This study evaluated the efficacy and safety of laparoscopic adjustable gastric banding (LAGB) in a large cohort of morbidly obese patients followed for up to 5 years. Methods: Morbidly obese patients, !16 years of age, who underwent LAGB surgery at the Surgical Weight Loss Clinic (SWLC) in Ontario, Canada between May 2005 and January 2011 were eligible for this retrospective chart review. Electronic files were searched to identify all patients who met the inclusion/exclusion criteria. Demographics, weights at baseline and follow-up visits (up to 60 months following surgery), and post-operative complications were documented. As follow-up visits occurred at unevenly spaced intervals within and across patients, modeling Methods were used to more accurately assess mean % weight loss (WL) and % excess weight loss (EWL) over time.
550-ORHypothesis: Combining topiramate with metformin improves weight, visceral adiposity, and risk factors more than metformin alone. This abstract presents interim data from a 12-month doubleblind, randomized, parallel-group trial in obese subjects with metabolic syndrome randomized to metformin alone or metformin + topiramate (n¼24; 6 males; 55AE 8 yrs; weight¼104AE12 kg; BMI¼38AE4 kg/m2). All received advice on calorie restriction and exercise, and half were taking orlistat. Baseline BMI was 38AE4 kg/m2, waist 117AE10 cm, MAP 93AE9 mmHg; heart rate 72 AE11 bpm; HBA1c 5.8AE0.4%; triglycerides 159AE125 mg/dl). There were substantial weight reductions at 12 months (table). BP was significantly reduced by metformin + topiramate, and the combination also reduced waist and heart rate more than metformin alone. HBA1c and triglycerides were significantly reduced by combination therapy only, though LDL and HDL were not different. In conclusion, there is a greater effect of metformin + topiramate on waist compared to metformin alone, suggesting that topiramate improves visceral obesity independent of weight loss. Decreased heart rate after topiramate suggests that this agent may modulate the autonomic nervous system. The long-term effects of combined metformin and topiramate on CV risk factors in metabolic syndrome warrant further exploration.
551-ORImproving the Management of Psychosocial Issues in Obesity: Learnings from the Diabetes Attitudes, Wishes and Needs Study T. MICHAEL VALLIS Dalhousie University, Capital Health, Halifax, Nova Scotia, CanadaIn 2012 the Diabetes Attitudes, Wishes and Needs Study (DAWN2), a multinational survey across 17 countries of the world, was completed. This was a 360 degree survey of the experience of individuals living with diabetes, family members of those with diabetes, and healthcare providers. In Canada, data were collected on 902 participants, including 500 individuals with diabetes (84% type 2 diabetes, mean BMI 32.3), 121 family members, and 281 healthcare providers. Data was collected on quality of life, attitudes and beliefs, active self-managment, care and support from the support team, care and support from family, community and society, including exper...
