Status Of Bariatric Surgery Research Articles

Maladaptive Eating Behaviours, Generalised Anxiety Disorder and Depression Severity: A Comparative Study between Adult Women with Overweight, Obesity, and Normal Body Mass Index Range.

(1) Background: Causes of obesity are multifactorial and include genetic predisposition as well as behavioural, psychological, social, and hormonal influences. We aimed to compare adult women with normal weight, overweight, and obesity, with a focus on maladaptive eating behaviours, the presence of generalised anxiety disorder, and the severity of depression. Additionally, we explored the context of anti-obesity pharmacotherapy and the status of bariatric surgery. (2) Methods: The sample was composed of 1105 adult women. The following measures, through the Computer-Assisted Web Interview (CAWI), were used in the present study: the Three Factor Eating Questionnaire (TFEQ-R18), the 7-item Generalised Anxiety Disorders Scale (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9). (3) Results: All domains of the TFEQ-R18 had correlations with Body Mass Index (BMI). There was a weak negative association between BMI and Cognitive Restraint (r = -0.172, p < 0.001) and a weak positive relationship between BMI and Uncontrolled as well as Emotional Eating (r = 0.165, p < 0.001; r = 0.191, p < 0.001, respectively). Women who screened positive for anxiety scored lower in the Cognitive Restraint domain (10.11 ± 3.58, p = 0.042) and higher in the Uncontrolled Eating (12.69 ± 6.04, p < 0.001) and Emotional Eating (5.29 ± 2.75, p < 0.001) domains. Similarly, women screening positive for depression had lower scores in Cognitive Restraint (9.88 ± 3.61, p < 0.001) and higher scores in Uncontrolled Eating (12.64 ± 6.09, p < 0.001) and Emotional Eating (5.31 ± 2.71, p < 0.001). A significant association between liraglutide and semaglutide administration and Cognitive Restraint was observed. (4) Conclusions: Individualised treatment for obesity should consider the existing and confirmed association between maladaptive eating behaviours and generalised anxiety disorder, as well as the severity of depression influencing the BMI altogether. The use of anti-obesity pharmacotherapy needs further exploration because the evidence for the use of liraglutide and semaglutide in terms of positive associations with eating behaviours is encouraging.

Bariatric Surgery in Cebu, Philippines: Current Status and Initial Experience With Laparoscopic Sleeve Gastrectomy.

BackgroundThe prevalence of obesity in the Philippines has increased more than three-fold over the last two decades. However, bariatric surgery has not been widely adopted yet in the country. Local data mainly on laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB) are limited as well. We report for the first time our experience with laparoscopic sleeve gastrectomy (LSG) and present the current local status of bariatric surgery in Cebu, Philippines.Patients and methodsThis is a retrospective study of all patients 18 years old and above who underwent LSG in a single, private, tertiary institution during the period 2009 - 2019. Our primary endpoint was weight loss after LSG. Secondary endpoint was postoperative complications.ResultsThirty-three patients (mean age 40.9 ± 14.5 years) underwent LSG. Baseline weight and BMI were 112.6 ± 29 kg and 41.3 ± 8.6, respectively. The mean operative duration was 201 ± 72.9 minutes. The were no open conversions with minimal morbidity. Mean hospital stay was 3.7 ± 0.9 days. The postoperative mean weight and BMI after one year were 68.9 ± 17 kg and 26.6 ± 6, respectively. Overall, mean excess weight loss (EWL) was 61.9 ± 44.1 % at a median follow-up of 5.4 months. Significant weight loss was noted after the third month.Conclusion LSG is a safe and effective method in producing weight loss. It can be a definitive treatment option as local prevalence of obesity is increasing in the Philippines. However, access to and the practice of bariatric surgery remains limited in the country. A collaboration among private and government stakeholders is essential.

BARIATRIC SURGERY IN BRAZILIAN PUBLIC HEALTH SYSTEM: THE GOOD, THE BAD AND THE UGLY, OR A LONG WAY TO GO. YELLOW SIGN!

ABSTRACTBackground:In Brazil, there has been a significant increase in obesity rates in all age groups. Data from 2017 show that obesity affects 19% of the population. Due to the magnitude of the problem, public health policies have aimed to prevent complications related to obesity by increasing the offerfor bariatric surgeries. Aim:To analyze the current status of bariatric surgery performed in the Brazilian public health system, including data from macroregions and also the effect of digestive surgery training on the number of procedures. Methods:The database of the public health registry (DATASUS) was assessedbetween 2008 and 2018 for descriptive analysis of data and evaluation of the selected parameters. The main surgical techniques, comorbidities, mortality and the costs profile of the system were evaluated. Results:There was a 339% increase in the number of bariatric surgeries in the period evaluated. Gastric bypass was performed in 94% of cases whereas sleeve in 2.4%. Other techniques were used in 3.6%. There were discrepancies in the number of surgeries performed in different regions of the country. Conclusion:There was a considerable advance in the number of bariatric surgeries performed by the public health system between 2008 and 2018. However, there is a need to increase the offer of this service and alsospecialized training, as well as a correction in the distribution of these procedures in the national territory to achieve integrality among its users.

Present status of bariatric surgery in Poland.

IntroductionThe first survey of bariatric surgery in Poland was published in 2007. New trends are observed worldwide, and there is a current need to investigate the status of bariatric surgery in Polish institutions. This survey was initiated to gain an overview of Polish bariatric surgery during 2007–2014.AimTo analyze the number and types of bariatric procedures performed in Polish institutions in 2014 and to perform a trend analysis from 2007 to 2014.Material and methodsA questionnaire regarding the numbers and types of bariatric procedures performed between 2007 and 2014 was e-mailed to all members of the Bariatric Society (a branch of the Association of Polish Surgeons) and to 28 surgical departments. Trend analyses from 2007 to 2014 were performed.ResultsAmong the surgical departments, 16 (57%) responded. The results showed that 1499 bariatric procedures were performed in Poland in 2014, with 96.4% done laparoscopically. The highest number was from Masovian Voivodeship. The most commonly reported procedures were laparoscopic sleeve gastrectomy (LSG) (60.7%), followed by laparoscopic Roux-en-Y gastric bypass (19.2%), mini gastric bypass (11.1%), and adjustable gastric banding (7.6%). Most significant was the rise in prevalence of LSG from 8.0% to 60.4% of the total bariatric procedures from 2007 to 2014.ConclusionsLaparoscopic sleeve gastrectomy is currently the most frequently performed bariatric procedure in Poland. The accuracy of the national survey of procedures would be enhanced if we could create a national registry.

The State of Bariatric Surgery in Canada.

Obesity is estimated to affect at least one in five adults in Canada, and it poses a significant population health challenge. Obesity increases the risk of other chronic health conditions such as type 2 diabetes and hypertension. Many interventions can help individuals with obesity lose weight and improve their quality of life including lifestyle changes, medical counselling and medication, and evidence shows that bariatric surgery is another tool that can be used to achieve significant weight loss. Improved access to bariatric surgery is an identified priority in several provinces. Administrative data on bariatric surgeries performed in Canadian hospitals are captured in the Canadian Institute for Health Information’s Discharge Abstract Database, Hospital Morbidity Database and National Ambulatory Care Reporting System, and provides information on important aspects of a patient’s hospital care. The analysis presented here is an update to our report released in May of 2014 (available free of charge at https://secure.cihi.ca/estore/productFamily. htm?locale=en&pf=PFC2609). Almost four out of five (78%) individuals who undergo bariatric surgery are women. The typical patient is in her forties and has obesity, as well as other conditions such as diabetes, hypertension or sleep disorders. These characteristics have remained relatively consistent since 2006–2007. In total, 6,525 bariatric surgeries were performed in Canadian hospitals in 2013–2014. The volume of surgeries has increased more than four-fold over the past seven years, and this reflects the efforts of governments to expand access. Capacity has greatly increased in Ontario, where almost half (43%) of all surgeries are currently performed, as well as in other provinces including Quebec. Gastric bypass (3,158 surgeries in 2013–2014) is currently the most common type of bariatric procedure performed in Canadian hospitals. Recent increases in the number of sleeve gastrectomy procedures have been paralleled by decreases in the number of gastric banding procedures (410 and 1,112 surgeries in 2009–2010 compared to 2,362 and 702 surgeries in 2013–2014, respectively). Additionally, the surgical approach has changed over time as almost all (98%) bariatric surgeries are now performed laparoscopically compared with 65% in 2006–2007. In 2013–2014, 5% of bariatric surgery patients experienced complications during their hospitalization for the surgery and 5% were readmitted to hospital within 30 days of discharge. Complication and readmission rates have shown steady declines over time. Some patients show a noticeable increase in their pattern of healthcare utilization in the years following bariatric surgery. This may be due to follow-up care directly related to their surgery or may represent deferred procedures such as joint replacements or hernia repairs that could not be provided to patients prior to significant weight loss. Studies with longer follow-up periods will help to clarify how bariatric surgery affects long-term healthcare utilization and the associated costs. Bariatric surgery can be an effective treatment for obesity and its related comorbidities. Variation in public coverage and capacity across jurisdictions will continue to shape the evolving landscape of bariatric surgery in Canada.

Assessment of the State of Bariatric Surgery in Canada: Prospective and Retrospective Approaches

s / Can J Diabetes 39 (2015) S38eS74 S69 on the rise over the last 2 decades in Canada. What is troublesome is that these conditions are influenced by a small set of wellestablished, modifiable causes such as an unhealthy diet, and lack of physical activity. Community-based health education interventions seem to have better impact on increasing men’s health literacy and motivation for healthy lifestyle. However, few studies have explored the effectiveness of these interventions among Canadian men. Objectives: 1) to assess the acceptability and feasibility of a community-based intervention aiming to promote healthy practices among men; and 2) to develop a set of recommendations to support men-sensitive healthcare decision making. Methods: Qualitative study using semi-structured interviews with 15 health professionals and 3 focus groups with overweight/ obese men. Verbatim were analyzed using a thematic content analysis. Results/Conclusion: Men-sensitive interventions need to include: 1) health information that is easily retrievable, actionoriented and delivered in simple and concise terms; 2) involve peers, friends and family; 3) shared decision making, comprehensiveness of care, informational continuity, support and humanity practices; 4) awareness campaign and information to address prejudice related to hegemonic masculinity; 5) interventions must be easily integrated into daily life, thus suggesting the inclusion of workplaces and flexible hours; and 6) healthcare managers and Health professionals continuing educational sessions on men’s health needs and expectations. We propose a men-sensitive educational intervention to guide future interventions and research on weight control and management in men.

Are There Gender-Specific Aspects in Obesity and Metabolic Surgery? Data Analysis from the German Bariatric Surgery Registry

Background: Since January 2005, the status of bariatric surgery in Germany has been examined in conjunction with a quality assurance study of the German Bariatric Surgery Registry (GBSR). All data are registered prospectively in cooperation with the Institute for Quality Assurance in Surgical Medicine at the Otto-von-Guericke University Magdeburg, Germany. Methods: Data are registered in an online database. Data collection on obesity and metabolic surgery is voluntary, and was started in 2005. In addition, follow-up data are collected once a year. Results: Since 2005, 8,293 sleeve gastrectomies, 10,330 Roux-en-Y gastric bypass procedures, and 3,741 gastric banding procedures have been performed in Germany, according to the data of the GBSR. Mean age and mean body mass index of female patients with gastric banding, sleeve gastrectomy, or Roux-en-Y gastric bypass were significantly lower than those of male patients. The incidence of relevant comorbidities was significantly higher in male than in female patients. Conclusion: Metabolic and obesity surgery is becoming more and more popular in Germany. Data from the GBSR study show significant differences in preoperative comorbidities and postoperative complication and mortality rates between male and female patients. There is a need for further evaluation of gender-specific aspects to optimize patient selection and reduce specific postoperative complications.

Current status of bariatric surgery in Japan and effectiveness in obesity and diabetes

The rate of obesity in Japan, defined as having a body mass index (BMI) of 25 kg/m2 or greater, is reportedly at 24 %, a lower level of severe obesity than in the EU and US. However, the incidence of obesity-related health problems is reportedly higher among Asians. Laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric surgery in Japan and accounted for 54 % of such surgeries in 2011; procedures such as laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass (LRYGB), practiced frequently worldwide, were uncommon. Possible reasons include concern over delayed postoperative discovery of gastric cancer in LRYGB, and rapid adoption of the comparatively simple LSG procedure. In type 2 diabetes mellitus (T2DM) patients, where continued pursuit of medical treatment is difficult and a potential exists for future deterioration of diabetes-complicated diseases, the criterion for surgical indication in the EU and US is a BMI of 30–35 kg/m2, with priority given to BMI >35 kg/m2. For Asian patients, the recommendation is to lower this indication criterion by 2.5 kg/m2. Efficacy of metabolic surgery is anticipated particularly among T2DM patients with obesity complication, a short history of insulin treatment, and intact insulin secreting ability, and in these cases bariatric surgery should be contemplated.

Current State of Laparoscopic Roux-en-Y Gastric Bypass as a Surgical Treatment Modality for Morbid Obesity in Adolescents

th percentile tend to become obese adults with more health complications and a higher mortality rate than those who become obese in adulthood, therefore, obesity brings major concerns to medical providers and parents [1]. Even though bariatric surgery is not a permanent cure for obesity, it has been proven to improve obesityrelated co-morbidities in children, who have failed multiple nonoperative weight loss methods [2]. The use of bariatric surgery in older children is still not universally accepted, and data on this treatment modality is lacking. In order to investigate the current state of bariatric surgery in pre-adult population, we designed a meta-analytic study to evaluate the current state of laparoscopic roux-en-y gastric bypass (LRYGB) as treatment modality for morbidly obese adolescents. Using PubMed, MEDLINE, and CHINAHL databases, a systematic review of most current and relevance articles from 2003 to 2012 was performed. A total 7 full articles were studied. Keywords used were adolescent, children, outcomes, and bariatric surgery. Improvement of obesity-related co-morbidities was emphasized in order to objectively evaluate the benefits of laparoscopic gastric bypass in morbidly obese adolescents.

The Current Status of Bariatric Surgery in Korea

The Current Status of Bariatric Surgery in Korea

Bariatric surgery in Singapore from 2005 to 2009

Obesity is a major public health concern worldwide, including Singapore. Bariatric surgery has grown in popularity to combat this situation, and innovations in this field have led to the emergence of new bariatric procedures. For the healthy growth of this specialized field of surgery, it is mandatory to audit the progress and state of bariatric surgery at regular intervals. An e-mail questionnaire survey was conducted in all the leading hospitals of Singapore practicing bariatric surgery between 2005 and 2009. All four hospitals to which the questionnaire survey was mailed responded. The responses from these hospitals were tabulated and analyzed. Between 2005 and 2009, a total of 278 bariatric procedures were performed on 151 men and 127 women with a mean age of 40.34 years (range: 18-64 years) by 12 practicing surgeons. The mean body mass index was 42.25kg/m(2) (range: 31.4-73kg/m(2)). All the operations were performed laparoscopically. The most commonly performed procedure was adjustable gastric banding (81.65%), followed by sleeve gastrectomy (13.66%) and Roux en Y gastric bypass (3.95%). There is a flux of newer procedures in Singapore. Adjustable gastric banding, which was the only available procedure being performed in 2004, was gradually being replaced by other procedures such as sleeve gastrectomy and Roux-en-Y gastric bypass in 2009.

3. Current Status of Bariatric Surgery.

3. Current Status of Bariatric Surgery.

A Nationwide Survey on Bariatric Surgery in Germany—Results 2005–2007

Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined since January 1st, 2005 with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg (Germany). In this prospective multicenter observational study, the data obtained for all primary bariatric procedures, including all repeated operations, performed on consecutive patients with morbid obesity at participating hospitals from 2005 to 2007 were prospectively collected using an Internet online data registry. In particular, perioperative characteristics, such as the spectrum of diagnostic measurements, type of surgical procedures, and short- and long-term outcomes, were investigated. During the study period, 629 surgical procedures were performed at 21 hospitals in 2005, 828 procedures at 32 hospitals in 2006, and 1,666 procedures at 35 hospitals in 2007. In 2005 and 2006, gastric banding was the most frequently performed operation, followed by the Roux-en-Y gastric bypass (RYGBP). In 2007, a RYGBP was carried out in 42.1% of all bariatric procedures. Among all patients, 74.4% were female. The mean body mass index (BMI) was 48.5 kg/m(2) in 2005, 48.4 kg/m(2) in 2006, and 48.0 kg/m(2) in 2007. Follow-up data after 12 months were available for 63.8% of the patients in 2005 and 2006; these data showed greater reduction of BMI after malabsorptive rather than restrictive bariatric procedures. The mortality was 0.1% (30 days) and 0.16% (overall). As indicated by the worldwide trend, there is an ongoing change from restrictive bariatric procedures to malabsorptive procedures and sleeve gastrectomy. Although the BMIs of German patients undergoing bariatric surgery appear to be substantially higher than those of patients from most other countries, there were no differences in intraoperative and short-term complications or in overall outcomes during follow-up when compared with published studies.

Laparoscopic Bariatric Surgery in Asia

Abstract:Often coexisting in developing countries with under‐nutrition, obesity is a complex condition, with serious medical, social, psychological and economic implications1. This has led to the dual burden of fighting against both under and over‐nutrition. It is widely recognized today that bariatric surgery is the only safe and effective approach to treatment of morbid obesity5. This article discusses the scope, evolution and current status of Bariatric Surgery in Asia

Bariatric surgery: further study is needed into the effects on type 2 diabetes

Practical Diabetes InternationalVolume 22, Issue 1 p. 8-8 CommentaryFree Access Bariatric surgery: further study is needed into the effects on type 2 diabetes CR Lemmon, P Barbeau. Bariatric surgery for the obese diabetic patient: the effect on type 2 diabetes and important psychological considerations. Pages 3–7 First published: 29 March 2005 https://doi.org/10.1002/pdi.730AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat As the founder of WLSinfo an information and support source for patients who have had or are considering bariatric surgery, I was delighted to be asked to provide a commentary on the article by Lemmon and Barbeau. Bariatric surgery is on the increase in the UK and, though no definitive statistics exist, anecdotal experience suggests an exponential growth in the last four years. At WLSinfo we have over 1600 members and over 16 support groups around the UK. The effect of surgery on diabetes has been known for many years1 though its rapid effects seem to indicate mechanisms beyond weight loss. I have discussed with many diabetic surgery patients their experiences and have encountered a large number of anecdotal reports of profound reduction in hypoglycaemic medication, increased control and general overall health benefits. This is clearly a relationship which needs further exploration.2 As both a mental health nurse and gastric bypass patient myself, I would concur that the incidence of mental health problems in this client group is higher than in the general population. My personal experience suggests that those patients with the best pre-operative information and post-operative support have the best outcomes, though this would be worthy of further investigation. In conclusion, I welcome this work pointing towards the need for further investigation of the effect of bariatric surgery on type 2 diabetes. In addition, there is a requirement for the establishment of complete multidisciplinary teams (including psychologists) at specialist tertiary NHS centres around the UK. Ken Clare, RMN, RGN, is the founder of WLSinfo (online at http://www.wlsinfo.org.uk). He had a gastric bypass in September 2002 References 1Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995; 222(3): 339– 350; discussion 350–352. 2Pinkney J, Kerrigan D. Current status of bariatric surgery in the treatment of type 2 diabetes. Obes Rev 2004; 5(1): 69– 78. Volume22, Issue1January/February 2005Pages 8-8 ReferencesRelatedInformation

A Primer on Bariatric Surgery: Treatment of Last Resort for Morbid Obesity

Morbid obesity represents the highest risk state of a growing national problem that is eminently preventable and therefore highly relevant to the disease management community. The obesity epidemic, the failure of conservative treatments to achieve long-term weight loss and heightened media attention to positive short-term results of bariatric procedures among national celebrities has resulted in a dramatic increase in the number of surgeries performed every year. Familiarity with the clinical issues surrounding morbid obesity and bariatric surgery is therefore essential to the disease management community. This paper reviews the state of bariatric surgery, common surgical approaches, their effectiveness, complications, impact on co-morbidities, cost and evolving insurance coverage policies. I also will propose a proactive approach to arrest disease progression to morbid obesity.

Current status of bariatric surgery in the treatment of type 2 diabetes.

Bariatric surgery (from the Greek words baros meaning 'weight' and iatrikos 'the art of healing') is a rapidly evolving branch of surgical science. The aim is to induce major weight loss in those whose obesity places them at high risk of serious health problems. In an attempt to balance the risks of surgery against the benefits of weight loss, bariatric operations are currently performed only in the morbidly obese, or those with a body mass index (BMI) > 35 kgm(-2) who already have developed comorbidity such as type 2 diabetes. Although weight loss is beneficial for obese patients with diabetes, current medical treatment for obesity is difficult. In contrast, observational studies show a major impact of bariatric surgery on diabetes, raising the question whether this approach should be used more widely to treat diabetes in obese patients? If bariatric surgery were shown to be the best way to treat diabetes in obese subjects the implications for health services would be wide-ranging. Bariatric surgery leads to withdrawal of diabetic treatment in about 60% or more of patients, and reductions of therapy for many others. Although data on bariatric surgery in subjects with diabetes are provocative, most studies have been uncontrolled or flawed in other ways. Most importantly, bariatric surgery has not yet been compared against standard medical treatment for diabetes in randomized controlled trials with diabetes-specific endpoints in all relevant patient groups. Potential indications for bariatric surgery are discussed, and the unanswered questions that need to be addressed by clinical trials are summarized. Although small numbers of patients may be interested in bariatric surgery for type 2 diabetes, current data are insufficient to endorse its wide scale use for this indication. Until essential studies are undertaken the role and economics of bariatric surgery in the diabetic clinic will remain uncertain.

Cost-effective bariatric surgery in Germany today.

The reason for this inquiry was to assess the actual state of Bariatric Surgery in Germany, especially relating to the much discussed economic aspect. A questionnaire was sent to those hospitals in Germany in which we knew that obesity surgery was performed, concerning the year 1997. To our regret, the feedback was only 37%, although this must be considered an adequate response for Germany. Nevertheless, some interesting trends are easily seen. Bariatric Surgery in Germany could pay for itself by saving the costs associated with conservative therapy and preventing co-morbidities in patients with morbid obesity.