A total weight loss of 25% shows better predictivity in evaluating the efficiency of bariatric surgery

Tu, Ya; Pan, Yunhui; Han, Junfeng; Pan, Jiemin; Zhang, Pin; Jia, Weiping; Bao, Yuqian; Yu, Haoyong

doi:10.1038/s41366-020-00690-5

Cited by 25 publications

(20 citation statements)

References 24 publications

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“…Data from the literature showed that weight loss of about 25%, along with improvements of comorbidities, indicated surgical success (Masnyj, Shea & Khaitan, 2020;Tu et al, 2021). In a recent study, the success criteria called for the consideration of clear goals regarding health improvement, which include the metabolic aspects of the patients.…”

Section: Discussionmentioning

confidence: 99%

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Attlee¹,

Hasab²,

Rashed³

et al. 2021

Mal J Nutr

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Background: Data on postoperative follow-ups and bariatric surgery (BS) outcomes performed in the United Arab Emirates (UAE) are crucial for registry. This study assessed the one-year postoperative changes in body composition and metabolic profiles in BS patients. Methods: The medical and dietetics records of 51 adult patients who underwent BS in the largest public hospital in Sharjah, UAE were reviewed. Data on body weight and composition, as well as metabolic profile (blood glucose and lipid levels) from the initial until the last hospital visit were recorded. Results: The median (interquartile range) follow-up period was 6.0 (8.0) months. The patients had significant total weight loss [19.3 (12.6)%] and reduction in body mass index (BMI) [18.0 (13.6)%] of approximately 7 BMI points. Moreover, the patients’ body composition improved significantly; loss was the highest in fat mass [–30.9 (22.1)%] and the least in lean body mass [–8.6 (8.4)%]. There was a steady decline in all body composition variables with a longer duration of follow-up visits from 1–3 months to 10–12 months. The fat mass (–40.3%):lean body mass (–10.7%) loss ratio was 3.8:1 at 10–12 months. The patients’ metabolic status was normal during the last postoperative visit. Conclusions: Incremental improvements in body composition of patients were evident with longer follow-up visits up to one year after BS. Hence, patients should attend regular follow-up visits after BS. Moreover, accurate and complete documentations of medical and dietetics visits are mandated.

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Section: Discussionmentioning

confidence: 99%

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Attlee¹,

Hasab²,

Rashed³

et al. 2021

Mal J Nutr

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“…The use of %EWL for the evaluation of BS weight-outcome has been recently questioned, mostly due to its dependency on pre-BS weight excess 37 , 38 , with the percentage of total-weight-loss (%TWL), calculated as: being proposed as an alternative parameter 37 , 38 . However, there is still no consensus in literature about which threshold to adopt for the definition of BS unsuccess, since %TWL < 20% was proposed by some authors 37 – 39 , while %TWL < 25% was suggested by others 40 . Therefore, to the scope of this study, we opted to use %EWL as the reference parameter for model development, due to the availability of an unanimously recognized cut-off for the definition of BS unsuccess; nevertheless, in order to further strengthen the consistency of our results, final model performances were also assessed considering %TWL as the outcome of choice.…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a scoring system for pre-surgical and early post-surgical prediction of bariatric surgery unsuccess at 2 years

Bioletto

Pellegrini

D’Eusebio

et al. 2021

Sci Rep

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Bariatric surgery (BS) is an effective treatment for morbid obesity. However, a simple and easy-to-use tool for the prediction of BS unsuccess is still lacking. Baseline and follow-up data from 300 consecutive patients who underwent BS were retrospectively collected. Supervised regression and machine-learning techniques were used for model development, in which BS unsuccess at 2 years was defined as a percentage of excess-weight-loss (%EWL) < 50%. Model performances were also assessed considering the percentage of total-weight-loss (%TWL) as the reference parameter. Two scoring systems (NAG-score and ENAG-score) were developed. NAG-score, comprising only pre-surgical data, was structured on a 4.5-point-scale (2 points for neck circumference ≥ 44 cm, 1.5 for age ≥ 50 years, and 1 for fasting glucose ≥ 118 mg/dL). ENAG-score, including also early post-operative data, was structured on a 7-point-scale (3 points for %EWL at 6 months ≤ 45%, 1.5 for neck circumference ≥ 44 cm, 1 for age ≥ 50 years, and 1.5 for fasting glucose ≥ 118 mg/dL). A 3-class-clustering was proposed for clinical application. In conclusion, our study proposed two scoring systems for pre-surgical and early post-surgical prediction of 2-year BS weight-loss, which may be useful to guide the pre-operative assessment, the appropriate balance of patients’ expectations, and the post-operative care.

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“…However, recently published studies have suggested that %TWL yields a more accurate reflection of outcomes without the need to define an ideal body weight ( Van De Laar, 2012; Hatoum and Kaplan, 2013 ). Tu et al (2021) retrospectively investigated 430 patients with obesity who underwent metabolic surgery and found that 397 patients (92.3%) exhibited MetS at baseline and 337 patients (84.9%) were in MetS remission 1 year after surgery. Multivariate regression analysis indicated that, compared with %EWL, %TWL better predicts MetS remission at 1 year after metabolic surgery ( P for trend = 0.029).…”

Section: Predictorsmentioning

confidence: 99%

“…Multivariate regression analysis indicated that, compared with %EWL, %TWL better predicts MetS remission at 1 year after metabolic surgery ( P for trend = 0.029). Furthermore, Youden’s index indicated that ≥25%TWL is the optimal metric to identify individuals who are good responders to bariatric surgery ( Tu et al, 2021 ).…”

Section: Predictorsmentioning

confidence: 99%

Metabolic surgery in China: present and future

Bao

2021

Journal of Molecular Cell Biology

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Obesity and its related complications comprise a serious public health problem worldwide, and obesity is increasing in China. Metabolic surgery is a new type of treatment with unique advantages in weight loss and obesity-related metabolic complications. The pathogenesis of obesity is complex and not yet fully understood. Here, we review the current efficacy and safety of metabolic surgery, as well as recent progress in mechanistic studies and surgical procedures in China. The exciting and rapid advances in this field provide new opportunities for patients with obesity and strike a balance between long-term effectiveness and safety.

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A total weight loss of 25% shows better predictivity in evaluating the efficiency of bariatric surgery

Cited by 25 publications

References 24 publications

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Improvement in body composition of adult postbariatric surgery patients at one-year follow-up at a public hospital in United Arab Emirates

Development and validation of a scoring system for pre-surgical and early post-surgical prediction of bariatric surgery unsuccess at 2 years

Metabolic surgery in China: present and future

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