicenter clinical trials and longitudinal studies. The analysis focused on comparing outcomes between procedures such as single-anastomosis gastric bypass (OAGB), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG), with an emphasis on weight trajectories, complications, and metabolic results. The results highlighted the importance of comparing different surgical techniques so that one can examine the efficacy and safety of OAGB versus RYGB. Additionally, the Longitudinal Assessment of Bariatric Surgery (LABS) Study provided valuable insights into long-term weight trajectories after bariatric surgery. Discussions of complications highlighted the challenges and potential risks associated with bariatric surgery. By integrating analysis of several studies, this review offers a broad view of the efficacy, safety and complexities of bariatric surgery. Comparisons between surgical approaches, long-term weight and metabolic outcomes, as well as potential complications, provide essential information for clinical decision-making and to guide patients in the management of obesity. Standardization of results and consideration of diabetes severity are crucial components in determining the most appropriate surgical approach.
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).
Bariatric Surgery for Morbid Obesity
Obesity Surgery, 2000
Background: Bariatric surgery is a treatment for severely obese patients. We examined the efficacy of bariatric surgery, addressing three questions: 1) "What is the overall weight reduction following bariatric surgery?" 2) "What complications are associated with bariatric surgery?" 3) "What impact does weight loss have on obesity-related comorbidity?" Methods: Fixed and random effects meta-analyses were used to determine the amount of weight reduction following bariatric surgery. The influence of a variety of co-variates that could affect study results was examined. Information from evidencebased sources was used to explore the impact of weight loss on comorbidities. Results: Meta-analyses results were affected by loss to follow-up, and within-study heterogeneity of variance. Therefore, results were pooled from studies with complete patient follow-up. Meta-analysis of six studies reporting weight loss at 1 year and four studies with mean follow-up of 9 months to 7 years demonstrated BMI reductions of 16.4 kg/m 2 and 13.3 kg/m 2 , respectively. Weight reduction following bariatric surgery may be associated with improvements in risk factors for cardiac disease including hypertension, type 2 diabetes and lipid abnormalities, and may decrease the severity of obstructive sleep apnea. Conclusion: Bariatric surgery is appropriate for obese patients (BMI >40 kg/m 2 or 35 kg/m 2 with obesity-related comorbidity) in whom non-surgical treatment options were unsuccessful. Additional research is needed to examine the long-term benefits of weight loss following bariatric surgery, particularly with respect to obesity-related comorbidities.