Weight Loss In Group Research Articles

Laparoscopic Conversion of Vertical Banded Gastroplasty to Roux-en-Y Gastric Bypass Gives Better Result Compared to an Open Approach.

Vertical banded gastroplasty (VBG) has a relatively high failure rate in the long run, requiring revisional surgery in 30-65%. A common conversion option is to Roux-en-Y gastric bypass (RYGB), which can be performed laparoscopically or open. Current literature contains small cohorts and inconclusive results. Therefore, we set out to compare our series of open and laparoscopic VBG to RYGB conversions. All conversions performed between 1996 and 2020 were included. Patients were divided into 3 groups based on conversion indication: weight recurrence (group 1), excessive weight loss (group 2), and eating/pouch difficulties (group 3). The primary outcome was postoperative complications according to the Clavien-Dindo (CD) classification. Secondary outcome was %total weight loss (%TWL) 1 to 5 years after revisional surgery. We included 205 patients (84.9% female) of whom 105 underwent laparoscopic and 100 open VBG to RYGB conversion. Twenty-three short-term complications occurred in the laparoscopic group, with 16 > CD3a. In the open group, 33 complications occurred with 12 > CD3a. Overall complications were 33.3% in laparoscopic and 64% in open patients. There were no significant differences between the laparoscopic and open group in BMI (p = 0.76) and %TWL (p = 0.694) after 5 years. After 5 years, lost to follow-up was 97% in the open group. Twenty-eight percent of patients who reached follow-up in the laparoscopic group had available data. We demonstrate that the overall complication rate is lower in the laparoscopic group compared to the open group. Regarding BMI, an improvement was achieved in both groups after 5 years.

Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study

AimsWeight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. MethodsThis was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. ResultsWeight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93–2.16), 1.21 (95% CI, 1.16–1.25), 1.12 (95% CI 1.08–1.17), and 1.60 (95% CI, 1.49–1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. ConclusionsIn a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.

The Impact of BMI Changes on the Incidence of Glomerular Hematuria in Korean Adults: A Retrospective Study Based on the NHIS-HEALS Cohort

Obesity and recurrent hematuria are known risk factors for chronic kidney disease. However, there has been controversy on the association between obesity and glomerular hematuria. This study aimed to investigate the association between body mass index (BMI) and weight change and recurrent and persistent hematuria in glomerular disease using a large-scale, population-based Korean cohort. Data were collected from the National Health Insurance Service-National Health Screening Cohort. Cox proportional hazards regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for recurrent and persistent hematuria in glomerular disease according to the BMI group. Compared with the BMI 23-25 kg/m2 group, the HR (95% CI) for incident recurrent and persistent hematuria in glomerular disease was 0.921 (0.831-1.021) in the BMI <23 kg/m2 group, 0.915 (0.823-1.018) in the BMI 25-30 kg/m2 group, and 1.151 (0.907-1.462) in the BMI ≥30 kg/m2 group. Compared with the stable weight group, the HRs (95% CIs) for incident recurrent and persistent hematuria in glomerular disease were 1.364 (1.029-1.808) and 0.985 (0.733-1.325) in the significant weight loss and gain groups, respectively. Despite adjusting for confounders, this result remained significant. Baseline BMI was not associated with the risk of incident recurrent and persistent hematuria in glomerular disease. Weight loss greater than 10% was associated with the incidence of recurrent and persistent hematuria in glomerular disease. Therefore, maintaining an individual's weight could help prevent recurrent and persistent hematuria in glomerular disease in middle-aged and older Korean adults.

The feasibility of a telephone-based weight loss intervention in rural Ohio: A pilot study.

Weight loss through lifestyle modification can produce health benefits and may reduce cancer risk. The goal of this study was to examine the feasibility of and adherence to a 15-week telephone-based weight loss intervention in rural Ohio, an area with high rates of obesity. This pilot 2-arm randomized controlled study was designed for rural Ohio residents who were overweight or obese. Eligible participants were 2:1 randomly assigned to either a 15-week weight loss intervention group or active control group. The weight loss intervention group received weekly telephone sessions to improve healthy diet and increase physical activity. The active control group received education brochures with information on physical activity and dietary guidelines. Feasibility was defined as at least 80% of participants completing the follow-up surveys, and acceptable adherence was defined as the percentage of participants in the weight loss group who attend ≥75% of weekly telephone sessions. A total of 423 individuals entered the online screening survey, 215 (50.8%) completed the survey, and 98 (45.6%) of those were eligible. Forty eligible individuals were enrolled and randomly assigned to the weight loss group (n = 27) or active control group (n = 13). The average age of the weight loss group was 49 (SD = 10) years, and 89% were female. The average age of the active control group was 51 (SD = 9) years, and 92% were female. Feasibility was demonstrated: 90% of participants completed the online follow-up surveys at 15-weeks. Among participants in the weight loss group, 22 out of 27 (81.5%) completed the 15-week intervention, the average number of sessions attended was 9.7 (64.9%). Adherence to the intervention was rated as acceptable among almost half of the group (48.1%). Feasibility of a 15-week telephone-based weight loss study among rural residents with overweight/obesity were determined. A future study will test this intervention for weight loss efficacy.

Weight Changes in Young Service Members After Lower Limb Amputation: Insights From Group-Based Trajectory Modeling.

Weight gain can contribute to osteoarthritis, cardiovascular disease, low back pain, and poor health-related quality of life. Weight trajectory patterns have been described in older veterans with limb loss; however, there is limited evidence of changes in weight in younger veterans with limb loss. Service members with unilateral or bilateral lower limb amputations (LLAs) (and without an upper limb amputation) were included in this retrospective cohort analysis (n = 931). The mean postamputation baseline weight was 78.0 ± 14.1 kg. Bodyweight and sociodemographic data were extracted from clinical encounters within electronic health records. Group-based trajectory modeling assessed weight change patterns 2 years postamputation. Three weight change trajectory groups were identified: 58% (542 of 931) of the cohort had stable weight, 38% (352 of 931) had weight gain (mean gain = 19.1 kg), and 4% (31 of 931) had weight loss (mean loss = 14.5 kg). Individuals with bilateral amputations were more frequently noted in the weight loss group compared with those with unilateral amputations. Individuals with LLAs because of trauma other than blasts were more frequently found in the stable weight group compared with those with amputations because of disease or a blast. Younger individuals (<20 years old) with amputations were more likely to be in the weight gain group compared with older individuals. More than half the cohort maintained a stable weight for two years after amputation, and more than a third experienced weight gain during the same time frame. Knowledge of underlying factors that were associated with weight gain could inform preventative strategies for young individuals with LLAs.

Re-sleeve gastrectomy: weight loss, comorbidities and gerd evaluation in a large series with 5years of follow-up.

Laparoscopic sleeve gastrectomy (SG) has rapidly become one of the most commonly performed procedures in bariatric surgery. Weight regain and insufficient weight loss are the most common causes for surgical failure. Re-sleeve gastrectomy (ReSG) can represent an option when there is evidence of a dilated gastric tube. The aim of the study is to evaluate safety, efficacy and rate of gastro-esophageal reflux disease (GERD) after ReSG in one of the largest series present in literature with long-term follow up. Retrospective study design. From February 2010 to August 2018, 102 patients underwent ReSG at our Centre. We divided patients into two groups, according to the main reason for surgical failure: insufficient weight loss or progressive weight regain. One hundred-two patients (78 women, 24 men) with BMI 38 ± 6kg/m2 underwent ReSG (mean age 44years). Rate of postoperative complications was 3.9% (4/102). After a mean follow-up of 55months, mean BMI decreased to 30,4kg/m2 and the mean percentage of excess weight loss (%EWL) was 51 ± 38.6. Symptoms of GERD were present in 35/102 patients (34.3%) and the need for a new operation occurred in six patients. Forty-five patients were submitted to ReSG for progressive weight regain (group A) and 57 for insufficient weight loss (group B). No differences were found in terms of postoperative BMI and %EWL. ReSG is a feasible procedure after primary SG failure in selected patients, but its efficacy in reducing the BMI under 30kg/m2 is still unclear. In addition, over 30% of patients suffer from long-term gastro-esophageal reflux.

Understanding the confluence of injury and obesity in a Grade 2 obesity and above population

ObjectiveObesity and injury are major inter-related public health challenges. The objective of this study was to explore the perceptions of injury in people with severe obesity. MethodsA cross-sectional design was employed to capture injury perception and lifestyle habits via questionnaires. Weight (kg) and height (m) were measured by clinicians for patients attending a weight loss group program. Univariate, chi-square, ANOVA and ordinal regression analyses were undertaken. ResultsThere were 292 participants (67.1% female), mean age 49.3 years and Body Mass Index 47.2 kg/m2 (range 30.7–91.9 kg/m2). Concern about having an injury was found in 83%, and 74.2% thought that weight would increase the likelihood of injury. A greater concern of being injured at baseline was associated with less weight loss at eight weeks (F=3.567; p=0.03). Depression, anxiety and sleepiness score were higher in those who reported greater ‘Concern about having an injury’. ConclusionsPeople with obesity fear injury and falling, which limits their willingness to exercise. Anxiety symptoms appear to exacerbate this connection. Implications for public healthIn individuals with obesity, anxiety, sleepiness and depression are associated with a fear of being injured. Addressing fear and reducing anxiety may decrease barriers to participating in physical activity.

Histological Skin Assessment of Patients Submitted to Bariatric Surgery: A Prospective Longitudinal Cohort Study.

Obesity is a stigmatizing disease that can cause dermatological aberrations, such as sagging after rapid weight loss. This study is to evaluate the effects of obesity and massive weight loss following bariatric surgery on collagen and elastic fibers of the extracellular matrix of the skin. Thirty-three skin biopsies were collected from patients prior to bariatric surgery and one year after surgery. Histological analyses were performed using hematoxylin-eosin and Weigert's resorcin-fuchsin staining for collagen and elastic and elaunin fibers, respectively. Differences between means were submitted to the Student's t-test or Mann-Whitney U test, with p < 0.05 significant. The study demonstrated an architectural alteration of the skin 1 year after bariatric surgery. In the histological analysis of the skin samples, a significant difference in the thickness of the epidermis was found 1 year after surgery in all age groups as well as in the 38-to-68-kg weight loss group (p < 0.0001). In addition to laxity, disorganization of collagen was found, with an apparent decrease in quantity and an increase in elastic fibers, although fragmented (p < 0.0001). Obesity and massive weight loss following bariatric surgery cause the disorganization of collagen fibers and the fragmentation of elastic fibers of the extracellular matrix of the skin.

The use of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery: a questionnaire study.

Enhanced recovery after surgery (ERAS) is a modern approach to perioperative management. This study aimed to evaluate compliance with certain aspects of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery. A questionnaire study was conducted among 197 patients undergoing elective surgery at the university hospital. We divided patients into two groups according to nutritional status. The study's results showed that 67 patients (34%) lost weight before admission (the weight-loss group). Twenty-five participants (37%) in the weight-loss group and 15 patients (12%) in the preserved-weight group underwent surgery due to cancer ( P < 0.001). More patients in the weight loss group (45 of 67) than in the preserved-weight group (40 of 129, P < 0.001) limited their food intake a week before the surgery. The preserved-weight group participants were mobilized earlier than the weight-loss group ( P = 0.04). The median number of hours since drinking their last fluids and eating their last meals before the surgery were 12.2 hours and 25.4 hours for both groups, respectively. Only eight patients received preoperative carbohydrate loading. We found higher serum protein concentrations in the preserved-weight group (7.10 [0.5] vs. 6.92 [0.71], P = 0.023); however, white blood cell count was higher in the weight-loss group (7.85 (2.28) vs.7.10 (0.50), P = 0.04). Both groups were highly satisfied with their hospital treatments. Our study revealed relatively high malnutrition in patients undergoing elective surgery. As a standard of perioperative care in the studied centre, the ERAS protocol implementation level is low.

Impact of Initial Body Weight Loss on Prognosis in Advanced Pancreatic Cancer: Insights From a Single-Center Retrospective Study.

Pancreatic cancer (PC) has a poor prognosis, with body weight loss commonly observed at diagnosis. However, the impact on PC prognosis of weight loss at the time of diagnosis on PC prognosis is unknown. This retrospective, single-center study enrolled consecutively patients diagnosed with metastatic or locally advanced PC or resectable PC who were intolerant of or refused surgery. Patients who had lost more than 5% of their body weight or more than 2% and had a body mass index (BMI) of less than 20kg/m2 at diagnosis were classified as experiencing body weight loss. Patients were subclassified into 2 groups: patients with and without weight loss. The study evaluated patient-related and PC-related factors affecting prognosis. Cox proportional hazards models were used to assess factors affecting prognosis. The primary endpoint was overall survival. Additionally, 1:1 propensity score matching was performed to reduce bias. In total, 220 patients were included in the study. The median age of the patients was 74years, and 49.1% were male. Weight loss at diagnosis was observed in 43.2% of patients. There were no significant differences in clinical factors, except for anthropometric parameters, between the groups. The median survival time did not differ between the weight loss and no weight loss groups (149 and 173days, respectively, P = .669). After matching, no significant differences in survival times were observed between the 2 groups. This study found no association between weight loss at diagnosis and prognosis in patients with advanced PC treated with best supportive care or chemotherapy.

Overweight, Weight Loss, and Self-Reported Global Life Satisfaction: The Lolland-Falster Health Study

Introduction: Obesity is associated with reduced quality of life and reduced life satisfaction, but does weight loss make you happier? The objective of this study was to investigate if body mass index (BMI) is associated with self-reported global life satisfaction, and if weight loss among individuals with overweight is associated with a higher life satisfaction than among weight-stable individuals with overweight. Methods: The participants in the present population-based cohort study from Denmark were 15,213 adults (18 years or older) in the Lolland-Falster Health Study who reported their global life satisfaction with the Cantril Ladder Score (CLS) (scores range from 0, very poor, through 10, very good). The association of BMI and history of weight loss with CLS was assessed by multivariable analyses adjusted for sex, age, educational level, cohabitation, self-reported health, and smoking status. Results: Higher BMI was associated with lower CLS (p < 0.0001). BMI 30–35 was associated with a 0.47 point (95% confidence interval [CI] 0.39; 0.55) lower score and BMI ≥45 with a 1.85 point (CI 1.45; 2.25) lower score, than BMI 18.5–25. History of weight loss was associated with lower CLS among individuals with BMI ≥25 (−0.15 lower CLS, p < 0.005), whereas in the subgroup of individuals with BMI ≥25 and good self-reported health, there was no significant difference in CLS between the weight stable and the weight loss groups (−0.05, p 0.33). Conclusion: This study found that higher BMI was associated with lower CLS. In subjects with BMI ≥25, weight loss was associated with lower CLS compared with stable weight during 5 years. In subjects with BMI ≥25 and good self-reported health, there was no relation between weight loss and CLS. Thus, contrary to our hypothesis, we found that weight loss among participants with overweight was not associated with higher life satisfaction.

THE STORAGE QUALITY OF EGGS FROM LAYERS FED WITH THE ADDITION OF VEGETABLE OILS

The aim of the study was to evaluate the quality of eggs from laying hens fed with vegetable oils, linseed and soybean, in terms of possible changes occurring during the storage. The material for the study consisted of 270 table eggs from hens fed with standard compound feed (C) and with the addition of linseed oil (L) and soybean oil (S) at a dose of 2.5%. On the day of laying, the zootechnical evaluation of egg quality was carried out (30 per group) and the rest of the eggs were placed in transport crates with the blunt end up and stored at 14 °C and 70% humidity. Analyses of their quality were performed after 14 and 28 days of storage. Characteristics of the whole egg (weight, specific gravity, proportion of morphological elements, air cell depth), shell (weight, colour, breaking strength, thickness, density, water conductivity), albumen (height, Haugh units, weight, pH) and yolk (weight, colour, pH) were evaluated. Regardless of the oil used, there was no variation between groups in egg weight loss, shell water conductivity or air cell depth during storage. The greatest range of yolk weight change was observed in eggs from groups of hens fed with added oils, which may indicate different permeability of vitelline membranes. Albumen quality traits showed no variation according to laying diet. The lightest shells characterised the eggs from hens in group L and the darkest from group C, while after 28 days of storage, the colour of the shells darkened, which was very evident in eggs from group S. Eggs from this group had the most resistant shells at the end of the experiment. It seems that the addition of linseed or soybean oil to laying feed can modify egg quality characteristics at the time of collection, while it does not significantly affect the storage stability of the raw material.

Preoperative predictors of obesity recurrence after laparoscopic gastrectomy

To find the preoperative predictors of obesity recurrence. We analyzed 81 patients with obesity who underwent laparoscopic sleeve gastrectomy. Patients were followed-up for 5 years and divided into 2 groups (64 (79.0%) patients were in the persistent weight loss group and 17 (21.0%) ones were in the obesity recurrence group). We tried to make a mathematical model for predicting obesity recurrence after bariatric surgery based on various parameters (age, height, weight, hemoglobin A1C, lipoprotein A, T3, T4, triglycerides, TSH, cholesterol, arterial hypertension, diabetes, metabolic syndrome, percentage of fat mass). We trained the following classification models: logistic regression, naive Bayes classifier, decision tree. None classifier provided sufficient prediction quality. This may indicate that these data do not allow predicting of obesity recurrence after sleeve gastrectomy. We failed to construct a mathematical model based on preoperative data of patients with obesity predicting recurrence in long-term period after sleeve gastrectomy.

ODP396 The Relationship Between Baseline Metabolic Factors and Post-surgical Weight Loss Outcomes in Adolescents Undergoing Laparoscopic Sleeve Gastrectomy

Abstract Introduction: There is a paucity of data exploring the effect of baseline metabolic factors on weight loss success following laparoscopic sleeve gastrectomy (LSG) in adolescents. This study aimed to identify if there is a relationship between abnormal baseline metabolic characteristics including Metabolic Syndrome (MeS), elevated Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), impaired glucose tolerance, and liver function in adolescents presenting for LSG and subsequent weight loss. METHODS: This was a retrospective study at the Center for Adolescent Bariatric Surgery. Subjects were recruited from 2010-2021. Patients with diabetes, identified by fasting blood glucose ≥ 125 mg/dl, 2-hour blood glucose ≥ 200 mg/dl, or HbA1c ≥ 6.5%, were excluded. Anthropometric measurements, fasting triglycerides, HDL, glucose, ALT, HbA1c, and oral glucose tolerance test results were collected pre-surgery and at 6 and/or 12 months post-surgery. Subjects were classified as having childhood MeS using de Ferranti et. al. [1] criteria. Successful weight loss was defined by a change in BMI of at least -11.49 kg/m 2 in the 6-month group and -13. 05 kg/m 2 in the 12-month group. ALT &amp;gt; 22 mg/dl for females and &amp;gt; 26 mg/dl for males, HbA1c ≥ 5.7%, and HOMA-IR &amp;gt; 2.7 were considered abnormal. Chi-squared or Fisher's analyses were performed using RStudio [2], calculating the presence of a relationship between abnormal metabolic factors pre-surgery and subsequent weight loss at 6 and 12 months. A p-value of &amp;lt;0. 05 was considered significant. RESULTS: 143 patients (6-month group: n = 122, 12-month group: n= 78) with a mean baseline age of 16 ± 1.82 years were included. The mean baseline BMI was 46.7 ± 7.9 kg/m 2 . At baseline, 45% of patients had MeS. A greater number of patients with baseline elevated systolic blood pressure (SBP) were in the successful weight loss group compared to the unsuccessful weight loss group at 6 (p = 0. 0163) and 12 (p = 0. 0315) months. Additionally, there were more patients with abnormal baseline HbA1c in the successful weight loss group at 6 months (p = 0. 0239), albeit this was not significant at 12 months. CONCLUSION: Our results suggest that patients with elevated versus normal HbA1c levels may have greater weight loss success after LSG surgery. Performing bariatric surgery in patients with prediabetes may therefore be a key to weight loss success in the adolescent population. Further analyses are needed to elucidate the relationship between glucose metabolism dysregulation and elevated SBP at baseline and weight loss success. REFERENCES: 1. de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation. 2004;110(16): 2494-7. 2. Holleran S, Ramakrishnan R (2021). cufunctions, a package to facilitate statistical analyses in R, http: //biomath. net/cufunctions.html"&amp;gt; NOTES: *ACB and ASF are co-first authors. Presentation: No date and time listed

Socioeconomic Disparity and Bariatric Surgery Outcomes: A Qualitative Analysis

INTRODUCTION: Disparity in socioeconomic status (SES) have been associated with less weight loss after bariatric surgery. Reasons for these disparities are unknown. Our objective was to identify socioeconomic barriers to weight loss after bariatric surgery. METHODS: We performed semi-structured interviews with bariatric surgery patients and providers from April to November 2020. Participants were asked to describe their postoperative experiences within 3 clinical areas: dietary habits, physical activity, and follow-up care. Purposeful sampling was used to recruit similar numbers of patients within low vs high SES and “optimal” vs “suboptimal” weight loss groups. Low SES patients were defined as having Medicaid within 3 years of operation. Patients with “optimal” weight loss had obtained ≥50% excess weight loss at their most recent clinic visit. Interview data were coded by team members using Directed Content Analysis based on the domains in Andersen’s Behavioral Model of Health Services Use and Torain’s Surgical Disparities Model. Codes pertaining to patient-level behaviors were included in the analysis. RESULTS: Twenty-four patients (median of 4.1 years postoperatively; mean age 50.6 ± 10.7 years; 83% female) and 21 providers (6 bariatric surgeons, 5 registered dietitians, 4 health psychologists, and 6 primary care providers) were interviewed. Barriers to weight loss at the patient level related to 5 areas (Table 1): (1) limited health literacy; (2) challenging employment environments; (3) limited income; (4) unreliable transportation; and (5) unsafe/inconvenient neighborhoods. Table 1. - Socioeconomic Barriers to Weight Loss after Bariatric Surgery Barrier Description 1. Limited health literacy Patients with less formal education needed more training/teaching regarding recommendations for diet, physical activity, and postoperative care. 2. Challenging employment environments Patients who had physically demanding jobs or multiple jobs struggled to follow dietary, physical activity, and follow-up care recommendations. 3. Limited income Lower-income patients: (a) had a difficult time affording supplements and vitamins; (b) skipped meals or relied on cheaper convenience food options/unhealthy options at food pantry; (c) did not have access to affordable fitness centers; (d) did not have reliable internet access for virtual follow-up meetings; (e) struggled with gas money and co-pays, which prevented their attendance at follow-up meetings. 4. Unreliable transportation Patients who did not have reliable transportation were restricted by bus routes to obtain healthier foods. Public transportation or insurance-provided transportation (eg, scheduled service driver) was often unreliable. 5. Unsafe/inconvenient neighborhoods Grocery stores in disadvantaged neighborhoods carried fewer healthy options. Patients in these neighborhoods struggled to have groceries delivered to their homes because of fear of theft. These neighborhoods were often unsafe for exercising or did not have sidewalks. CONCLUSION: Numerous socioeconomic barriers to weight loss exist for bariatric surgery patients. Interventions targeting these factors are needed to support patients, particularly those who are socioeconomically disadvantaged.

Complications Post Abdominoplasty After Surgical Versus Non-surgical Massive Weight Loss: a Comparative Study.

This study aims to investigate the rate of short- and long-term complications as well as the need for operative revisions after abdominoplasty for patients following surgical versus non-surgical weight loss methods. This is a retrospective chart review that enrolled consecutive patients undergoing abdominoplasty across a 5-year period, aged 18years and above, opting for abdominoplasty after weight loss achieved through bariatric surgery or diet and exercise alone. A total of 364 patients lost weight through bariatric surgery and 106 by diet and exercise alone. There were no significant differences in comorbidity status, but past body mass index (BMI) was higher for the surgical weight loss (SW) group (47.6 ± 10.2 and 40.4 ± 8.6, respectively; p value < 0.0001). Percent excess weight loss (EWL) was 68 ± 14.5 for the SW group and 55.7 ± 19.4 for the NSW group, p value < 0.0001. Pre- and postoperative blood hemoglobin levels were significantly lower in the SW group (p < 0.05). Neither short-term complications (thromboembolic events, wound complications, or infections) nor long-term complications (umbilical deformity, delayed wound healing, or infection) and operative revisions were significantly different across both groups (p > .05). Bariatric surgery does not increase the risk of short- or long-term complications or the need for operative revision after abdominoplasty.

Monitoring energy balance through clinical and serum biomarkers in patients with hematologic malignancies undergoing chemotherapy.

Despite widespread concern about energy imbalance due to tumor and chemotherapy-related side effects, little is known about detailed variations in energy input, metabolic rate, and physical activity. This study explored changes in energy balance components and serum biomarkers of patients with hematologic malignancies undergoing chemotherapy. Our prospective study included 40 patients with hematologic malignancies hospitalized for chemotherapy. We measured energy balance components, physical function, and serum biomarkers at baseline and weekly after chemotherapy for 3weeks. Significant weight loss, representing negative energy balance, occurred at 2 (p = 0.002) and 3weeks (p < 0.001) post-chemotherapy. Statistically reduced oral intake was observed at 3weeks post-chemotherapy (p = 0.040), and resting energy expenditure statistically decreased according to Harris-Benedict equation, but not to Penn State University equation. Physical function according to DEMMI score decreased significantly at 3weeks post-chemotherapy (p = 0.002). Serum biomarker analysis demonstrated significant changes in albumin, total protein, CXCL13, and GDF15, with exception of leptin. Although conventional serum biomarkers (total protein and albumin) did not reach pathological states despite their statistical differences, subgroup analysis showed CXCL13 in weight loss group and GDF15 in reduced oral intake group were significantly changed. Over half of patients (65.0%, n = 26) suffered from energy imbalance associated with weight loss and reduced oral intake during chemotherapy. Serial laboratory results suggested that novel biomarkers (CXCL13, GDF15) could be correlated with cachexic state and reduced food intake. Monitoring clinical and serum biomarkers associated with energy balance together can help identify needs for nutritional support in patients with hematologic malignancies undergoing chemotherapy.

Experiences of Barriers to Self-Compassion in Women Experiencing Weight Difficulties: An Interpretative Phenomenological Analysis.

There is currently little understanding of why some individuals find it difficult to engage in self-compassion (SC), defined as a form of self-kindness, self-acceptance, and courage to face one’s distress. This is especially true for women experiencing weight difficulties, despite the emergence of promising results from compassion-focused approaches to weight management. Consequently, this study undertakes a qualitative study to explore the experiences of barriers to self-compassion in women who were actively trying to manage their weight, using interpretative phenomenological analysis (IPA). A qualitative study was employed using an interpretive approach. Using purposive sampling, 10 women were recruited from London-based weight loss groups. Three super-ordinate themes emerged: (I) feeling unable to prioritise own needs over others’ needs; (II) having to learn and sustain a new approach to weight loss; and (III) having very high standards. The emergent themes suggest that women who face weight difficulties have numerous barriers to self-compassion. To fully utilise compassionate-based weight loss interventions for women, it is important to recognise these barriers and implement strategies to lessen their impact.

Comparison of Therapeutic Effects Between Electroacupuncture and Thread-Embedded Acupuncture in Obese Patients Undergoing a Dietary Intervention.

Obesity is an epidemic with an increasing prevalence in developing countries. The condition affects almost all physiologic functions of the body and is a significant threat to public health. Treatment of obesity is often difficult and expensive. Pharmacologic therapy has many side-effects. Acupuncture, a nonpharmacologic therapy, has shown promising results for treating obesity. Electroacupuncture (EA) and thread-embedded acupuncture (TEA) can be used. The aim of this study was to analyze the therapeutic effects of EA and TEA, using polydioxanone (PDO), on weight loss, waist circumference, and plasma-leptin concentrations in obese patients undergoing a dietary intervention. This single-blinded, randomized clinical trial randomized 34 subjects into 2 groups: EA and TEA. In the EA group, EA was administered 3 times per week for 4 weeks (a total of 12 sessions). In the TEA group, EA was administered only once. Body weight and waist circumference were measured at baseline, and on days 3, 7, 14, 21, and 28 (end) of the trial. Plasma-leptin concentrations were measured at the beginning and end of the trial. There was a significant decrease in body weight and waist circumference in the groups before and after treatment (P < 0.001), and a significant decrease in plasma-leptin concentrations in the EA (P = 0.012) and TEA groups (P = 0.001). There were no significant differences between the groups in weight loss (P = 0.621), waist circumference (P = 0.545), and plasma-leptin concentration (P = 0.784). EA and PDO TEA are equally effective for reducing body weight, waist circumference, and plasma-leptin concentrations in obese patients undergoing dietary interventions. However, TEA is more time-efficient than EA.

Neonatal nutritional risk and pulmonary function.

Introduction:The neonatal period is a critical initial stage of postnatal lung development and maturation. This study aimed to investigate the effects of the nutritional status on pulmonary function in late preterm and full-term neonates.Methods:A total of 172 newborns were included in the study. Nutritional risk screening, weight measurement, assessment of albumin and caloric intake, and a pulmonary function examination were conducted on the 7th day after birth.Results:There was a significant correlation between the nutritional risk and changes in body weight. Tidal volume (VT), minute ventilation (MV), VT per kg body weight (VT/kg), and MV per kg body weight (MV/kg) in the low nutritional risk group were significantly higher than those in the medium nutritional risk group (all P < .05). Albumin and caloric intake in the low nutritional risk group were significantly higher than those in the medium nutritional risk group (both P < .01). VT, VT/kg, MV, and MV/kg in the weight loss group were lower than those in the no weight loss group (all P < .05).Conclusions:Changes in neonatal weight mainly affect lung volume (VT, VT/kg, MV, and MV/kg), suggesting that an improvement in the neonatal nutritional status is important for the development of lung volume.