Bariatric Analysis And Reporting Outcome System Research Articles

An Indian multicentre real-world study on long-term quality of life outcomes following bariatric surgery.

The purpose of this study was to assess the impact of metabolic and bariatric surgery (MBS) on Quality of Life (QoL) in Indian patients with obesity over 10 years. A retrospective chart review was conducted at 11 centres for individuals with MBS between February 2013 and May 2022. Patient medical records provided the source of de-identified data. Data from 2132 individuals with a mean age of 43.28 ± 11.96 years was analysed. There were 37.43% men and 62.57% females in the study population. The study population had a mean preoperative body mass index (BMI) of 45.71 ± 10.38 kg/m2. The Bariatric Analysis and Reporting Outcome System (BAROS) scoring method showed a higher overall QoL score throughout all follow-up periods, with 'very good' outcomes at one, three and 7 years and 'good' outcomes at 5 and 10 years. Improvements in QoL were associated with a substantial improvement (p < .01) in BMI at every follow-up time point. Following MBS, individuals with obesity exhibited a substantial and long-term improvement in their overall QoL for up to 10 years. This study presents Indian data on QoL, which is considered one of the most important decision-making factors for or against an intervention.

Laparoscopic sleeve gastrectomy vs one-anastomosis gastric bypass 5-year follow-up: a single-blinded randomized controlled trial

BackgroundLaparoscopic sleeve gastrectomy (LSG) is the most performed bariatric procedure worldwide, whereas one-anastomosis gastric bypass (OAGB) is the third most performed procedure. Both procedures have reported good weight loss (WL) and low complications. However, should both have differences in the durability of WL and malnutrition? MethodsA single-blinded, randomized controlled trial of 300 patients was conducted to compare the outcomes of LSG and OAGB over a 5-year follow-up. The primary endpoint was WL in percentages of total WL (%TWL) and excess WL (%EWL). The secondary endpoints were complications, gastroesophageal reflux disease (GERD), associated medical problems, bariatric analysis and reporting outcome system (BAROS) assessment, and weight recurrence (WR). ResultsOverall, 201 patients (96 in the LSG group and 105 in the OAGB group) completed 5 years of follow-up. OAGB had significantly higher %TWL and %EWL than those of LSG throughout the follow-up. LSG had significantly higher WR and GERD. Both procedures had significant improvement in associated medical problems and BAROS scores compared with baseline, with no significant difference. WR was associated with higher relapse of associated medical conditions after initial remission and with lower BAROS scores regarding WL scores. ConclusionOAGB had significantly higher WL, less WR, and less GERD. However, it had a higher incidence of bile reflux. Both procedures had comparable complication rates, excellent remissions in associated medical problems, and improved quality of life. WR was associated with significantly more relapse of associated medical problems and significantly lower BAROS scores.

Five-Year BAROS Score Outcomes for Roux-en-Y Gastric Bypass, One Anastomosis Gastric Bypass, and Sleeve Gastrectomy: a Comparative Study.

Metabolic and bariatric surgery (MBS) has been shown to enhance the quality of life (QoL) in individuals with obesity. The Bariatric Analysis and Reporting Outcome System (BAROS) is a highly reliable scoring system utilized to assess weight loss, obesity-associated medical conditions, and QoL following MBS. This study aimed to assess the efficacy of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB) in improving health outcomes for individuals with severe obesity, employing the BAROS questionnaire. A retrospective study was conducted, enrolling 299 patients with a body mass index (BMI) of 40 or higher who had undergone primary MBS (RYGB, OAGB, or SG) and had a 5-year follow-up. Patients were evaluated using the BAROS scoring system, which included measures of % excess weight loss (%EWL), improvement and remission of obesity-related medical problems, and postoperative short-term and long-term complications. The mean age and pre-op BMI of the patients was 39.4 ± 9.4 years and 44.6± 6.5 kg/m2, respectively. The total BAROS score was significantly higher in patients who underwent OAGB compared to those who underwent RYGB and SG (P, 0.02). However, no significant differences were observed in other aspects of the BAROS score, such as QoL. This study demonstrated that all three common metabolic and bariatric surgical procedures (SG, RYGB, and OAGB) significantly improved the QoL after surgery. Furthermore, patients who underwent OAGB had a significantly higher total BAROS score at the 5-year follow-up compared to those who underwent RYGB and SG.

Gender Comparisons of Surgical Outcomes in Patients Undergoing One Anastomosis Gastric Bypass (OAGB): a Historical Cohort Study.

Clinical trials in the field of bariatrics have frequently been gender imbalanced, with males representing only 20% of examinees. Long-term gender-oriented results in one anastomosis gastric bypass (OAGB), and specifically quality of life (QOL) parameters, have not been addressed sufficiently. A better understanding of gender's effect on OAGB outcomes can play an important role in selecting the appropriate bariatric surgery for patients. Our study was aimed at examining mid-term gender-associated outcome of OAGB, including the effect on QOL. A retrospective cohort study of patients who underwent OAGB at surgical ward A, SUMC, Israel, between 2015 and 2020. Demographics, body mass index (BMI), and comorbidities were extracted from the national medical records system. Follow-up quality of life (QOL) and weight parameters were supplemented via telephone questionnaires, using the Bariatric Analysis and Reporting Outcome System (BAROS). A total of 152 patients were included; of these, 51 (33.6%) were males, with an average follow-up period of 4.1 (± 1.3) years post-surgery. Basic demographics showed no significant pre- or post-surgery differences between males and females, except for pre-op weight (which as expected was higher for males). Males had a higher overall BAROS score than females (3.8 ± 2.1 vs. 2.6 ± 2.1, p < 0.001). OAGB surgery results in better outcomes for male than for female patients as measured by the BAROS, despite a similar BMI reduction, and with no difference in complications. Gender-specific outcomes are one of the variables that one should be aware of in optimizing patient selection and pre-operative patient counseling.

Nutrition Care Process and its Impact on Remission of “Diabesity” and Allied Factors Post Roux-En Y Gastric Bypass Bariatric Surgery - A Case-Control Cohort Study

With a rising trend in obesity, diabetes and bariatric surgeries in India, nutrition care and management of patients post-surgery is still a cause of concern. To assess the impact of the nutrition care process on remission of “diabesity” and associated factors post Roux-en YGastric Bypass (RYGB) bariatric surgery. A single-point, hospital-based, Cohort- Case-Control, 3-month longitudinal study of 73 RYGB patients enrolled based on consent. Experimental (E) group (n=36) received nutritional care through personal counselling, group counselling and digital means under 3 broad management categories: 1) Pre-surgery nutritional assessment, diagnosis and counselling (deficiencies and diet), 2) Post-surgery diet progression, nutritional therapy for early and late complications, physical activity progression and behaviour related eating complications; and 3) Guidance and recommendations for lifelong follow-ups and importance of supplementation, as compared to the Control (C) group (n=37) which received care as per old protocols. Pre-post indicators related to weight loss and remission of diabetes were done as per the American Society for Metabolic and Bariatric Surgery guidelines and quality of life post bariatric surgery was done as per Bariatric Analysis and Reporting Outcome System (BAROS). All data were analyzed using SPSS-23 software. Post 3 mos. significant (≤0.001) weight loss (34 kg vs. 29 kg), remission in diabetes (49% vs. 34%) and improved quality of life scores were recorded in the experimental group as compared to the control group. A customized 3-section Nutritional Care Process is recommended in all bariatric surgery settings for improved nutritional and quality of life outcomes post-surgery.

Long-term Follow-up 15 Years After Duodenal Switch or Gastric Bypass for Super Obesity: a Randomized Controlled Trial

BackgroundIn super obesity, Roux-en-Y gastric bypass (RYGB) may be insufficient why some surgeons advocate biliopancreatic diversion with duodenal switch (BPD/DS), a more malabsorptive procedure. There is a paucity of evidence regarding results beyond 10 years, especially after BPD/DS. The aim of this randomized controlled trial was to compare the long-term outcome of BPD/DS, and RYGB in patients with super obesity, i.e., body mass index (BMI) > 50 kg/m2.MethodsThis is a 13- to 17-year follow-up study of a single-center, single-blinded randomized trial in which 47 patients (BMI > 48 and eligible for bariatric surgery) were randomized 1:1 to BPD/DS and RYGB (25 men, 24 BPD/DS, 39.1 ± 9.9 years, BMI 54.5 ± 6.1 kg/m2). The primary outcome was weight loss. The study was financed by Swedish governmental funding of clinical research (ALF). Trial registration number: ISRCTN10940791.ResultsThirty-four (18 BPD/DS) of the living 42 patients (81.0%) participated. BPD/DS resulted in higher BMI loss (20.4 ± 7.9 vs. 12.4 ± 8.6, p = .008) and higher percent of total body weight loss (37.5% ± 12.2 vs. 22.8% ± 14.8, p = .004). BPD/DS was associated with lower fasting glucose, glycated hemoglobin (HbA1c), and low-density lipoprotein (LDL) as well as lower hemoglobin. Adverse events were more common after BPD/DS (2.7 vs. 0.9 per patient, p = .004). The global assessment tool BAROS (Bariatric Analysis and Reporting Outcome System) demonstrated superior scores for BPD/DS (p = .047).ConclusionWhen compared to RYGB, BPD/DS results in superior weight loss and metabolic control as well as superior BAROS score, however, at the cost of more adverse events.Graphical

Relationship Between Coping Strategies and Outcome of Bariatric Surgery in Patients With Morbid Obesity

Background and Objective Bariatric surgery is one of methods for treatment of morbid obesity. Psychological factors can affect its outcome. This study aims to investigate the relationship between coping strategies and the outcome of bariatric surgery in patients with morbid obesity. Materials &amp; Methods This prospective observational study was conducted on 85 patients who underwent bariatric surgery in the obesity clinic of Hazrat-e Rasul Akram and Milad Hospitals in Tehran, Iran. Subjects were evaluated before and two years after surgery using Folkman &amp; Lazarus’ ways of coping questionnaire and the Bariatric Analysis and Reporting Outcome System (BAROS). Results During the follow-up, 9 patients left the study. The mean age of participants was 38.11±11.5 years (ranged 17-65 years). Problem-focused coping strategies and their components had a significant positive relationship with the surgery outcome (P&lt;0.05), but emotion-focused coping strategies had no significant relationship with the surgery outcome (P&gt;0.05). Conclusion Problem-focused coping strategies can predict the outcome of bariatric surgery.

Quality of life evaluation in Mexican patients with severe obesity before and after bariatric surgery.

In Mexico, neither the 36-item Short Form Health Survey (SF-36) nor the Bariatric Analysis and Reporting Outcome System (BAROS) instruments have been used to assess quality of life (QoL) before and after bariatric surgery (BS). To describe changes in QoL using the SF-36 and BAROS questionnaires in patients with severe obesity before and after BS. Clinical and anthropometric data of patients undergoing bariatric surgery between 2015 and 2016 were collected. Statistical significance was considered with a p-value < 0.05. 230 patients were analyzed, 98 before and 132 and after BS; most were females (81 %). Initial body mass index was 48 kg/m2 (44-53). SF-36-measured QoL showed an increase in the physical component score from 43 to 54.2 points (p < 0.001), and in the mental component, from 53.3 to 56.6 points after BS. With BAROS, 98.5 % showed good to excellent QoL results within the first three months after BS. When measured with the SF-36 and BAROS questionnaires, QoL of Mexican patients with severe obesity was found to improve after BS.

WEIGHT LOSS AND BEYOND, ASSESSMENT OF QUALITY OF LIFE AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY USING BAROS IN PATIENTS WITH OBESITY IN TURKEY.

Sleeve gastrectomy is an effective method for management of obesity. The Bariatric Analysis and Reporting Outcome System (BAROS) is a comprehensive and standard system for the assessment of outcomes of weight loss surgery. It is consisted of weight loss, changes in obesity-related comorbidities and quality of life measurements. We investigated results of the sleeve gastrectomy based on the BAROS. Outcomes of laparoscopic sleeve gastrectomy surgery was studied in 45 patients with obesity (11 male, 34 female), after 45 months in Turkey. Total weight loss was 26.4±0.1% of body weight at 45 months. Weight regain was seen in 97.8% of the patients with an average 14.5 kg and 13.7% body mass index points. The surgery caused 76% decrease in incidence of obstructive sleep apnea, 73% decrease in type 2 diabetes, 63% decrease in hyperlipidemia and 62% decrease in hypertension. Significant improvement is observed in all quality-of-life parameters. The final score of the BAROS was 4.23±1.02. Based on BAROS, sleeve gastrectomy provides significant improvements in weight loss, incidence of medical comorbidities and quality of life after surgery. Future studies should address prevention of weight regain after the surgery.

S1151 Pregnancy After ESG: Are All Efforts Thwarted?

Introduction: Endoscopic Sleeve Gastroplasty (ESG) is an organ sparing bariatric procedure aimed to reduce gastric volume and modify gastric motility with full thickness endoscopic suture. Pregnancy is a condition in which physiologically the pregnant woman potentially undergoes weight gain. Methods: A retrospective analysis of a prospective database was conducted to evaluate weight trajectories and lifestyle modification in women that got pregnant after ESG. Weight loss outcomes, evolution of comorbidities and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire were analyzed at the beginning and at the end of the pregnancy and at the first follow-up visit after delivery. Results: From May 2017 to October 2021, out of 115 fertile women 10 became pregnant after ESG [nine Rome (Fondazione Policlinico Universitario Agostino Gemelli) and one in Israel [Hadassah Medical Center]) with a mean interval of 5,8±4,0 months. Baseline BMI was 38,4±3,5 kg/m2. Two patients reported H-INS and another one had both H-INS and HBP. Two women affected by Poly-Cystic Ovary Syndrome (PCOS) reported difficulty getting pregnant before ESG. At the beginning of pregnancy and at the delivery mean TBWL was 18,1±8,1% and 10,4±12,2 %, whereas mean EWL was 55,7±24,6 % and 30,4,2±37,2%. Six out of 10 patients had weight gain in the ranges recommended by the Centers for Disease Control and Prevention. At the first follow-up visit after the delivery (mean interval, 3,7±2,5 months) the TBWL was 9,9±9,9 %, the EWL was 30,5±30,7 %, whereas the BAROS score was 3,5±2,2. The patient affect by H-INS and HBP resolved both before and during the pregnancy, whereas one patient with H-INS had an improvement during the gestation. Conclusion: Lifestyle changes after ESG do not disappear after pregnancy and allow for a gradual loss of weight gained during gestation. Weight loss following ESG could help those women who have difficult-to-get-pregnancy, such as PCOS. Table 1. - Weight loss outcomes of the ten patients who got pregnant after Endoscopic Sleeve Gastroplasty. All data are reported as mean value ± Standard. Deviation Population (N=10) Weight loss (kg) EWL (%) TBWL (%) BMI (kg/m2) ΔBMI (kg/m2) EBMIL (%) BAROS (pt) QoL Beginning of Pregnancy 18.3±8.9 55.7±24.6 18.1±8.1 30.9±4.0 6.8±3.2 55.7±24.6 4.8±1.9 2.3±0.7 Delivery 11.4±14.1 30.4±37.2 10.4±12.2 33.7±4.5 4.0±4.6 30.4±37.2 3.4±1.7 2.1±0.7 First follow-up after the delivery 10.3±11.2 30.5±30.7 9.9±9.9 34.0±5.0 3.7±3.7 30.5±30.7 3.5±2.2 2.1±0.9 Abbreviations: EWL= Excess Weight Loss; TBWL= Total Body Weight Loss; BMI= Body Mass Index; ΔBMI= Variation of BMI; EBMI= Excess BMI Loss; BAROS= Bariatric Analysis and Reporting Outcome System questionnaire; QL= Quality of Life subcategory of the BAROS.

S1448 Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population

Introduction: With the ageing of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short and medium-term outcomes of ESG in patients with obesity aged 65 years and older. Methods: A retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire and the presence of comorbidities were assessed. Results: Eighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m 2 . After ESG the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12 and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12 and 24 months, respectively (Table). The median BAROS score was 3.0, 3.4 and 2.5 at 6, 12, and 24 months, respectively. 6/12 patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. 2/6 patients with OSA stopped therapy with CPAP. No adverse events were recorded. Conclusion: According to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suiTable for bariatric surgery because of age and comorbidities. Table 1. - Retrospective analysis Variable 1 monthN*=18 3 months N=18 6 monthsN=18 12 monthsN=12 18 months N=101 24 monthsN =101 P-value # EWL%Median (25%-75%) 21 (19-30) 36 (30-43) 39 (34-45) 37 (30-49) 44 (25-48) 41 (34-48) 0.034 TBWL%Median (25%-75%) 9.4 (7.4-11.8) 13.0 (11.6-15.3) 15.1 (10.9-18.8) 15.5 (10.5-19.6) 16.3 (9.3-22.1) 15.5 (9.6-21.6) 0.009 BAROS scoreMedian (25%-75%) 2.6 (1,1-2.5) 2.6 (2.0-3.4) 3.0 (2.3-3.9) 3.4 (2.4-3.9) 3.0 (2.5-3.5) 2.5 (2.1-3.4) 0.2 *N = Number of patients#Kruskal-Wallis rank sum testBAROS, Bariatric Analysis and Reporting Outcome System; EWL, excess weight loss; TBWL, total body weight loss.

Outcomes of Endoscopic Sleeve Gastroplasty in the Elder Population

PurposeWith the aging of the population and the epidemic spread of obesity, the frequency of older individuals with obesity is steadily growing. To date, no data evaluating the use of endoscopic sleeve gastroplasty (ESG) in the elderly have been published. In this case series, we evaluate the short- and medium-term outcomes of ESG in patients with obesity aged 65 years and older.Materials and MethodsA retrospective analysis was done on a prospective database; patients aged 65 years and older were included in our analysis. EWL%, TBWL%, the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire, and the presence of comorbidities were assessed.ResultsEighteen patients aged 65 years and older underwent ESG between November 2017 and July 2021. The median age was 67 years and the mean baseline BMI was 41.2 kg/m2. After ESG, the median TBWL% was 15.1%, 15.5%, and 15.5% at 6, 12, and 24 months, while the median %EWL was 39%, 37%, and 41% at 6, 12, and 24 months, respectively. The median BAROS score was 3.0, 3.4, and 2.5 at 6, 12, and 24 months, respectively. Six out of twelve patients with hypertension and 3/4 diabetic patients reduced or removed their medications within 12 months following ESG. Two out of six patients with OSA stopped therapy with CPAP. No adverse events were recorded.ConclusionAccording to our experience, ESG is a promising therapeutic option for elder individuals with obesity who fail non-invasive methods, and who refuse or are deemed not suitable for bariatric surgery because of age and comorbidities.Graphical abstract

Changes in Cognition Functions and Depression Severity After Bariatric Surgery: A 3-Month Follow-up Study

Background: Changes in cognitive profile, such as memory and other functions in patients with morbid obesity after bariatric surgery have been reported in the literature with inconsistent results. Objectives: This study aimed to evaluate cognitive changes, executive function and depression severity before and after bariatric surgery in patients with morbid obesity. Methods: In this prospective cohort study, 70 patients with morbid obesity (40 patients undergoing bariatric surgery and 30 patients in the waiting list) referred to the Rasool Akram Medical Complex, obesity clinic, Tehran, Iran, in 2016 entered the study. The two groups were assessed using the Wechsler Memory Scale (WMS) (consists of 7 subscales and assesses memory), the Wisconsin Cart Sorting test (WCST) (includes 64 cards and assesses cognitive skills), the Hamilton Depression Scale (HAM-D) (for measuring depression) and bariatric analysis and reporting outcome system (BAROS) questionnaire (scale to report of the therapeutic results of bariatric surgery and including the three criteria of the weight loss percentage, the change in health state, and the quality of life) at the beginning of the study and three months after the surgery. Moreover, the Bariatric Analysis and reporting outcome system (BAROS) questionnaire was filled three months after surgery. Results: The average changes in WMS score (P = 0.043), working memory (P = 0.002), HAM-A (P = 0.032), weight, and BMI (P = 0.0001) in the surgery group were significantly higher than the control group. There was a significant positive correlation between change in the number of preservative errors in WCST within the surgery group with BAROS score (P = 0.004). Moreover, there was a significant correlation between changes in the score of WMS and those in BMI in the surgery group. Conclusions: Bariatric surgery is associated with improvements in some cognitive functions and worsening of depressive scores in patients with morbid obesity.

A Comparison of One- and Two-Stage Laparoscopic Sleeve Gastrectomy Following Failed Laparoscopic Adjustable Gastric Banding Using the BAROS Score.

Revision of a failed band can be done by laparoscopic sleeve gastrectomy (LSG). It can be performed synchronously with band removal or during two separate procedures. Comparing single- and two-staged LSG following a failed LAGB in terms of short- and mid-term outcomes, with an emphasis on postoperative quality of life. A retrospective cohort study comparing revisional LSG's safety and efficacy after failed LAGB removal. Data included patients' medical files, as telephone interviews. We compared demographics, weight loss, complications, long-term outcomes, and quality-of-life measures, including the Bariatric Analysis and Reporting Outcome System (BAROS). Ninety-three patients were enrolled, of which 68 (73.1%) underwent a single-stage revisional LSG. Of these, 40 were males (35.1%) with a mean age of 44.9years (± 12.9). The two-staged group were older. The reasons for band removal differed between the groups: whereas in the two-stage surgery, the common causes were slippage (29.2%) or band intolerance (25%); in the single-stage group, it was weight gain (51%). There were no differences in short- and mid-term complications, weight loss, and quality of life. In selected cases, laparoscopic sleeve gastrectomy as a revision of failed gastric banding in one stage is as safe as a two-stage procedure in terms of short- and mid-term complications, weight loss, and quality of life. We believe that there is little benefit in performing elective surgery in two stages unless there are clinical indications. Exceptions for two-stage revision should include cases of band erosion and acute slippage with patient preference for band removal.

Comparison of Dietary Quality and Surgical Satisfaction Between Patients With Suboptimal and Optimal Weight Loss After Sleeve Gastrectomy Using Food Tolerance Score and Bariatric Analysis and Reporting Outcome System Questionnaires.

This study aimed to assess the association of dietary quality and surgical satisfaction with the amount of total weight loss (TWL) 1 year after laparoscopic sleeve gastrectomy (LSG) using the food tolerance score (FTS) and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaires. This single-center retrospective study included patients who underwent LSG due to morbid obesity. Only those who have 1-year follow-up data were included and divided into 2 groups: suboptimal TWL (STWL) ≤20% and optimal TWL (OTWL) >20%. Clinical data and questionnaires recorded 1 year after surgery were collected. FTS was used to evaluate the degree of food tolerance, and BAROS assessed surgical outcomes, including weight loss, comorbidity changes, and quality of life (QoL). The total FTS and BAROS scores of the 2 groups were compared. Of 580 patients, 159 were included. Patients in STWL (n=17) were significantly older than those in OTWL (n=142) (42.24±9.28 vs. 35.92±8.71 years old, P=0.006). The total FTS (1-30 points) for STWL and OTWL were 24.88±3.43 and 25.04±3.14, respectively (P=0.845). Although the total BAROS scores (maximum: 9 points) were significantly lower in STWL than in OTWL (5.96±1.48 vs. 7.20±1.40, P<0.001). The only variable that made this difference was weight loss. There were no significant differences in other variables, such as medical conditions, QoL, and complications. In terms of FTS and BAROS score, there is no difference in postoperative satisfaction and QoL between STWL and OTWL after LSG, except for the degree of weight loss.

Social isolation but not deprivation involved in employment status after bariatric surgery.

An increase in employment rate was observed among individuals who underwent bariatric surgery. This study assessed the relationship between employment rate and weight loss, deprivation, and Bariatric Analysis and Reporting Outcome System (BAROS) scores after bariatric surgery in a deprived area. This retrospective study evaluated the employment rate at a mean period of 2.3±0.1 years after bariatric surgery among 133 individuals. The Evaluation of Deprivation and Inequalities in Health Examination Centers (EPICES score), satisfaction scale, and BAROS (self-esteem, physical activity, social life, work conditions, and sexual activity) questionnaires were used. The mean age of the participants was 45 (range: 19-67) years. Approximately 88% were women. The initial mean body mass index (BMI) was 42.7 kg/m2, and about 88% of the participants underwent sleeve gastrectomy. The mean decrease in BMI was 12 ± 0.5 kg/m2. The mean EPICES score (N<30), BAROS, and satisfaction scale (range: 1-5) scores were 31.9±18, 1.3±1.1, and 4.27±1.19, respectively. After surgery, 19 participants obtained a job. However, three were unemployed. Based on a multivariate analysis, employed and unemployed participants (77 vs 52) before surgery had a lower initial BMI and better BAROS and satisfaction scale scores. After surgery, there was no difference between participants who obtained a new job and those still did not have a job in terms of questionnaire responses. Obtaining a new job was not associated with BMI, sex, or age differences. However, there was a positive correlation between social life score and weight loss. Bariatric surgery increased an individual's chance of finding a job independently of deprivation status. Participants with a pre-operative job had a better perception of satisfaction and BAROS scores. Moreover, social isolation was correlated with unsuccessful weight loss.

Early Outcomes of Laparoscopic Sleeve Gastrectomy (LSG) in Morbidly Obese Patients

Objective: To determine the early outcomes of laparoscopic sleeve gastrectomy with respect to weight loss and amelioration of comorbid conditions in morbidly obese patients. Study Design: Prospective descriptive study. Place and Duration of Study: MTI-Lady Reading hospital Peshawar and Royal Imperial hospital Swat from January 2018 to January 2020. Materials and Methods: Total thirty-eight morbidly obese patients of either sex with age range of 25-65 years were included in this study. Informed written consent was taken from all the patients and their demographic details such as age, sex and comorbid conditions were recorded. All the patients underwent laparoscopic sleeve gastrectomy. Preoperative and postoperative data such as body mass index, total &amp; excess weight loss and impact on comorbidities were analyzed. Bariatric Analysis and Reporting Outcome System (BAROS) scoring system was used to analyze the outcomes. Follow-up was taken at 1 year post-operatively. Results: Majority were female 25 (65.8%) patients and 13 (34.2%) males with mean age of 45.39±9.64 years. Comorbidities such as hypertension, diabetes mellitus, hyperlipidemia and obstructive sleep apnoea were recorded in 13.2%, 26.3%, 7.9% and 10.53% patients respectively. Mean excess body weight loss (EWL) was 60.25±12.7 kg and mean body mass index loss was 15.14+9.33 kg/m2at 1 year follow up. Postoperative systolic blood pressure improvement was observed in 23 (60.5%) patients. A significant improvement was observed regarding diabetes mellitus (preoperatively mean HbA1C 9.7±5.9 vs postoperatively mean HbA1C 4.42±3.6) p-value &lt;0.001. According to the BAROS score, 5 (13.3%) showed excellent, 14 (36.8%) showed very good, 17 (44.74%) showed good, 2 (5.3%) showed fair and no patient showed poor outcomes. Satisfaction rate among patients was 94.7%. Conclusion: Laparoscopic sleeve gastrectomy is an excellent procedure both in terms of weight loss and amelioration of comorbid conditions in morbidly obese patients. Key words: Sleeve gastrectomy, Laparoscopic, Excess body weight loss, Morbid obesity

Good to excellent Quality of Life in patients suffering from severe obesity post bariatric surgery - A single-center retrospective study report using BAROS Questionnaire.

Context:Despite the positive outcomes reported in terms of weight loss and resolution of co-morbidities, the impact of bariatric surgery on patient-reported outcomes of quality of life (QoL) still remains scarce, particularly in the Indian population. The present study was conducted to evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) procedures in patients with severe obesity over a period of 2 years in terms of weight loss, resolution of comorbidities, safety and changes in QoL using the Bariatric analysis and reporting outcome system (BAROS).Subjects and Methods:The data of 100 patients who underwent RYGB and LSG between March 2014 and December 2017 were analyzed. The study endpoints such as QoL, major and minor complication rates, co-morbidity resolutions and the percentage of excess weight loss (%EWL) were measured using the Moorehead-Ardelt BAROS questionnaire II.Results:At a follow-up point of 2 years, patients achieved a mean %EWL of 79.2 (±28.9) % and the mean postoperative body mass index decreased to 31.7 (±6.22) kg/m2. No major complications were reported to have occurred. Excellent global BAROS outcome was obtained in 20% of patients, very good in 47%, good in 29%, fair 2% and failure in 2% patients 24 months post-surgery. The mean BAROS score was 5.8 ± 1.73, and a ‘good’ to ‘excellent’ QoL outcome was observed in 96% of patients.Conclusion:RYGB and LSG are safe and effective bariatric procedures. These procedures provided substantial results in good to excellent health-related QoL, weight loss and medical conditions.

Evaluation of nutritional deficiencies and health-related quality of life during the first year after laparoscopic sleeve gastrectomy and laparoscopic mini-gastric bypass

Background Nutritional deficiencies and health-related quality of life represent a major concern after bariatric procedures and can cause serious complications. Bariatric procedures have different effects on the domains of quality of life. Objective To prospectively compare between the effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic mini-gastric bypass (LMGB) on nutritional deficiencies and quality of life during the first postoperative year. Patients and methods We included 40 patients. In the first group, 20 patients underwent LSG, whereas 20 patients in the second group underwent LMGB. Postoperative assessment of nutritional parameters and quality of life was performed every 3 months. Quality of life was assessed using bariatric analysis and reporting outcome system (BAROS) and short form-12 questionnaires. Results All nutritional parameters showed significant decrease with more significant deficiencies after LMGB. Quality of life improved significantly after both procedures. Using BAROS questionnaire, LMGB was associated with significant better results. Conclusion LSG and LMGB are associated with significant decrease of nutritional parameters and significant improvement of quality of life. However, LMGB is associated with significantly more nutritional deficiencies and better improvement of quality of life than LSG.

Evaluación de la calidad de vida en pacientes mexicanos con obesidad severa antes y después de cirugía bariátrica

Introduction: In Mexico, neither the 36-item Short Form Health Survey (SF-36) nor the Bariatric Analysis and Reporting Outcome System (BAROS) instruments have been used to assess quality of life (QoL) before and after bariatric surgery (BS). Objective: To describe changes in QoL using the SF-36 and BAROS questionnaires in patients with severe obesity before and after BS. Methods: Clinical and anthropometric data of patients undergoing bariatric surgery between 2015 and 2016 were collected. Statistical significance was considered with a p-value < 0.05. Results: 230 patients were analyzed, 98 before and 132 and after BS; most were females (81 %). Initial body mass index was 48 kg/m2 (44-53). SF-36-measured QoL showed an increase in the physical component score from 43 to 54.2 points (p < 0.001), and in the mental component, from 53.3 to 56.6 points after BS. With BAROS, 98.5 % showed good to excellent QoL results within the first three months after BS. Conclusion: When measured with the SF-36 and BAROS questionnaires, QoL of Mexican patients with severe obesity was found to improve after BS.