A Specialized Medical Management Program to Address Post-operative Weight Regain in Bariatric Patients

Abstract

A medically supervised weight management program complementary to surgery is beneficial for the treatment of weight regain and may prove important in assisting the surgical patient achieve long-term weight loss success.

The effectiveness and safety of pharmaceuticals to manage excess weight post-bariatric surgery: a systematic literature review

“…As such, weight loss pharmaceuticals are not approved for use in this patient population. Similar to what is observed in non-post-surgical populations, results of this systematic literature review suggest postbariatric surgery patients taking pharmaceuticals for weight loss can have reductions in weight 4,[7][8][9][10][11][12][13][14][15][16][17][18] . While studies examined different pharmaceuticals, and surgery types, all reported weight loss.…”

“…There were differences in the study design of the 13 articles included in this review. Eleven of the studies were cohort studies 4,[7][8][9][10][11][12][13][14][15][16] , and the remaining two are a matched prospective cohort 17 and case series 18 . Types of bariatric surgery procedures also varied, but the most common procedure was roux-en-y gastric bypass (RNY), in ten [7][8][9][10][11][12][13]15,16,18 studies, followed by adjustable gastric banding (AGB) 4,10,12,13,[15][16][17] and sleeve gastrectomy (SG) [7][8][9][10]12,13,15 both in seven studies.…”

“…Five 12,14,15,17,18 papers focused on one medication for weight loss post bariatric surgery, whereas eight 4,[7][8][9][10][11]13,16 papers studied the use of multiple medications. Four [7][8][9]16 of these eight studies compared weight loss outcome according to type of medication.…”

“…The global quality rating for each article can be found is presented in Table 2. Overall, articles 7,[9][10][11][12][13][14][15][16]18 received a moderate or strong quality rating (84.6%, n ¼ 11 of 13). In fact, the majority of articles received a strong rating (69.2%, n ¼ 9 of 13) 7,9,10,12-16 , and only two articles 4,17 (15.4%) received a weak rating.…”

“…Two post-hoc analysis of this study observed less weight loss with metformin in younger (21-30 Value is calculated from postoperative weight minus post-topiramate weight using patient-level data. 18 Moderate Jester 11 Moderate Nor Hanipah 13 Strong Pajecki 12 Strong Rye 14 Strong Schwartz 16 Strong Srivastava 10 Strong Stanford 9 Strong Stanford 7 Strong Toth 8 Strong Zilberstein 4 Weak Zoss 17 Weak JOURNAL OF DRUG ASSESSMENT years; p ¼ .05151) 8 adults, and greater weight loss with liraglutide 1.8 mg in older (!60 years; p ¼ .03) 7 adults. Schwartz et al (2016) 16 observed greater weight loss with the use of phentermine (6.35 kg) as monotherapy compared to a combination phentermine and topiramate (3.81 kg) in post-bariatric surgery patients.…”