A 52-Year-Old Woman With Obesity

Wee, Christina C.

doi:10.1001/jama.2009.1197

Cited by 17 publications

(7 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1–5 Given obesity’s profound adverse health and quality-of-life consequences, as many as 150 000 Americans undergo WLS each year. 6 …”

mentioning

confidence: 99%

“…Data suggest mortality risks range from less than 1% to as high as 5% in some high-risk groups. 1,7,8 Risk of serious complications and the need for revisional surgery can be as high as 20%. 1,2 High-quality long-term data on diverse populations in the United States are lacking, but data from the Swedish Obese Subjects Study suggest that, although initial weight loss can be impressive within the first or second postoperative year, recidivism occurs in a large subset of patients.…”

mentioning

confidence: 99%

“…1,7,8 Risk of serious complications and the need for revisional surgery can be as high as 20%. 1,2 High-quality long-term data on diverse populations in the United States are lacking, but data from the Swedish Obese Subjects Study suggest that, although initial weight loss can be impressive within the first or second postoperative year, recidivism occurs in a large subset of patients. 3 Nevertheless, WLS leads to improvement in comorbidities, especially diabetes mellitus, 9,10 even after accounting for weight regain.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery

Wee¹,

Hamel²,

Apovian³

et al. 2013

JAMA Surg

Self Cite

View full text Add to dashboard Cite

Importance Weight loss surgery (WLS) has been shown to produce long-term weight loss but is not risk free or universally effective. The weight loss expectations and willingness to undergo perioperative risk among patients seeking WLS remain unknown. Objectives To examine the expectations and motivations of WLS patients and the mortality risks they are willing to undertake and to explore the demographic characteristics, clinical factors, and patient perceptions associated with high weight loss expectations and willingness to assume high surgical risk. Design We interviewed patients seeking WLS and conducted multivariable analyses to examine the characteristics associated with high weight loss expectations and the acceptance of mortality risks of 10% or higher. Setting Two WLS centers in Boston. Participants Six hundred fifty-four patients. Main Outcome Measures Disappointment with a sustained weight loss of 20% and willingness to accept a mortality risk of 10% or higher with WLS. Results On average, patients expected to lose as much as 38% of their weight after WLS and expressed disappointment if they did not lose at least 26%. Most patients (84.8%) accepted some risk of dying to undergo WLS, but only 57.5% were willing to undergo a hypothetical treatment that produced a 20% weight loss. The mean acceptable mortality risk to undergo WLS was 6.7%, but the median risk was only 0.1%; 19.5% of all patients were willing to accept a risk of at least 10%. Women were more likely than men to be disappointed with a 20% weight loss but were less likely to accept high mortality risk. After initial adjustment, white patients appeared more likely than African American patients to have high weight loss expectations and to be willing to accept high risk. Patients with lower quality-of-life scores and those who perceived needing to lose more than 10% and 20% of weight to achieve “any” health benefits were more likely to have unrealistic weight loss expectations. Low quality-of-life scores were also associated with willingness to accept high risk. Conclusions and Relevance Most patients seeking WLS have high weight loss expectations and believe they need to lose substantial weight to derive any health benefits. Educational efforts may be necessary to align expectations with clinical reality.

show abstract

“…1–5 Given obesity’s profound adverse health and quality-of-life consequences, as many as 150 000 Americans undergo WLS each year. 6 …”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery

Wee¹,

Hamel²,

Apovian³

et al. 2013

JAMA Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Multiple studies have identified that these surgical procedures have been very effective in terms of weight loss and the associated reduction of comorbidities. [8,9] As a result, nurse practitioners will continue to encounter bariatric surgery recipients in their practice settings. This article will summarize the most common bariatric weight loss procedures, review the current pharmacokinetic concerns in bariatric surgery recipients, and address implications for prescribing practices for primary care providers caring for patients who have undergone bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapeutics for bariatric surgery patients in the primary care setting: An overview for nurse practitioners

Abate

Buttaro

2014

Clinical Nursing Studies

View full text Add to dashboard Cite

Patients who have undergone bariatric procedures for weight loss are increasingly seen in the primary care setting. Due to the unique characteristics of surgical weight loss procedures, the prescribing practices of health care providers must be evaluated. This article addresses the anatomical changes associated with laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, biliopancreatic diversion with a duodenal switch, and vertical sleeve gastrectomy, because absorption, distribution, metabolism and excretion of medications may be more complex for bariatric surgery recipients than for other patients. Associated prescribing modifications for primary care providers caring for bariatric surgery recipients in the primary care setting are also discussed.

show abstract

“…[10–12] Research has shown that despite conservative modalities resulting in 4–8% weight loss, 90% of patients relapse within five years. [13–15] Indeed the maintenance of weight loss is crucial in attaining the beneficial effects of weight reduction which include: resolution or improvement of comorbidities, improvement in health-related quality of life (QOL) and increased survival. [6] Bariatric surgery is currently the only effective therapeutic alternative that provides enduring weight loss in the severely and morbidly obese.…”

mentioning

confidence: 99%

Short-term outcome and quality of life of endoscopically placed gastric balloon and laparoscopic adjustable gastric band

Tayyem

Obondo

Ali

2011

Saudi J Gastroenterol

View full text Add to dashboard Cite

Background/Aim:A prospective longitudinal study was conducted to describe short-term outcome and quality of life (QOL) of endoscopically placed gastric balloon (EPGB) and laparoscopic adjustable gastric band (LAGB).Materials and Methods:Forty seven consecutive patients with body mass index (BMI) of 42 to 72 kg/m2 were assigned to undergo EPGB (n=17) or LAGB (n=30) between May 2008 and May 2010. The main measured outcomes included weight loss, resolution or improvement of comorbidities, hospital stay, complications and QOL.Results:Patients were followed up for a mean of 14 months. Hospital stay was shorter for EPGB patients (one versus two days, P<0.001). Early postoperative complications recorded in EPGB were minor including nausea and vomiting. No late complications were recorded in the EPGB group. One case of band slippage was reported in the LAGB group and fixed laparoscopically. Percent excess weight loss was less in EPGB compared to LAGB (26.2% versus 44.0%, P=0.004). Resolution or improvement of comorbidities was comparable in both groups. The globally impaired preoperative quality of life showed considerable improvement in both groups.Conclusion:EPGB is a safe and effective approach in short-term management of morbid obesity. Weight loss, resolution of comorbidities and improvement in QOL were comparable between both groups.

show abstract

A 52-Year-Old Woman With Obesity

Cited by 17 publications

References 67 publications

Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery

Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery

Pharmacotherapeutics for bariatric surgery patients in the primary care setting: An overview for nurse practitioners

Short-term outcome and quality of life of endoscopically placed gastric balloon and laparoscopic adjustable gastric band

Contact Info

Product

Resources

About