Abstract
INTRODUCTION: sychosocial factors (i.e. diet/physical activity/stress), genetic risk, and obesogens (early life endocrine disruptors) have each been suggested to be major underlying mechanisms involved in the obesity pandemic. Vertical sleeve gastrectomy (VSG) has emerged as the preferred weight loss surgery worldwide; VSG has an improved safety profile and good long term outcomes. Since genetic risk and obesogens are pathophysiological factors independent of an individual’s control, our hypothesis is that VSG will result in better weight loss in subjects whose obesity is related to psychosocial factors, compared to subjects with genetic risk or exposure to obesogens. METHODS: This is a retrospective review of 84 new obese subjects, who live in urban and suburban locations, who were seen in a community teaching hospital bariatric GI clinic from Oct 2018 to June 2019 and underwent VSG with at least 6 months of follow up. Obesogen (O) exposure is defined by: mother and father normal weights; subject had body mass index (BMI) of ≥ 30 kg/m2 at age 18. Genetic risk (GR) is defined by: mother and/or father obese; subject had BMI of ≥ 30 at age 18. Psychosocial (PS) factors are defined by: subject with BMI < 30 at age 18. RESULTS: As shown in Table1/Table2, subjects with genetic risk are significantly younger, while subjects with exposure to obesogens or with genetic risk have higher weights and higher BMIs at presentation. Percent total body weight loss at 6 months was not different among the three groups, but few men were seen for 6 months of follow up. Higher BMI individuals did not demonstrate a reduction in mean weight loss. CONCLUSION: This study did not support improved short term weight loss after VSG in individuals with obesity related to psychosocial factors. Potential difference in results among the three groups will need to be examined in long term studies, in which additional men are available for analysis. Further prospective studies are needed to evaluate the potential clinical significance of subjects exposed to obesogens.Table 1.: DemographicsTable 2.: Statistical analysis
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