A Systematic Review of Genetic Correlates of Weight Loss After Bariatric Surgery

Gupta, Sapana R.; Zhou, Yingjie; Wadden, Thomas A.; Berkowitz, Robert I.; Chao, Ariana M.

doi:10.1007/s11695-021-05585-6

Cited by 15 publications

(13 citation statements)

References 73 publications

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“…Three mutations were identified: c.485C>T (T162I), 508A>G (I170V), and 307G>A (V103I). Six individuals composed the SG [four females, two males; 18 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)…”

Section: Resultsmentioning

confidence: 99%

“…A recent article reported long-term weight loss outcome on bi-allelic mutation in the MC4R gene in a patient who underwent sleeve gastrectomy only ( 27 ). The recent systematic review reported that most of the studies on outcomes of BS in MC4R mutation found no association of MC4R mutations with weight loss ( 20 ). We are reporting, for the first time to our knowledge, long-term outcomes of revisional surgery (RYGB) in both sexes with the MC4R null genotype.…”

Section: Discussionmentioning

confidence: 99%

“…Similar observation in a patient with homozygous MC4R deficiency (MC4R-d) was reported in 2015 ( 19 ). A systematic review in 2021 synthesized outcomes of BS among patients with monogenic forms of obesity and found that weight loss results were inconsistent for patients with MC4R-d ( 20 ). Our group has previously reported short-term effects of BS in three patients with homozygous MC4R mutations, the youngest of whom was only 4 years old when a laparoscopic vertical sleeve gastrectomy (LSG) was performed ( 21 ).…”

Section: Introductionmentioning

confidence: 99%

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Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

et al. 2022

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BackgroundMelanocortin-4 receptor (MC4R) mutations are the most common of the rare monogenic forms of obesity. However, the efficacy of bariatric surgery (BS) and pharmacotherapy on weight and glycemic control in individuals with MC4R deficiency (MC4R-d) is not well-established. We investigated and compared the outcomes of BS and pharmacotherapy in patients with and without MC4R-d.MethodsPertinent details were derived from the electronic database among identified patients who had BS with MC4R-d (study group, SG) and wild-type controls (age- and sex-matched control group, CG). Short- and long-term outcomes were reported for the SG. Short-term outcomes were compared between the two groups.ResultsSeventy patients were screened for MC4R-d. The SG [six individuals (four females, two males); 18 (10–27) years old at BS; 50.3 (41.8–61.9) kg/m2 at BS, three patients with homozygous T162I mutations, two patients with heterozygous T162I mutations, and one patient with heterozygous I170V mutation] had a follow-up duration of up to 10 years. Weight loss, which varied depending on mutation type [17.99 (6.10–22.54) %] was stable for 6 months; heterogeneity of results was observed thereafter. BS was found superior to liraglutide on weight and glycemic control outcomes. At a median follow-up of 6 months, no significant difference was observed on weight loss (20.8% vs. 23.0%, p = 0.65) between the SG and the CG [eight individuals (four females, four males); 19.0 (17.8–36.8) years old at BS, 46.2 (42.0–48.3) kg/m2 at BS or phamacotherapeutic intervention]. Glycemic control in patients with MC4R-d and Type 2 diabetes improved post-BS.ConclusionOur data indicate efficacious short-term but varied long-term weight loss and glycemic control outcomes of BS on patients with MC4R-d, suggesting the importance of ongoing monitoring and complementary therapeutic interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

et al. 2022

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“…For people suffering from extreme obesity, bariatric surgery such as Roux-en-Y gastric bypass and sleeve gastrectomy is the most (cost-) effective treatment option to reduce weight, comorbidities, and mortality and to increase health-related quality of life [ 1 , 2 , 3 ]. Although most patients show substantial postoperative weight loss 1 year after surgery, approximately 20% experience suboptimal weight loss (SWL) (i.e., ≤50% of percentage excess weight loss (%EWL)) or ≤20–25% of percentage total weight loss (%TWL) [ 4 , 5 , 6 ]. The first year following bariatric surgery is critical to optimize weight loss [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers to and Facilitators of Participation in Weight Loss Intervention for Patients with Suboptimal Weight Loss after Bariatric Surgery: A Qualitative Study among Patients, Physicians, and Therapists

Westerman¹,

Stralen²,

Beuken³

et al. 2022

Obes Facts

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Introduction: Not all patients with suboptimal weight loss after bariatric surgery are willing to participate in postoperative behavioral intervention to improve their weight loss. The objective of this study was to explore barriers to and facilitators of participation in postoperative behavioral intervention. Methods: Thirty semi-structured interviews were conducted with patients (18), physicians (6), and therapists (6) (i.e., psychologists, dieticians, or physiotherapists). A thematic analysis approach was used. Results: Emotional responses caused by confrontation with suboptimal weight loss hampered patients’ deliberation about participation; insufficient exploration of their need for help limited patients’ ability to make informed decisions; patients were receptive to their physician’s advice when their physician respected their autonomy; using visual weight loss graphs helped to explain suboptimal weight loss to patients; and financial costs and time constraints obstructed participation. Conclusions: To improve adequate intervention participation, health care providers should focus on emotion regulation, support patients in exploring their own need for help, and respect patients’ autonomy.

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“…En segundo lugar, se pudo presentar un retraso en la identificación de los pacientes que venían con una pérdida insuficiente de peso debido a su inasistencia a los controles programados, dificultando así tomar las medidas necesarias para mantener un peso corporal dentro de metas. Recientemente, algunos grupos de investigadores han explorado sobre posibles factores genéticos y metabólicos que se relacionan a una mala respuesta a la cirugía, pero esta es aún un área en desarrollo con conclusiones sólidas por determinar 20 .…”

Section: Discussionunclassified

Factores de riesgo asociados a la pérdida insuficiente o ganancia significativa de peso en pacientes sometidos a cirugía bariátrica

et al. 2023

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Introducción. La cirugía bariátrica es efectiva para inducir una rápida pérdida del exceso de peso, pero existen dudas sobre la duración de este efecto a largo plazo. Este estudio buscaba identificar la proporción de pacientes operados que presentaron una pérdida insuficiente o una ganancia significativa de peso y los posibles factores relacionados. Métodos. Estudio de cohorte retrospectivo en pacientes adultos sometidos a cirugía bariátrica. Se describieron variables demográficas y clínicas. Se realizó un análisis multivariado para identificar factores relacionados con un peso fuera de metas posterior a la cirugía. Resultados. Se incluyeron 187 pacientes, 117 con baipás gástrico y 70 con manga gástrica. La mediana de índice de masa corporal preoperatorio fue 41,3 kg/m2 y postoperatorio de 28,8 kg/m2. El 94,7 % de los pacientes en ambos grupos logró una adecuada pérdida del exceso de peso. La ganancia de peso mayor del 20 % se presentó en el 43,5 % de los pacientes, siendo mayor en el grupo de manga gástrica (p<0,004). Los factores independientes para ganancia de peso fueron el sexo masculino (OR 5,5), cirugía tipo manga gástrica (OR 3,4), síndrome de apnea del sueño (OR 2,9) y enfermedad mental medicada (OR 2,8). Conclusión. La cirugía bariátrica produce una pérdida del exceso de peso suficiente en casi la totalidad de los pacientes, pero un buen número recuperan peso luego de 3 años. Los principales factores asociados a ganancia de peso son el sexo masculino y la cirugía tipo manga gástrica.

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A Systematic Review of Genetic Correlates of Weight Loss After Bariatric Surgery

Cited by 15 publications

References 73 publications

Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

Weight and Glycemic Control Outcomes of Bariatric Surgery and Pharmacotherapy in Patients With Melanocortin-4 Receptor Deficiency

Barriers to and Facilitators of Participation in Weight Loss Intervention for Patients with Suboptimal Weight Loss after Bariatric Surgery: A Qualitative Study among Patients, Physicians, and Therapists

Factores de riesgo asociados a la pérdida insuficiente o ganancia significativa de peso en pacientes sometidos a cirugía bariátrica

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