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Surgery For Obesity and Related... Apr 2019Outcomes of bariatric surgery, while frequently impressive, are not universal and vary between patients and across surgical procedures. Between 20% and 30% of patients... (Review)
Review
Outcomes of bariatric surgery, while frequently impressive, are not universal and vary between patients and across surgical procedures. Between 20% and 30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. The reasons for this are not fully understood, but likely involve both physiologic processes, behavioral factors, and psychological characteristics. Evidence suggests that preoperative psychosocial status and functioning can contribute to suboptimal weight losses and/or postoperative psychosocial distress. Much of this work has focused on the presence of recognized psychiatric diagnoses and with particular emphasis on mood disorders as well as binge eating disorder. Several studies have suggested that the presence of preoperative psychopathology is associated with suboptimal weight losses, postoperative complications, and less positive psychosocial outcomes. Contemporary psychological theory suggests that it may be shared features across diagnoses, rather than a discrete diagnosis, that better characterizes psychopathology. Mood and substance use disorders as well as binge eating disorder, share common features of impulsivity, although clinicians and researchers often use complementary, yet different terms, such as emotional dysregulation or disinhibition (i.e., loss of control over eating, as applied to food intake), to describe the phenomenon. Impulse control is a central factor in eating behavior and extreme obesity. It also may contribute to the experience of suboptimal outcomes after bariatric surgery, including smaller than expected weight loss and psychosocial distress. This paper reviews the literature in these areas of research and articulates a direction for future studies of these complex relationships among persons with extreme obesity.
Topics: Bariatric Surgery; Depression; Feeding and Eating Disorders; Humans; Impulsive Behavior; Obesity, Morbid; Psychopathology; Risk; Substance-Related Disorders; Treatment Outcome; Weight Loss
PubMed: 30858009
DOI: 10.1016/j.soard.2019.01.029 -
Chirurgie (Heidelberg, Germany) Jun 2023
Topics: Humans; Bariatric Surgery; Obesity, Morbid
PubMed: 37212897
DOI: 10.1007/s00104-023-01839-4 -
International Journal of Surgery... Aug 2019Despite an epidemic of obesity, the availability of bariatric surgery is limited. Negative beliefs about obesity and bariatric surgery are one of the barriers to access....
Despite an epidemic of obesity, the availability of bariatric surgery is limited. Negative beliefs about obesity and bariatric surgery are one of the barriers to access. In this article, we address and dispel some of the common myths surrounding obesity and bariatric surgery.
Topics: Bariatric Surgery; Humans; Obesity
PubMed: 31279133
DOI: 10.1016/j.ijsu.2019.06.022 -
The Journal of Clinical Endocrinology... Jan 2022
Topics: Bariatric Surgery; Gastric Bypass; Humans; Incretins
PubMed: 34543416
DOI: 10.1210/clinem/dgab694 -
Deutsches Arzteblatt International May 2011Bariatric surgery has increased in numbers, but the treatment of morbid obesity in Germany still needs improvement. The new interdisciplinary S3-guideline provides... (Review)
Review
BACKGROUND
Bariatric surgery has increased in numbers, but the treatment of morbid obesity in Germany still needs improvement. The new interdisciplinary S3-guideline provides information on the appropriate indications, procedures, techniques, and follow-up care.
METHODS
Systematic review of the literature, classification of the evidence, graded recommendations, and interdisciplinary consensus-building.
RESULTS
Bariatric surgery is a component of the multimodal treatment of obesity, which consists of multidisciplinary evaluation and diagnosis, conservative and surgical treatments, and lifelong follow-up care. The current guideline extends the BMI-based spectrum of indications that was previously proposed (BMI greater than 40 kg/m(2), or greater than 35 kg/m(2)with secondary diseases) by eliminating age limits, as well as most of the contraindications. A prerequisite for surgery is that a structured, conservative weight-loss program has failed or is considered to be futile. Type 2 diabetes is now considered an independent indication under clinical study conditions for patients whose BMI is less than 35 kg/m(2) (metabolic surgery). The standard laparoscopic techniques are gastric banding, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion. The choice of procedure is based on knowledge of the results, long-term effects, complications, and individual circumstances. Structured lifelong follow-up should be provided and should, in particular, prevent metabolic deficiencies.
CONCLUSION
The guideline contains recommendations based on the scientific evidence and on a consensus of experts from multiple disciplines about the indications for bariatric surgery, the choice of procedure, techniques, and follow-up care. It should be broadly implemented to improve patient care in this field.
Topics: Bariatric Surgery; Foreign-Body Migration; Hernia, Abdominal; Humans; Malabsorption Syndromes; Obesity, Morbid; Radiography
PubMed: 21655459
DOI: 10.3238/arztebl.2011.0341 -
Current Obesity Reports Jun 2021The prevalence of obesity is increasing in all age groups. Following its success in adults, and with limited success using conservative therapies, metabolic and... (Review)
Review
PURPOSE OF REVIEW
The prevalence of obesity is increasing in all age groups. Following its success in adults, and with limited success using conservative therapies, metabolic and bariatric surgery (MBS) is increasingly being utilized in adolescents. This review highlights the current evidence and guidelines supporting its use.
RECENT FINDINGS
Safety and efficacy mirror results seen in adults. The most recent evidence, as outcomes enter the long term, suggests that comorbidity resolution, including diabetes and hypertension, can even outperform that of adults. Mental health problems persist despite good weight loss. Overall, the positive early weight and comorbidity outcomes are well sustained into the long term. There is a growing need to prevent and treat adolescent obesity. Current evidence supports the use of MBS in adolescents. Ongoing and future studies will provide 10-year outcomes and assist in the refinement of multimodal pathways incorporating MBS for the treatment of severe childhood obesity.
Topics: Adolescent; Bariatric Surgery; Body Mass Index; Cardiovascular Diseases; Comorbidity; Diabetes Mellitus, Type 2; Humans; Hypertension; Obesity, Morbid; Pediatric Obesity; Treatment Outcome; Weight Loss
PubMed: 33725324
DOI: 10.1007/s13679-021-00423-3 -
Wiener Klinische Wochenschrift Nov 2023Bariatric surgery results in significant weight loss, reduction or even remission of obesity-associated comorbidities, reduced mortality, and improved quality of life in...
Bariatric surgery results in significant weight loss, reduction or even remission of obesity-associated comorbidities, reduced mortality, and improved quality of life in many patients; however, obesity is a chronic disease, thus follow-up care is required after bariatric surgery. Furthermore, specific issues, such as micronutrient deficiencies and subsequent complications, can arise both in the short-term and the long-term. Abdominal pain after bariatric surgery must always be regarded as a serious symptom. A further focus should be on the diagnosis and treatment of dumping syndrome. Patients with type 2 diabetes should be regularly screened for recurrent hyperglycemia as well as specific sequelae, even though blood glucose levels may be substantially improved or normalized. In addition to centers with multidisciplinary teams, primary care and, in particular, general practitioners will play an increasingly more important role in the follow-up care after bariatric surgery.
Topics: Humans; Diabetes Mellitus, Type 2; Quality of Life; Obesity; Bariatric Surgery; Malnutrition; Obesity, Morbid; Postoperative Complications
PubMed: 37821696
DOI: 10.1007/s00508-023-02272-7 -
International Journal of Surgery... 2010Obesity is fast becoming one of the world's leading health problems and together with its many associated medical sequelae significantly increases morbidity and... (Review)
Review
Obesity is fast becoming one of the world's leading health problems and together with its many associated medical sequelae significantly increases morbidity and mortality. In this review, we briefly explore the history of bariatric surgery, the benefits of surgery and the various procedures carried out.
Topics: Bariatric Surgery; Body Mass Index; Female; Humans; Life Style; Male; Obesity, Morbid; Patient Satisfaction; Postoperative Complications; Quality of Life; Risk Assessment; Treatment Outcome; Weight Loss
PubMed: 20026002
DOI: 10.1016/j.ijsu.2009.12.003 -
Obesity Facts 2021Bariatric surgery is gaining acceptance as an efficient treatment modality for adults and adolescents with morbid obesity. The early postbariatric period has the...
Bariatric surgery is gaining acceptance as an efficient treatment modality for adults and adolescents with morbid obesity. The early postbariatric period has the potential to induce an immunomodulatory imbalance due to the development or worsening of nutritional deficiencies, changes in hormonal balance (specifically after sleeve gastrectomy), and a shift in the proinflammatory cytokine profile along with a major change in the gut microbiome and permeability. These changes may induce encephalomyelitic T cell activity, change neural barrier permeability, and induce gut dysbioisis, favoring a proinflammatory metabolic profile. Such changes, in genetically prone individuals or those with additional risk factors, may lead to the development of myelopathy, particularly MS. Key Message: Postbariatric myelopathy is rare but should be considered in bariatric patients with relevant complaints in the postoperative period.
Topics: Adolescent; Bariatric Surgery; Gastrectomy; Gastric Bypass; Humans; Obesity, Morbid; Spinal Cord Diseases
PubMed: 34311464
DOI: 10.1159/000515374 -
Gastrointestinal Endoscopy Clinics of... Apr 2017Weight regain after bariatric surgery is common and can be managed with surgical interventions or less morbid endoscopic techniques. These endoscopic approaches target... (Review)
Review
Weight regain after bariatric surgery is common and can be managed with surgical interventions or less morbid endoscopic techniques. These endoscopic approaches target structural postoperative changes that are associated with weight regain, most notably dilation of the gastrojejunal anastomosis aperture. Purse string suture placement, as well as argon plasma coagulation application to the anastomosis, may result in significant and durable weight loss. Furthermore, various endoscopic approaches may be used to safely and effectively manage other complications of bariatric surgery that may result in poor weight loss or weight regain after surgery, including fistula formation.
Topics: Anastomosis, Surgical; Argon Plasma Coagulation; Bariatric Surgery; Endoscopy, Gastrointestinal; Humans; Obesity; Postoperative Complications; Reoperation; Stomach
PubMed: 28292402
DOI: 10.1016/j.giec.2016.12.007