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Nutrients Feb 2022Obesity surgery is a highly efficacious treatment for obesity and its comorbidities. The underlying mechanisms of weight loss after obesity surgery are not yet fully... (Review)
Review
Obesity surgery is a highly efficacious treatment for obesity and its comorbidities. The underlying mechanisms of weight loss after obesity surgery are not yet fully understood. Changes to taste function could be a contributing factor. However, the pattern of change in different taste domains and among obesity surgery operations is not consistent in the literature. A systematic search was performed to identify all articles investigating gustation in human studies following bariatric procedures. A total of 3323 articles were identified after database searches, searching references and deduplication, and 17 articles were included. These articles provided evidence of changes in the sensory and reward domains of taste following obesity procedures. No study investigated the effect of obesity surgery on the physiological domain of taste. Taste detection sensitivity for sweetness increases shortly after Roux-en-Y gastric bypass. Additionally, patients have a reduced appetitive reward value to sweet stimuli. For the subgroup of patients who experience changes in their food preferences after Roux-en-Y gastric bypass or vertical sleeve gastrectomy, changes in taste function may be underlying mechanisms for changing food preferences which may lead to weight loss and its maintenance. However, data are heterogeneous; the potential effect dilutes over time and varies significantly between different procedures.
Topics: Bariatric Surgery; Gastric Bypass; Humans; Obesity; Obesity, Morbid; Taste
PubMed: 35215515
DOI: 10.3390/nu14040866 -
Clinical Journal of the American... Aug 2019
Topics: Bariatric Surgery; Humans; Kidney Failure, Chronic; United States
PubMed: 31345841
DOI: 10.2215/CJN.07350619 -
Frontiers in Endocrinology 2020Obesity has become a global epidemic with a soaring economic encumbrance due to its related morbidity and mortality. Amongst obesity-related conditions, cancer is indeed... (Review)
Review
Obesity has become a global epidemic with a soaring economic encumbrance due to its related morbidity and mortality. Amongst obesity-related conditions, cancer is indeed the most redoubtable. Bariatric surgery has been proven to be the most effective treatment for obesity and its associated metabolic and cardiovascular disorders. However, the understanding of whether and how bariatric surgery determines a reduction in cancer risk is limited. Obesity-related malignancies primarily include colorectal and hormone-sensitive (endometrium, breast, prostate) cancers. Additionally, esophago-gastric tumors are growing to be recognized as a new category mainly associated with post-bariatric surgery outcomes. In fact, certain types of surgical procedures have been described to induce the development and subsequent progression of pre-cancerous esophageal and gastric lesions. This emerging category is of great concern and further research is required to possibly prevent such risks. Published data has generated conflicting results. In fact, while overall cancer risk reduction was reported particularly in women, some authors showed no improvement or even increased cancer incidence. Although various studies have reported beneficial effects of surgery on risk of specific cancer development, fundamental insights into the pathogenesis of obesity-related cancer are indispensable to fully elucidate its mechanisms.
Topics: Bariatric Surgery; Humans; Neoplasms; Obesity
PubMed: 32351453
DOI: 10.3389/fendo.2020.00213 -
Chirurgia (Bucharest, Romania : 1990) Oct 2022Bariatric/metabolic surgery (BMS) is the most effective treatment of morbid obesity, while Enhanced Recovery After Surgery (ERAS) after BMS represents a multimodal... (Review)
Review
INTRODUCTION
Bariatric/metabolic surgery (BMS) is the most effective treatment of morbid obesity, while Enhanced Recovery After Surgery (ERAS) after BMS represents a multimodal perioperative protocol designed to achieve early recovery for patients with peculiar characteristics. The aim of the current narrative review is to summarize and discuss the current role, the application, and the future developments of ERAS protocols in the field of BMS.
METHODS
A literature search for studies published up to June 30, 2022, with no restrictions on language or publication period, was performed on Medline and Embase, using the keywords "ERAS" OR "enhanced recovery after surgery" AND "bariatric surgery" OR "metabolic surgery". Postoperative length of hospital stay LOS, overall and major morbidity and mortality, readmission rates, postoperative nausea or vomit PONV, opioids and antiemetics use, hospital costs, ERAS in specific health care settings, barriers to ERAS and further developments were analyzed.
RESULTS/CONCLUSIONS
The results were presented with a narrative review, using tabulation to summarize the results of meta-analyses and RCTs: 6 articles reporting guidelines, 5 metaanalyses, 9 randomized controlled trials, and 48 observational studies. ERAS protocols are feasible and safe in the setting of BMS, and associated to reduced LOS, PONV and postoperative pain, reduced opioid and antiemetic use and reduced costs. Postoperative mortality and readmission rates are similar between patients receiving standard care and those with ERAS protocols. Furthermore, increase of ERAS application may be useful in health care systems dealing with epidemic infectious diseases and implemented by technological advancements.
Topics: Humans; Postoperative Nausea and Vomiting; Treatment Outcome; Bariatric Surgery; Obesity, Morbid; Length of Stay; Postoperative Complications
PubMed: 36318680
DOI: 10.21614/chirurgia.2754 -
Current Diabetes Reports Aug 2019Obesity is increasing at an alarming rate and now poses a global threat to humankind. In recent years, we have seen the emergence of medical devices to combat the... (Review)
Review
PURPOSE OF REVIEW
Obesity is increasing at an alarming rate and now poses a global threat to humankind. In recent years, we have seen the emergence of medical devices to combat the obesity epidemic. These therapeutic strategies are discussed in this review dividing them into gastric and duodenal therapies.
RECENT FINDINGS
Traditionally, medical devices for obesity such as the intragastric balloon have focused on reducing gastric size, but more recently there has been a shift towards developing devices that modulate neural and hormonal responses to induce early satiety thus reducing oral intake. Medical devices for obesity treatment may have a role in those patients who are struggling to control their weight despite significant lifestyle modifications such as diet and exercise and who decline or are unfit for bariatric surgery. For the wider adoption and integration of these devices in the obesity treatment paradigm, more long-term efficacy and safety data from randomised controlled trials are required.
Topics: Bariatric Surgery; Duodenum; Humans; Obesity; Stomach
PubMed: 31471810
DOI: 10.1007/s11892-019-1217-3 -
Liver International : Official Journal... May 2021Bariatric surgery is common, but alcohol misuse has been reported following these procedures. We aimed to determine if bariatric surgery is associated with increased...
BACKGROUND & AIMS
Bariatric surgery is common, but alcohol misuse has been reported following these procedures. We aimed to determine if bariatric surgery is associated with increased risk of alcohol-related cirrhosis (AC) and alcohol misuse.
METHODS
Retrospective observational analysis of obese adults with employer-sponsored insurance administrative claims from 2008 to 2016. Subjects with diagnosis codes for bariatric surgery were included. Primary outcome was risk of AC. Secondary outcome was risk of alcohol misuse. Bariatric surgery was divided into before 2008 and after 2008 to account for patients who had a procedure during the study period. Cox proportional hazard regression models using age as the time variable were used with interaction analyses for bariatric surgery and gender.
RESULTS
A total of 194 130 had surgery from 2008 to 2016 while 209 090 patients had bariatric surgery prior to 2008. Age was 44.1 years, 61% women and enrolment was 3.7 years. A total of 4774 (0.07%) had AC. Overall risk of AC was lower for those who received sleeve gastrectomy and laparoscopic banding during the study period (HR 0.4, P <.001; HR 0.43, P =.02) and alcohol misuse increased for Roux-en-Y and sleeve gastrectomy recipients (HR 1.86 and 1.35, P <.001, respectively). In those who had surgery before 2008, women had increased risk of AC and alcohol misuse compared to women without bariatric surgery (HR 2.1 [95% CI: 1.79-2.41] for AC; HR 1.98 [95% CI 1.93-2.04]).
CONCLUSIONS
Bariatric surgery is associated with a short-term decreased risk of AC but potential long-term increased risk of AC in women. Post-operative alcohol surveillance is necessary to reduce this risk.
Topics: Adult; Alcoholism; Bariatric Surgery; Female; Gastric Bypass; Humans; Laparoscopy; Liver Cirrhosis, Alcoholic; Male; Obesity, Morbid; Retrospective Studies; Treatment Outcome
PubMed: 33529460
DOI: 10.1111/liv.14805 -
Ugeskrift For Laeger Dec 2022Patients with excess skin after massive weight loss often experience skin maceration, infection, wounding and reduced quality of life. Abdominoplasty is a surgical... (Review)
Review
Patients with excess skin after massive weight loss often experience skin maceration, infection, wounding and reduced quality of life. Abdominoplasty is a surgical procedure that removes excess skin aiming to relieve physical inconveniences and improve quality of life. The abdominoplasty can be performed with different techniques using a horizontal, vertical and/or a circumferential procedure. The purpose of this review is to describe the indications for the different surgical approaches, the surgical principles and the complications following abdominoplasty in patients after massive weight loss.
Topics: Humans; Quality of Life; Abdominoplasty; Plastic Surgery Procedures; Bariatric Surgery; Skin Diseases; Weight Loss; Retrospective Studies
PubMed: 36621875
DOI: No ID Found -
Obesity Surgery Jun 2020
Topics: Bariatric Surgery; Betacoronavirus; COVID-19; Coronavirus Infections; Diabetes Mellitus, Type 2; Humans; Metabolic Diseases; Obesity, Morbid; Pandemics; Pneumonia, Viral; SARS-CoV-2
PubMed: 32291701
DOI: 10.1007/s11695-020-04578-1 -
Eye (London, England) Jun 2022The incidence of bariatric surgery is increasing due to obesity being one of our top public health challenges. As such, bariatric-related ophthalmic changes are a... (Review)
Review
The incidence of bariatric surgery is increasing due to obesity being one of our top public health challenges. As such, bariatric-related ophthalmic changes are a potentially new clinical area of knowledge, with increasing published evidence on post-bariatric complications experienced by patients and identified by clinicians. We reviewed the available literature and summarised the different complications and potential recommendations. A search strategy was conducted with PubMed, Cochrane, Medline, Embase, Allied and Complementary Medicine and DH-DATA databases to look for papers answering our research question: "What are the ophthalmological complications for patients after bariatric surgery?". Our search gave a total of 59 relevant papers. Bariatric surgery, particularly subtypes that cause direct bypass of nutrients from the stomach, lead to nutritional deficiencies. Vitamin A, crucial for proper functioning of body systems and specialised cells, manifests ophthalmologically as corneal ulceration, nyctalopia, conjunctival xerosis and more. Thiamine levels are also depleted, leading to Wernicke's Encephalopathy. Pre-existing diabetic retinopathy is also noted to worsen sub acutely, although evidence is conflicting. Patients undergoing surgery to treat idiopathic intracranial hypertension would have reduced IOP and resolving papilloedema. Other comorbidities of obesity like HB levels, obstructive sleep apnoea, and metabolic syndrome also resolve post-surgery. History taking remains the cornerstone of medical practice. From the evidence, we suggest consideration of pre-surgery screening for ophthalmic pathology and post-operative monitoring of disease progression. Real-world data needs to continuously be analysed to create definitive management pathways that can help clinicians recognise ophthalmic complications early, improving patient outcomes.
Topics: Bariatric Surgery; Comorbidity; Humans; Obesity; Ophthalmologists; Sleep Apnea, Obstructive
PubMed: 34675393
DOI: 10.1038/s41433-021-01811-8 -
Family Medicine Jan 2020
Topics: Bariatric Surgery
PubMed: 31914188
DOI: 10.22454/FamMed.2020.281985