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Frontiers in Endocrinology 2023To evaluate the breadth, depth and effectiveness of the evidence quality of all existing studies on bariatric surgery and mental health outcomes. (Review)
Review
AIMS
To evaluate the breadth, depth and effectiveness of the evidence quality of all existing studies on bariatric surgery and mental health outcomes.
DESIGN
Umbrella review of existing Systematic review and meta-analyses.
DATA SOURCES
PubMed, Embase, Web of Science, and the Cochrane Liberally databases of Systematic review and meta-analyses, and hand searching the reference lists of eligible publications.
RESULTS
The search identified nine studies and 20 mental health outcomes from 1251 studies. Evidence shows that bariatric surgery is associated with significant improvement in areas such as anxiety, depression and eating disorders (including binge-eating disorder), and there is a significant harmful association with suicide, self-harm and alcohol use disorder (AUD). Among them, the most studied outcome is depression (4 articles). High-quality evidence proves that the score of depressive symptoms can be significantly improved after bariatric surgery within a two-year follow-up period and is not affected by the follow-up time. Low-quality evidence shows that bariatric surgery can significantly reduce depressive symptoms regardless of age and BMI, with an odds ratio (OR) of 0.49. Regardless of the postoperative BMI, the anxiety symptoms of women over 40 still decreased significantly, with an OR of 0.58. Regardless of the type of surgery, surgery can significantly reduce the incidence of eating disorders and symptoms. However, there is no obvious change in the follow-up time of AUD in the first two years after bariatric surgery, and the risk increases obviously in the third year, with an OR of 1.825. The evidence of moderate research shows that the risk of suicide and self-harm increases after bariatric surgery. The odds ratios in the same population and the control group were 1.9 and 3.8 times, respectively.
CONCLUSION
Bariatric surgery is beneficial for improving most mental health-related outcomes. However, we should be cautious about the increased risk of adverse mental health after surgery, such as suicide, self-harm, and AUD.
Topics: Female; Humans; Anxiety; Anxiety Disorders; Bariatric Surgery; Mental Health; Systematic Reviews as Topic; Meta-Analysis as Topic
PubMed: 38027159
DOI: 10.3389/fendo.2023.1283621 -
BMJ (Clinical Research Ed.) Jul 2015
Topics: Bariatric Surgery; Humans; Obesity; Patient Education as Topic; Primary Health Care; Referral and Consultation; State Medicine; United Kingdom
PubMed: 26229049
DOI: 10.1136/bmj.h3802 -
Current Atherosclerosis Reports May 2018Cumulating evidence is available to demonstrate the efficacy of bariatric surgery (BS) in achieving weight loss and optimizing comorbidities. However, currently, only a... (Review)
Review
PURPOSE OF REVIEW
Cumulating evidence is available to demonstrate the efficacy of bariatric surgery (BS) in achieving weight loss and optimizing comorbidities. However, currently, only a minority of eligible patients approaches bariatric centers. The underuse of BS can no longer be explained by the lack of evidence supporting its beneficial outcomes along with its favorable safety-profile, rather, by the supporting infrastructure, insurance coverage, and mindset of society, including potential patients and allied healthcare professionals. As a framework to approach mindset barriers in the diffusion of BS, we used the Rogers' levels of the innovation adoption process: (1) knowledge, (2) persuasion, (3) decision, (4) implementation, and (5) confirmation.
RECENT FINDINGS
Knowledge: people tend to believe that obesity is a result of lack of willpower and they have difficulties in differentiating BS from cosmetic surgery. Eligible patients often do not assess themselves as being morbidly obese and are unaware that they would qualify for BS. Persuasion: majority of BS candidates search health information online, with the aim of getting information about surgical techniques and other patients' experiences. Decision: metabolically more compromised patients are more likely to opt for BS.
IMPLEMENTATION
general practitioners who already referred patients for BS seem to be more confident to refer again, to tackle obesity and manage postoperative follow-up. Confirmation: postbariatric patients seem to be more self-confident and more productive at work; however, their stigmatization might prevail related to the way they have achieved weight loss. Dissemination of balanced and corroborative information seems to be the main instrument to combat mindset barriers. The integration of general practitioners under the umbrella of bariatric centers has a great potential to increase referrals. Social media may represent a helpful tool to be used by medical professionals and patient-role models to improve confident decision-making of bariatric candidates.
Topics: Bariatric Surgery; Communication Barriers; Health Knowledge, Attitudes, Practice; Health Services Misuse; Humans; Obesity, Morbid; Social Perception; Social Stigma
PubMed: 29785493
DOI: 10.1007/s11883-018-0738-6 -
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 -
Saudi Journal of Gastroenterology :... 2015Bariatric surgery is the most effective therapeutic option for obese patients; however, it carries substantial risks, including procedure-related complications,... (Review)
Review
Bariatric surgery is the most effective therapeutic option for obese patients; however, it carries substantial risks, including procedure-related complications, malabsorption, and hormonal disturbance. Recent years have seen an increase in the bariatric surgeries performed utilizing either an independent or a combination of restrictive and malabsorptive procedures. We review some complications of bariatric procedures more specifically, hypoglycemia and osteoporosis, the recommended preoperative assessment and then regular follow up, and the therapeutic options. Surgeon, internist, and the patient must be aware of the multiple risks of this kind of surgery and the needed assessment and follow up.
Topics: Bariatric Surgery; Humans; Hypoglycemia; Obesity; Obesity, Morbid; Osteoporosis; Postoperative Complications
PubMed: 26458852
DOI: 10.4103/1319-3767.164183 -
Obesity Surgery Jan 2017Enhanced recovery after surgery (ERAS) protocol is well established in many surgical disciplines and leads to a decrease in the length of hospital stay and morbidity.... (Meta-Analysis)
Meta-Analysis Review
Enhanced recovery after surgery (ERAS) protocol is well established in many surgical disciplines and leads to a decrease in the length of hospital stay and morbidity. Multimodal protocols have also been introduced to bariatric surgery. This review aims to evaluate the current literature on ERAS in obesity surgery and to conduct a meta-analysis of primary and secondary outcomes. MEDLINE, Embase, Scopus and Cochrane Library were searched for eligible studies. Key journals were hand-searched. We analysed data up to May 2016. Eligible studies had to contain four described ERAS protocol elements. The primary outcome was the length of hospital stay; the secondary outcomes included overall morbidity, specific complications, mortality, readmissions and costs. Random effect meta-analyses were undertaken. The initial search yielded 1151 articles. Thorough evaluation resulted in 11 papers, which were analysed. The meta-analysis of the length of stay presented a significant reduction standard mean difference (Std. MD) = -2.39 (-3.89, -0.89), p = 0.002. The analysis of overall morbidity, specific complications and Clavien-Dindo classification showed no significant variations among the study groups. ERAS protocol in bariatric surgery leads to the reduction of the length of hospital stay while maintaining no or low influence on morbidity.
Topics: Bariatric Surgery; Comorbidity; Humans; Length of Stay; Obesity, Morbid; Postoperative Complications; Recovery of Function
PubMed: 27817086
DOI: 10.1007/s11695-016-2438-z -
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 -
The Journal of Steroid Biochemistry and... Oct 2017Bariatric surgery is a highly effective treatment for obesity, but it may have detrimental effects on the skeleton. Skeletal effects are multifactorial but mediated in... (Review)
Review
Bariatric surgery is a highly effective treatment for obesity, but it may have detrimental effects on the skeleton. Skeletal effects are multifactorial but mediated in part by nutrient malabsorption. While there is increasing interest in non-nutritional mechanisms such as changes in fat-derived and gut-derived hormones, nutritional factors are modifiable and thus represent potential opportunities to prevent and treat skeletal complications. This review begins with a discussion of normal intestinal calcium transport, including recent advances in our understanding of its regulation by vitamin D, and areas of continued uncertainty. Human and animal studies of vitamin D and intestinal calcium transport after bariatric surgery are then summarized. In humans, even with optimized 25-hydroxyvitamin D levels and recommended calcium intake, fractional calcium absorption decreased dramatically after Roux-en-Y gastric bypass (RYGB). In rats, intestinal calcium absorption was lower after RYGB than after sham surgery, despite elevated 1,25-dihyroxyvitamin D levels and intestinal gene expression evidence of vitamin D responsiveness. Such studies have the potential to shed new light on the physiology of vitamin D and intestinal calcium transport. Moreover, understanding the effects of bariatric surgery on these processes may improve the clinical care of bariatric surgery patients.
Topics: Animals; Bariatric Surgery; Biological Transport; Calcium; Homeostasis; Humans; Intestinal Absorption; Intestinal Mucosa; Vitamin D
PubMed: 28027914
DOI: 10.1016/j.jsbmb.2016.12.012 -
Chinese Medical Journal Jan 2018With the evolution of society and changes in human lifestyle, obesity is becoming increasingly prevalent worldwide, and obesity-related comorbidities such as diabetes,... (Review)
Review
OBJECTIVE
With the evolution of society and changes in human lifestyle, obesity is becoming increasingly prevalent worldwide, and obesity-related comorbidities such as diabetes, hyperlipidemia, hypertension, and coronary heart disease are more common. As a result, new devices and methods for bariatric and metabolic endoscopy are being developed for clinical use, offering new options for patients. This review discussed the progress in bariatric and metabolic endoscopy.
DATA SOURCES
This review was based on data in articles published in the PubMed database up to September 2017, with the following keywords: "obesity", "endoscopy", "weight loss", and "metabolism".
STUDY SELECTION
Original articles about various endoscopic methods of weight loss and other reviews of bariatric and metabolic endoscopy were included and analyzed.
RESULTS
The technology of bariatric and metabolic endoscopy has advanced rapidly in recent years. The intragastric balloon (IGB), with its comparatively long period of development, is the most mature and widely used instrument. Multiple new endoscopic devices have been created in recent years, with different targets to achieve weight loss. Despite the proliferation of new devices, the lack of clinical data results in a shortage of clinical experience and instruction in the use of this new equipment.
CONCLUSIONS
Bariatric and metabolic endoscopy would help obese people lose weight or prepare for bariatric surgery and hopefully alleviate some of the complications of bariatric procedures. Adequate studies and data are still needed for the new endoscopic devices.
Topics: Bariatric Surgery; Body Weight; Endoscopy; Gastric Balloon; Gastroplasty; Humans; Metabolic Diseases; Obesity; Weight Loss
PubMed: 29271386
DOI: 10.4103/0366-6999.221283 -
Family Medicine Jan 2020
Topics: Bariatric Surgery
PubMed: 31914188
DOI: 10.22454/FamMed.2020.281985