Factors Affecting Weight Loss Research Articles

Epidemiology and Other Factors Affecting Weight Loss in Hispanics

Epidemiology and Other Factors Affecting Weight Loss in Hispanics

Factors Affecting Weight Loss Management among Obese Nurses Working in Public and Private Health Care Sectors

Obesity in the general population have been growing globally in recent years, a trend that has also been seen among nurses. Along with the severe health consequences of obesity, the condition impairs an individual's capacity to work and increases absenteeism rates. It is therefore essential to understand the factors that are producing all of this. Objectives: To explore the barriers of weight loss management among obese nurses. Methods: In this study, an exploratory qualitative study approach was adopted. Data was collected from the 12 study participants who were purposive sampled, semi-structured face-to-face individual interviews were conducted. The audio recordings were translated into English and verbatim transcribed. The analysis was conducted out using the computer-assisted programmer NVIVO-12. NVIVO-12 produced codes that were grouped into sub-themes, and themes. Results: Obstacles to weight loss management among obese nurses were a lack of desire and a change in lifestyle owing to a lack of time, nurses, and resources. Weight management was hindered by the workplace environment and shift changes. Conclusions: The demanding nature of hospital work leads to stress-induced unhealthy eating habits among nurses, hindering their ability to maintain a balanced diet and manage their weight.

Effectiveness of the Modified Hemoglobin, Albumin, Lymphocyte, and Platelet Score in Predicting Weight Loss After Laparoscopic Sleeve Gastrectomy.

Introduction: The overexpression of proinflammatory cytokines in obesity has suggested an association between obesity and inflammation. In this study, we aimed to predict the success of weight loss at the end of the first year of patients who underwent laparoscopic sleeve gastrectomy (LSG) for morbid obesity using hemoglobin, albumin, lymphocyte, and platelet (HALP) score and modified HALP (m-HALP) score. Materials and Methods: Patients were divided into two groups according to the success of weight loss. The groups were compared in terms of HALP score, m-HALP score, demographic parameters, and preoperative laboratory tests. The diagnostic performance measurements of the m-HALP score were calculated. In addition, logistic regression analysis was performed for the factors affecting weight loss in the first year after LSG. Results: Seventy-two patients were evaluated. The median m-HALP score of the patients with an excess weight loss percentage (EWL%) <60 threshold was 562 (416.6-891.9), the median m-HALP score of the patients with an EWL% above the 60 threshold was 394.3 (347.9-543), and the difference between the outcome groups was significant (P = .002).The accuracy of m-HALP score in identifying the patients whose EWL would be <60% 1 year after the surgery was 63.9 (95% confidence interval = 51.7-74.9). Conclusion: This study showed that the m-HALP score is effective in predicting weight loss after bariatric surgery.

Behavioral and Psychological Factors Affecting Weight Loss Success.

There is a large variability between individuals in the weight loss response to any given diet treatment, which fuels interest into personalized or precision nutrition. Although most efforts are directed toward identifying biological or metabolic factors, several behavioral and psychological factors can also be responsible for some of this interindividual variability. There are many factors that can influence the response to dietary weight loss interventions, including factors related to eating behavior (emotional eating, disinhibition, restraint, perceived stress), behaviors and societal norms related to age and sex, psychological and personal factors (motivation, self-efficacy, locus of control, self-concept), and major life events. The success of a weight loss intervention can be influenced by many psychological and behavioral constructs and not merely by physiological factors such as biology and genetics. These factors are difficult to capture accurately and are often overlooked. Future weight loss studies should consider assessing such factors to better understand the underlying reasons for the large interindividual variability to weight loss therapy.

Factors associated with weight loss by age among community-dwelling older people

BackgroundFactors associated with weight loss in community-dwelling older people have been reported in several studies, but few studies have examined factors associated with weight loss by age groups. The purpose of this study was to clarify factors associated with weight loss by age in community-dwelling older people through a longitudinal study.MethodsParticipants in the SONIC study (Longitudinal Epidemiological Study of the Elderly) were community-dwelling people aged 70 or older. The participants were divided into two groups: 5% weight loss and maintenance groups, and compared. In addition, we examined factors affecting weight loss by age. The analysis method used was the χ2 test, and the t-test was used for comparison of the two groups. Factors associated with 5% weight loss at 3 years were examined using logistic regression analysis with sex, age, married couple, cognitive function, grip strength, and the serum albumin level as explanatory variables.ResultsOf the 1157 subjects, the proportions showing 5% weight loss after 3 years among all subjects, those aged 70 years, 80 years, and 90 years, were 20.5, 13.8, 26.8, and 30.5%, respectively. In logistic regression analysis, factors associated with 5% weight loss at 3 years by age were influenced by BMI of 25 or higher (OR = 1.90, 95%CI = 1.08–3.34, p = 0.026), a married couple (OR = 0.49, 95% = 0.28–0.86, p = 0.013), serum albumin level below 3.8 g/dL (OR = 10.75, 95% = 1.90–60.73, p = 0.007) at age 70, and the grip strength at age 90 (OR = 1.24, 95%CI = 1.02–1.51, p = 0.034), respectively.ConclusionsThe results suggest that factors associated with weight loss by age in community-dwelling older people through a longitudinal study differ by age. In the future, this study will be useful to propose effective interventions to prevent factors associated with weight loss by age in community-dwelling older people.

Program Factors Affecting Weight Loss and Mobility in Older Adults: Evidence From the Mobility and Vitality Lifestyle Program (MOVE UP).

Background. The Mobility and Vitality Lifestyle Program (MOVE UP) is a behavioral weight-management intervention for improving mobility among community-dwelling older adults. We examined program factors that affect implementation outcomes and participant-level health outcomes. Methods. The MOVE UP program was implemented in the greater Pittsburgh area from January 2015 to June 2019 to improve lower extremity performance in community-dwelling older adults who were overweight or obese. Thirty-two sessions were delivered over 13 months. All sessions were designed to be 1-hour in length, on-site, group-based, and led by trained and supported community health workers (CHWs). Participants completed weekly Lifestyle Logs for self-monitoring of body weight, diet, and physical activity. We evaluated the MOVE UP program using the RE-AIM framework, and collected quantitative data at baseline, 5-, 9-, and 13-months. Multilevel linear regression models assessed the impacts of program factors (site, CHW, and participant characteristics) on implementation outcomes and participant-level health outcomes. Results. Twenty-two CHWs delivered MOVE UP program to 303 participants in 26 cohorts. Participants were similar to the target source population in weight but differed in some demographic characteristics. The program was effective for weight loss and lower extremity function in both intervention and maintenance periods (ps < .01), with an independent effect for Lifestyle Logs submission but not session attendance. Discussion. CHWs were able to deliver a multi-component weight loss intervention effectively in community settings. CHW and site characteristics had independent impacts on participants' adherence. Lifestyle Log submission may be a more potent measure of adherence in weight loss interventions than attendance.

Weight loss in children undergoing allogeneic hematopoietic stem cell transplantation within the first 100 days: Its influencing factors and impact on clinical outcomes.

This study aimed to evaluate the nutritional status of children subjected to allogeneic hematopoietic stem cell transplantation (alloHSCT) in the first 100 days. Objectives were to clarify the effect of weight loss on clinical outcomes, and to analyze factors influencing weight loss. Eighty pediatric patients receiving alloHSCT were enrolled in the study. Body mass index (BMI) z-scores and weight for age (WFA) z-scores were collected. A multivariate regression model was set up to investigate factors affecting weight loss. Post-transplant clinical outcomes relative to weight loss on 100 days after transplantation were analyzed. At admission, eight patients (10%) were underweight, the number had increased to 23 (30.67%) by 100 days post-HSCT. On day + 100, only nutrition screening tool for childhood cancer (SCAN) scores ≥ 3 (OR: 4.474, 95% CI: 1.215, 16.472; P = 0.024) and acute graft versus host disease (aGVHD) (OR: 9.915, 95% CI: 3.302, 29.771; P < 0.001) were regarded as significant influencing factors of weight loss. The Weight loss ≥ 5% group was associated with longer hospital stays (P = 0.001), greater cost of inpatient treatment (P = 0.001), and a higher incidence of 100-day re-admission and intensive care unit (ICU) transfer (P = 0.03 and P = 0.033, respectively). Cumulative number of fever days (P = 0.023) and antibiotic use (P = 0.007) also increased significantly. The Weight loss ≥ 5% group had a significantly lower one-year overall survival rate compared with the Weight loss < 5% group (P = 0.015). Pediatric patients' nutritional status declined significantly after HSCT. Weight loss within the first 100 days influenced short-term clinical outcomes and one-year overall survival.

Evaluation of High-Interval Education to Improve Outcomes for Bariatric Patients With Health Disparities.

A correlation of health disparities, socioeconomic barriers, and health literacy were hypothesized as causative factors of poor weight loss, weight regain, and loss to clinical follow-up in postbariatric patients. This study explored nurse practitioner-led interventions to address health disparities and improve outcomes. This pilot project evaluated 3-month weights of an intervention cohort as compared with a retrospective cohort. The intervention cohort received a weekly educational phone call from the clinical nurse practitioner. Quantitative data based on 3-month weights reveal an average excess body weight percentage lost at the 3-month postoperative clinical visit (36.54 ± 0.11, p = .2929) in the retrospective cohort ( n = 30) as compared with the intervention cohort ( n = 30; 33.46 ± 0.11, p = .2929). Participants responding to the barriers screening tool did not correspond with the actual needs represented by the population. Food access and transportation were leading factors affecting weight loss. This project revealed implications including the need for development of bariatric-specific social needs assessments, the need to explore telehealth as a modality to improve patient education, the need to modify education to overcome deficits in health literacy. Findings also validate the role of the nurse practitioner as a leader of multidisciplinary care teams.

Patterns of body weight change affect weight loss during a multidisciplinary intervention in adolescents with obesity

AimThe current pediatric obesity health challenge necessitates a better understanding of the factors affecting weight loss success during interventions. The aim of this observational study was to test the impact of the rate of initial weight loss and body weight variability on weight loss during a 9-month residential, multidisciplinary weight loss program in adolescents with obesity. MethodsThis retrospective study considered a whole sample of 510 adolescents with obesity (12–16 years, 435 girls). Body weight assessment was performed before (T0) and each week during the 9 months of a multidisciplinary weight loss program. Initial weight change (week 4-W4) and overall weight change at week 12 (T1) and the end of the intervention (T2) were considered. Participants were divided into three groups (tertiles), based on their percentage of weight loss between T0 and W4; and weight variability was expressed by the root mean square error (RMSE) around each participant’s regression line at each considered period (W4, T1, T2). ResultsAdolescents with lower initial weight loss at W4 (tertile 3) displayed the lesser weight loss at T1 and T2 compared with adolescents in tertile 1 and 2. The RMSE was positively associated with the percentage of weight loss of the period considered, but when the analyses were adjusted for age and initial body weight, there was no more significant association. ConclusionsThe rate of weight loss during the first few weeks is crucial for weight loss success, and weight variability is positively associated with weight loss in adolescents with obesity. Overall, results show that initial body weight is a determinant characteristic to consider during a lifestyle intervention. Further studies are thus needed to better understand the relationship between body weight change patterns and weight loss during the dynamic state that is adolescence.

A cross-sectional survey of patients attending follow-up visits after sleeve gastrectomy: Factors affecting weight loss

BackgroundBariatric surgery offers long-term weight loss and maintenance for patients with obesity. Several factors may be associated with patients' inability to achieve successful excess weight loss (EWL) after the surgery. The purpose of this study was to identify factors associated with improved or in-progress EWL among patients who had undergone laparoscopic sleeve gastrectomy (LSG). MethodsThis original clinical investigation was conducted at the Outpatient Surgical Department-Medical Research Institute Hospital at Alexandria University in Egypt. A sample size of 100 adult surgical patients who had undergone LSG was selected from patients who attended follow-up in the study setting. Group A had an EWL% ≥50 and group B had an EWL <50. Body Mass Index (BMI) classes were defined as 25–30 kg/m2, >30–35 kg/m2, >35–40 kg/m2, >40 ≥ 45 kg/m2 ResultsPost-operatively, after six months, 100% of the patients in group A had a BMI between 25 and 30 mg/m2, compared to 0% in group B. Nevertheless, patients in group EWL<50 (group B) who had pre-operatively BMI class ≥45 mg/m2, had a reduction in weight of 89.5% post-operatively, (n = 2 still had a BMI >45 kg/m2 post operatively), In total, 63.9% of the patients in group B managed to get towards a BMI of 30–35 kg/m2 post-operatively. The main factors associated with group B (less %EWL after 6 months) were found to be related to higher preoperative BMI, the onset of obesity started in childhood, less preoperative weight loss, longer postoperative duration towards weight reduction, and lower postoperative compliance to dietary instructions (P = 0.0001, 0.048, 0.0001, 0.017, and 0.016, respectively). ConclusionRoutine cross-sectional surveying can help clinicians in understanding patients’ post-operative follow-up routines. Special attention to pre-operative BMI, weight-loss regimens, and childhood-onset as well as post-operative duration, low responders, and compliance with clinical assessment can improve weight loss outcomes.

Predictors for successful weight reduction during treatment with Dapagliflozin among patients with type 2 diabetes mellitus in primary care

AimsStudies on factors affecting weight loss effect after start of dapagliflozin in type 2 diabetes mellitus (T2DM) patients are few. The aim of this study was to identify if there were any patient characteristics that could predict weight loss after starting treatment with dapagliflozin.MethodsThe study included 200 Korean patients with T2DM who were prescribed dapagliflozin in a family medicine clinic during 2014–2019. We studied patients for 1 year after starting dapagliflozin treatment. Data were collected from medical records. Clinically meaningful weight reduction was defined as ≥3% decrease in body weight and odds ratios (ORs) and 95% confidence intervals (CIs) for succeeding this weight reduction was calculated for different baseline characteristics.ResultsIn total, 113 (56.5%) patients were male. Weight loss of ≥3% in 1 year treatment with dapagliflozin was achieved in 122 (61%) patients. The likelihood of this level of weight loss was significantly increased with regular exercise (OR 2.13, 95% CI 1.07–4.25), with concomitant metformin treatment (OR 2.90, 95% CI 1.23–6.80), and in patients with normal renal function (OR 13.84, 95% CI 1.33–144.26). Patients receiving sulfonylurea treatment were less likely to achieve ≥3% weight reduction (OR 0.39, 95 CI 0.19–0.79).ConclusionsT2DM patients that performed regular exercise, had normal renal function and were receiving metformin were more likely to have clinically meaningful body weight reduction after one year treatment with dapagliflozin.

Korean Medicine with Self-monitoring for Weight Control and Factors Associated with Weight Loss: a Retrospective Observational Study

Objectives: The purpose of this study was to investigate the effect of weight loss in Korean Medicine (KM) obesity treatment combined with self-monitoring and to identify the relevant factors which are related to successful weight loss. In addition to this, adverse events reported by the patients were analyzed to assess the safety of KM treatments for obesityMethods: This was a retrospective observational study that analyzed the medical records of the patients that participated in the 10-week of KM treatment. All patients took herbal medicine for weight loss and were instructed to reduce calorie intake and adhere to self-monitoring. Clinical data including body weight were collected for evaluating the effect of the treatments. Behavior factors affecting weight loss were collected. The correlation between each factor and weight loss was analyzed. Adverse events (AEs) were collected at each time to evaluate the safety of the intervention.Results: One hundred eighteen patients’ records were included in this study. The average weight loss was 7.64kg(74.59kg to 66.95kg). 94.9% of patients lost 5% or more of their initial weight. The degree of weight loss was identified to be related to self-assessment of diet control and self-assessment of appetite control. The average self-weighing frequency significantly increased(2.45 times/week before treatment and 4.70 times/weeks during treatment). Constipation, insomnia, and dizziness were found to be the most frequent AEs, and except for one case, most AEs were mild cases.Conclusion: From this study, we found that KM obesity treatment combined with self-monitoring showed significant weight loss without serious AE.

Psychopathological factors affecting weight loss after bariatric surgery: One year follow-up study

Psychopathological factors affecting weight loss after bariatric surgery: One year follow-up study

Weight Loss and Eating Pattern 7Years After Sleeve Gastrectomy: Experience of a Bariatric Center of Excellence.

Report the analysis from a single center series of consecutive primary sleeve gastrectomy (SG) on the factors affecting weight loss at long term. Patients submitted to primary SG with a follow-up of 7years were screened. Weight loss was evaluated with %excess weight loss (%EWL) and %excess BMI loss (%BMIL). Weight regain (WR) was defined as in increase of 25% of the obtained %EWL and insufficient weight loss (IWL) as loss < 50% EWL. Eating behaviors were evaluated with 7days record (7dR). All the variables potentially affecting the weight loss were cross-matched for correlation. The study population was divided in three groups: group A (WR), group B (IWL), and group C (sustained weight loss) for comparative analysis. A total of 86 patients (21 M/65 F) with a preoperative BMI of 47.08 ± 6.15kg/m2 were evaluated. Cumulative 7years weight loss was as follows: 61.66 ± 22.69% EWL and 32 ± 9% EBMIL. A total of 4.6% had an IWL while 27.9% a WR. The analysis showed a significant difference among the daily calories and fats consuming, number of meals, physical activity, grazing/sweet eating habits, and adherence to follow-up (p< 0.05) between groups A and C. Cox hazard demonstrated a significant risk (p< 0.05) to WR in case of adherence to follow-up shorter than 48months, high daily calories, and fats intake (hazard ratio (HR) range 5-9). Eight patients (9.3%) had a surgical revision. Our data demonstrated that long-term results (7years) of SG are strongly related to eating habits and patient's behaviors.

One Size Does Not Fit All: Sociodemographic Factors Affecting Weight Loss in Adolescents.

Successful lifestyle changes for weight reduction are heavily dependent on recognizing the importance of societal and cultural factors. Patients 13–19 years of age with a BMI ≥95th percentile are eligible for our multidisciplinary adolescent weight loss clinic. A behavioral questionnaire was administered at the initial visit. Patients were seen every 4–6 weeks. Bivariate analysis was used to identify sociodemographic factors associated with differences in weight loss. Overall, receiving reduced cost meals was associated with a lower likelihood of losing weight (kg) (p < 0.01). When stratified by race, White adolescents were more likely to lose weight if caretakers reported having enough money to buy healthy food (p < 0.05); in contrast, Black adolescents were less likely to lose weight (p < 0.05). However, Black patients were more likely to lose weight if they reported eating fruits and vegetables (p < 0.05). Female adolescents were more likely to lose weight if they felt unhappy about their appearance (p < 0.05). Interestingly, male adolescents were less likely to lose weight if they felt unhappy about their appearance (p < 0.05). Social and cultural norms influence weight loss in adolescents in unique and differing ways. Culturally competent individualized interventions could increase weight loss in diverse groups of adolescents with obesity.

What Factors Affect Changes in Body Composition and Swallowing Function in Patients Hospitalized for Oral Cancer Surgery?

PurposeThere are few studies about sarcopenia before and after surgery for oral cancer. Therefore, we examined body composition during hospitalization and factors affecting weight loss, skeletal muscle mass index (SMI) reduction, and swallowing function at discharge in this patient group.Patients and MethodsA prospective survey was conducted at Tokyo Medical and Dental University Dental Hospital for patients who underwent primary surgery for oral cancer and reconstruction using free flaps. We compared body weight, SMI, grip strength, and walking speed at admission and discharge. We also examined factors affecting weight loss and SMI reduction and the functional oral intake scale (FOIS) score at discharge.ResultsThere were 26 patients that we could survey during the period. As a result of Wilcoxon’s signed-rank test, body weight, SMI, and grip strength were significantly reduced during hospitalization, but no reduction was noted for sarcopenia. As a result of multiple regression analysis, postoperative chemoradiotherapy was a risk factor for weight loss, reduced SMI, and low FOIS score at discharge.ConclusionPostoperative chemoradiotherapy is a risk factor for weight loss, muscle mass loss, and dysphagia at discharge, and chemoradiotherapy may affect rather than an invasion of surgery. After surgery, besides follow-ups for cancer, oral cancer patients should be followed up to assess dysphagia, undernutrition, and sarcopenia.

Service evaluation of the effectiveness of hospital based weight management services in the one to one outpatient and group settings

Background: Obesity levels continue to rise in the UK and the cost to the NHS is predicted to be more than £6 billion by 2015 if no action is taken to address this trend. Weight management services, given either in one-to-one clinic appointments or within a group setting, need to be evaluated to determine which system is more effective in terms of weight loss per patient and the cost to the National Health Service. This service evaluation is a preliminary investigation of the effectiveness of weight loss clinics compared with a group weight-loss programme. Methods: Data were collected on patients referred for weight management over a 15-month period from August 2009 to November 2010, attending either a general adult dietetic outpatient clinic (one-to-one) or the hospital's ‘Healthy Choice Group Programme’ (HCGP). The one-to-one clinic setting offered an initial dietetic appointment of 30 min and follow-ups of 15 min duration. The HCGP offered 10 weekly sessions of 90 min in duration. The gender, weight (kg), type of appointment and outcome of appointments were collected. The number of patients per pathway who had weight changes (defined as weight loss ≥−0.1 kg; weight gain ≥+0.1 kg) were compared with the National Institute of Health & Clinical Excellence (NICE) Guidelines for Obesity (2006), which recommend a maximum 0.5–1 kg per week weight reduction for long-term weight loss for adult patients. An unpaired t-test was used to compare weight change between the two services and chi-squared was used to observe change related to weight change defined between the two services. Results: Sixty-six percent (n = 67/102) of patients in one-to-one clinics were female and 52% of all patients showed weight change. The average weekly weight change was −0.4 kg, −0.2 kg, −0.1 kg and 0 kg for the 1st, 2nd, 3rd and 4th follow-up appointments, respectively. For the HCGP, 79% (n = 188/239) were female and 60% of all patients showed a weight change. The average weekly weight change was −0.4kg, −0.2kg, −0.3kg and −0.1kg for the 1st, 2nd, 3rd and 4th follow-up appointments, respectively. The average weekly weight loss for the remaining five follow-up HCGP sessions ranged from 0 kg to −0.2 kg. There was no significant difference (P > 0.05) in mean weight loss between the interventions but the chi-squared test showed significant difference between the services with more patients in the groups losing weight than in the clinic (P = 0.001). Table 1. Total weight change comparing one-to-one with Healthy Choice Group Programme Weight management session Patients with weight loss Patients with weight gain Patients with weight stable n (%) Total (kg) Mean (SD) (kg) n (%) Total (kg) Mean (SD) (kg) n (%) Outpatient clinic (one-to-one) (n = 63) 44 (70) −261.7 −5.9 (7.7) 19 (30) 66.5 3.5 (3.7) 0 (0%) HCGP (n = 143) 105 (73) –318.4 –3.0 (3.8) 32 (23) 97.6 3.1 (8.8) 6 (4%) Data presented on all patients who attended at least twice and excludes non-attendees. Discussion: The preliminary data from both services showed that the weekly weight changes were below the level recommended by the NICE guidelines. Although, on average, the mean (SD) weight loss was greater among patients attending the clinic compared to the groups [−5.9 (7.7) kg; −3.0 (3.8) kg, respectively], this difference was not statistically significant. Additionally a higher percentage of patient lost weight in the HCGP (60%) compared with those attending the one-to-one clinic service (52%) which was also confirmed by the chi-squared test. Conclusions: The average weekly weight changes for both the outpatient clinic and HCGP services were below the level recommended by the NICE guidelines for long-term weight management. A downward trend was also evident in the amount of weight lost across the follow-up sessions for both services. A similar percentage of patients achieved weight loss in the outpatient and HCGP sessions; however, the mean weight loss was greater in the one-to-one clinic sessions compared to the HCGP. Further work is needed to investigate factors affecting weight loss in patients such as readiness and motivation to change and the level of understanding of the importance of weight reduction to overall health. Additional research should also investigate whether a mixed intervention can achieve weight loss in more patients. Reference: NICE (2006) Obesity: Guidance on the Prevention, Identification, Assessment and Management of Overweight and Obesity in Adults and Children. Clinical Guideline 43. London: NICE (accessed 30 March 2011).

Differences in outcomes of laparoscopic gastric bypass

Background Although several risk factors affecting weight loss outcomes with bariatric procedures have been identified, the effect of age, gender, race, and illness severity on postoperative outcomes of laparoscopic gastric bypass has not been extensively examined. Methods The University HealthSystem Consortium database is an administrative and financial database that provides information on the inpatient stay. A retrospective analysis of patient outcomes was performed using 4-year discharge data from the University HealthSystem Consortium database. Results A total of 37,765 patients underwent laparoscopic gastric bypass. The women exhibited significantly reduced mortality, morbidity, intensive care unit (ICU) admissions (9.87% male versus 6.73% female; P <.001), duration of hospitalization (2.72 ± 4.03 d for men versus 2.59 ± 2.88 d for women; P <.001), and hospital costs ($17,346 ± $15,397 for men versus $14,383 ± $11,170 for women; P <.001). Blacks demonstrated significantly greater 30-day readmission rates, duration of hospitalization, and costs compared with whites. Hispanics had lower ICU admission and hospital costs compared with whites. With increasing age, an increased risk of overall morbidity, ICU admissions, duration of hospitalization, and costs was observed. Compared with the minor severity group, the major/extreme severity group had significantly greater observed mortality, overall morbidity, ICU admissions, duration of hospitalization, and hospital costs. Conclusion The present study identified gender, race, age, and illness severity as risk factors affecting postoperative outcomes after laparoscopic gastric bypass. Male gender and increasing age were overall associated with an increased risk of complications. Significant racial disparities in the outcome measures were observed with blacks having an increased risk of adverse events. Illness severity was shown to adversely affect the surgical outcomes in laparoscopic gastric bypass.

Towards evidence‐based practice: The role of the dietitian in the management of diabetes

Towards evidence‐based practice: The role of the dietitian in the management of diabetes

Factors affecting weight loss in obese Type 2 diabetes — the vital role of the dietitian

AbstractWe investigated 56 newly presenting Type 2 diabetics who were significantly overweight (BMI &gt;27.0). Patients were given standard management and observed for a six month period. They were then divided into ‘good weight losers’ (13 patients who lost 10% or more of initial body weight) and ‘poor weight losers’ (19 patients who lost 3% or less of initial body weight). When the two groups were compared, there was no dimrence in age, sex ratio, initial body weight, marital status, sociai class, smoking, drinking, exercise and use of oral hypoglycaemic agents. Good weight losers, however, had significantly more visits to clinic (4.0 ± 1.0 v. 3.1 ± 1.1, p&lt;0.05), and particularly to the dietitian (5.2 ± 2.3 v. 2.9 ± 1.2, p&lt;0.005) during the six month period. Obese Type 2 diabetics should thus ideally see dietitians on a monthly basis during the immediate post‐diagnosis period.