Weight Loss In Bariatric Patients Research Articles

Analysis of Body Contouring and Sustained Weight Loss in a Diverse, Urban Population: A 7-Year Retrospective Review.

Studies demonstrating the positive impact of body contouring on sustained weight loss in bariatric patients describe a narrow cohort. The authors sought to evaluate the impact of postbariatric body contouring procedures on sustained weight loss in minority race patients. A retrospective review of bariatric surgery patients at a single institution was performed. Patients were grouped as follows: (1) those who underwent body contouring, (2) those who had consultation but did not undergo body contouring, and (3) those without consultation. Body mass index (BMI) and excess body weight loss (EBWL) over 7 years were the primary outcomes. 2531 patients were analyzed: 350 in group 1, 364 in group 2, and 1817 in group 3. At postoperative year 7, groups 1 and 2 had average BMIs 4.71 and 2.31 kg/m 2 lower than group 3, respectively, while adjusting for covariates. After exclusion of 105 patients in group 2 who were not offered body contouring because of inadequate weight loss, however, group 2 had an average BMI 4.07 kg/m 2 lower than group 3 at postoperative year 7. During postoperative year 1, group 1 had an average EBWL of 74.38%, which declined 1.51% yearly, and group 2 had an average EBWL of 70.12%, which declined 1.86% yearly. After exclusion of the aforementioned patients, group 2 had an average EBWL of 74.9% at postoperative year 1, which declined 1.88% yearly. Body contouring after bariatric surgery did not impart a clinically significant, long-term sustained weight loss benefit in the authors' cohort. In the authors' study population, patients identifying as black had significantly worse sustained weight loss. Therapeutic, III.

Bacteria with potential: Improving outcomes through probiotic use following Roux-en-Y gastric bypass.

Obesity impairs the gastrointestinal microbiome (GM) and may promote micronutrient deficiencies. Bariatric surgery (BS), the most efficacious treatment for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities, but might not fully restore microbial balance. Moreover, BS may result in deleterious consequences that affect weight loss and further intensify post-operative micronutrient deficiencies. To date, the use of probiotics appears to be associated with greater weight loss in bariatric patients, improved vitamin synthesis and availability, and decreased instances of small intestinal bacterial overgrowth. Thus, manipulation of the GM through probiotics represents a promising therapeutic approach in bariatric patients. This review aims to highlight the benefits of using probiotics in bariatric surgical patients by addressing the impact of probiotics on the GM, how BS impacts the microbial environment, associations between gastrointestinal dysbiosis and negative health outcomes, how BS contributes to dysbiosis, and how probiotics may prove efficacious in treating patients who undergo Roux-en-Y gastric bypass (RYGB). Based on currently available data, the role of microbial manipulation post-RYGB through probiotics has shown great potential, but a further clinical investigation is warranted to better understand their efficacy.

SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods

PurposeThis longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods.MethodsAdult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3–6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs.ResultsFactor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome.ConclusionsSCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI.Level of evidenceIII, well-designed cohort.

The Relationship Between Energy Intake and Weight Loss in Bariatric Patients.

There is a huge variation in weight loss outcomes between bariatric patients, possibly due to differences in caloric intake and changes in the amount physical activity. However, the association between the change in energy intake and weight loss has not yet been the subject of an extensive investigation. To explore the relationship between total energy intake and % total body weight loss (%TBWL) over a period of 4years post-surgery. Of the 466 patients who were asked to participate, a total 135 patients were included in this study. They all underwent bariatric surgery, 54 with primary Roux-en-Y Gastric Bypass, 43 redo Roux-en-Y gastric bypass after laparoscopic gastric banding and 38 laparoscopic sleeve gastrectomy. Pre- and post-operative dietary intake and physical activity were collected for both a weekday and a weekend day. The main analysis was performed using multiple regression analyses and was adjusted for age at surgery, BMI at baseline, obstructive sleep apnoea syndrome, type of eating behaviour, change in physical activity and protein intake (g/kg body weight). %TBWL over time, post-operative energy intake and change in physical activity did not differ between the different procedure groups (p = 0.312, p = 0.988 and p = 0.050, respectively). Change in energy intake did differ between different procedure groups (p = 0.031) and linear regression showed that this was related to total body weight loss for the fully adjusted model (β = - 0.004, p = 0.014). This study showed a higher decrease in energy intake to be related with a higher %TBWL.

Mental Illness Has a Negative Impact on Weight Loss in Bariatric Patients: a 4-Year Follow-up

BackgroundMental health disorders are highly prevalent among bariatric surgery patients. Bariatric surgery induces weight loss with continuous health improvements. However, long-term follow-up data on weight loss and quality of life data of patients who have a mental illness after bariatric surgery are scarce, and it is not clear whether mental illness is associated with more pronounced weight regain. The aim was to investigate the impact of preoperative mental illness on the course of long-term weight changes after bariatric surgery. MethodsPatients with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass surgery (RYGB) between 2005 and 2013 with a follow-up of at least 3 years were included. The study population was divided into two groups: patients with mental illness (MI) and patients without (No-MI). Weight loss outcomes over time were compared using mixed models up to 4 years after surgery. ResultsIn total, 254 patients (RYGB 61.0%, SG 39%) were included. The distribution of baseline characteristics was similar between the MI (n = 108) and No-MI groups (n = 146). The most prevalent mental illness was depressive disorder (63.9%). In the MI group, the percent of total weight loss (%TWL) was significantly smaller over the study period. After 36 months, the predicted mean group-difference of %TWL was 4.6% (95% CI 1.9, 7.2; p = 0.001), and the predicted odds ratio for weight regain was 4.9 (95% CI 1.6, 15.1) for patients in the MI group. ConclusionPreoperative mental illness leads to lower long-term weight loss and an increased risk of weight regain after bariatric surgery.

The Role of Attachment in Body Weight and Weight Loss in Bariatric Patients

PurposeThe aim of this study is to explore the role of attachment styles in obesity.Material and MethodsThe present study explored differences in insecure attachment styles between an obese sample waiting for bariatric surgery (n = 195) and an age, sex and height matched normal weight control group (n = 195). It then explored the role of attachment styles in predicting change in BMI 1 year post bariatric surgery (n = 143).ResultsThe bariatric group reported significantly higher levels of anxious attachment and lower levels of avoidant attachment than the control non-obese group. Baseline attachment styles did not, however, predict change in BMI post surgery.ConclusionAttachment style is different in those that are already obese from those who are not. Attachment was not related to weight loss post surgery.

Formal Nutritional Education Improves Weight Loss in Bariatric Patients Following Laparoscopic Sleeve Gastrectomy.

Laparoscopic sleeve gastrectomy (LSG) is an increasingly performed procedure in the bariatric surgery armamentarium. This study evaluates our experience with LSG at Dwight D. Eisenhower Army Medical Center (DDEAMC) during the time period of 2008-2010. We found that the inclusion of formal nutritional education significantly increased our weight loss results following LSG. This is a retrospective review from our LSG caseload from 2008 to 2010. During that time, we performed 159 LSG. In our review, we performed comparative data of all operative years during 2008-2010 for up to 3years postoperatively. Our main focus was in regard to weight loss as measured by percentage of excess body weight loss (%EWL), percentage of total weight loss (%TWL), and percentage of excess BMI loss (%EBL). We also evaluated the effect of LSG on diabetes mellitus (DM) and hypertension (HTN) postoperatively. We found an improvement in our %EWL, %TWL, and %EBL rates in our LSG cases following the inclusion of formal nutritional education. There was a mean increase in %EWL of 15%, %TWL of 7%, and %EBL of 21%, which were statistically significant, that was present at all postoperative years of follow-up. We determined the only variable that changed in our bariatric program starting in 2010 was the inclusion of formal nutritional education. We also found a statistically significant improvement in resolution of HTN with the inclusion of formal nutritional education. The addition of formal nutritional education can enhance weight loss following bariatric surgery. We have shown a significant improvement in weight loss results following LSG with the implementation of formal nutritional education; this is the only study to our knowledge evaluating formal nutritional education and LSG.

The Relationship Between Pre-Existing Factors and Weight Loss in Bariatric Patients

The Relationship Between Pre-Existing Factors and Weight Loss in Bariatric Patients

Predictors of Weight Loss in Bariatric Patients at the Ohio State University

Predictors of Weight Loss in Bariatric Patients at the Ohio State University

A Prospective Study of Body Dissatisfaction and Concerns in Extremely Obese Gastric Bypass Patients: 6- and 12-Month Postoperative Outcomes

Body image is a multifaceted construct commonly associated with obesity. This study examined changes in body dissatisfaction, and shape and weight concerns in bariatric surgery patients from baseline to 6 and 12 months post-surgery. 109 extremely obese patients who underwent gastric bypass surgery completed the Body Shape Questionnaire (BSQ), and the Shape and Weight Concern subscales of the Eating Disorder Examination-Questionnaire (EDE-Q) at baseline, and 6 and 12 months post-surgery. Patients experienced substantial weight loss and reported statistically significant reductions in BSQ, and Shape and Weight Concern scores from baseline to 6 and 12 months post-surgery. Improvements on the BSQ and Shape Concern scale were maintained between 6 and 12 months post-surgery, while patients reported continued reductions in weight and Weight Concern scale scores. Moreover, at 6 and 12 months follow-up, over 80% of female patients had body image scores comparable to published norms. Correlations between change in BMI and the body image measures were variable, and degree of weight loss did not predict body image scores 6 or 12 months post-surgery. Results from the present study illustrate significant and immediate post-surgical reductions in body dissatisfaction and concerns, along with weight loss in bariatric patients. Such improvements indicate a normalization of body image-related concerns in these patients, the majority of who remain overweight or obese despite the substantial post-surgical weight losses. Changes in weight and body image relate poorly to each other, suggesting that mediating factors may be involved.