Bariatric surgery. A systematic review and meta-analysis

Buchwald, Hēnry; Avidor, Yoav; Braunwald, Eugene

doi:10.1016/j.accreview.2004.12.068

Cited by 1,278 publications

(1,888 citation statements)

References 0 publications

Supporting

Mentioning

1,606

Contrasting

Unclassified

213

Order By: Relevance

“…Secondly, although RYGB is the most common bariatric surgical intervention, especially in the US, 60 reliable measurements of FFM loss in only two studies with a total of 49 subjects could be found. 51,50 Given the potential for adverse consequences of this intervention, 61 it is very poorly studied.…”

Section: Discussionmentioning

confidence: 98%

Changes in fat-free mass during significant weight loss: a systematic review

2006

View full text Add to dashboard Cite

Objective: To identify the proportion of weight lost as fat-free mass (FFM) by various weight loss interventions. Methods: Medline and Embase were systematically searched for reliable measurements of FFM before and after weight loss of 410 kg and eligible data were pooled. In a fixed effect model of % FFM loss/weight loss (%FFML), linear regression analysis was used to determine the influence of degree of caloric restriction, exercise, magnitude of weight loss, initial body mass index (BMI) and type of surgery. Results: Data were included from 26 cohorts treated with dietary and behavioral interventions and 29 cohorts of bariatric surgery patients. The degree of caloric restriction was positively associated with %FFML (r 2 ¼ 0.31, P ¼ 0.006) and in three randomized controlled trials exercise was shown to decrease %FFML. Compared with laparoscopic adjustable gastric banding (LAGB), biliopancreatic diversion (BPD) and roux en Y gastric bypass (RYGB) caused greater log e (natural log) %FFML (r 2 ¼ 0.453, Po0.001). Differences in log e %FFML between surgical procedures were independent of initial BMI and magnitude of weight loss. Conclusions: The degree of caloric restriction, exercise and rate of weight loss influence the proportion of weight lost as FFM after non-surgical interventions. For surgical interventions, BPD and RYGB result in greater %FFML than LAGB.

show abstract

Section: Discussionmentioning

confidence: 98%

Changes in fat-free mass during significant weight loss: a systematic review

2006

View full text Add to dashboard Cite

show abstract

“…1 At present, surgical intervention is the only treatment alternative yielding more enduring weight loss and improvements in health status and HRQL. 9 Nevertheless, much of the research reporting improvements in psychosocial areas after bariatric surgery suffers from methodological limitations, such as small study samples, short follow-up periods, large numbers of dropouts and lack of appropriate control subjects. 8,10 Few studies have followed patients for longer periods, and reliable information on the long-term effects of weight reduction treatment on HRQL is lacking.…”

Section: Introductionmentioning

confidence: 99%

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

et al. 2007

View full text Add to dashboard Cite

Objective: To examine trends and effects of weight loss treatment on health-related quality of life (HRQL) in the severely obese over 10 years. Design: Swedish obese subjects (SOS) intervention study is a controlled, longitudinal trial of the health effects of weight loss in the severely obese. Subjects: A total of 655 of 851 surgically treated and 621 of 852 conventionally treated obese men (body mass index, BMIX34) and women (BMIX38) who completed 10 years of the study. Measurements: HRQL was assessed before treatment and after 0.5, 1, 2, 3, 4, 6, 8 and 10 years. Results: HRQL change during the 10-year observation period largely followed phases of weight loss, weight regain and weight stability. Improvements and deteriorations in HRQL were associated with the magnitude of weight loss or regain, except regarding anxiety. Peak improvements in the surgical group were observed during the first year of weight loss, whereas the weight regain phase (mainly between 1-and 6-year follow-up) was accompanied by a gradual decline in HRQL. The period from 6-to 10-year follow-up was characterized by relatively stable observations in both weight and HRQL. At 10 years, net gains were noted in all HRQL domains compared to baseline. Comparisons of treatment effects on HRQL in the surgical vs conventional group after 10 years showed significantly better outcome in the surgical group on current health perceptions, social interaction, psychosocial functioning and depression, whereas no significant differences were found for overall mood and anxiety. Long-term results of the study suggest that a maintained weight loss of about 10% is sufficient for positive long-term effects on HRQL, a limit that was reached in about two-thirds of the surgically treated patients who completed 10 years of the study. Conclusion: Long-lasting weight reduction in the severely obese has a general long-standing positive outcome on HRQL. Bariatric surgery is a favorable option for the treatment of severe obesity, resulting in long-term weight loss and HRQL improvements in a majority of patients. However, difficulties among some surgical patients to control and maintain weight loss over time should not be ignored. Future research should study if the long-term efficacy of bariatric surgery may be further enhanced by implementing lifestyle modification techniques in the postoperative management of patients.

show abstract

“…8 Advances in minimally invasive surgery have shortened recovery time, reduced peri-operative morbidity, and expanded the range of patients amenable to this procedure. 9 While previous studies have demonstrated that marked weight reduction following BAS results in a reduction in LV mass and improved diastolic filling, 10 outcomes of patients with severe systolic heart failure following BAS have not been previously reported.…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Ramani

McCloskey

Ramanathan

et al. 2008

Clinical Cardiology

103

View full text Add to dashboard Cite

Background: Morbid obesity (MO) is a risk factor for congestive heart failure (CHF). The presence of MO impairs functional status and disqualifies patients for cardiac transplantation. Bariatric surgery (BAS) is a frontline, durable treatment for MO; however, the safety and efficacy of BAS in advanced CHF is unknown. Hypothesis: We hypothesized that by utilizing a coordinated approach between an experienced surgical team and heart failure specialists, BAS is safe in patients with advanced systolic CHF and results in favorable outcomes. Methods: We performed a retrospective chart review of 12 patients with MO (body mass index [BMI] 53±7 kg/m 2 ) and systolic CHF (left ventricular ejection fraction [LVEF] 22±7%, New York Heart Association [NYHA] class 2.9±0.7) who underwent BAS, and then compared outcomes with 10 matched controls (BMI 47.2±3.6 kg/m 2 , LVEF 24±7%, and NYHA class 2.4±0.7) who were given diet and exercise counseling. Results: At 1 y, hospital readmission in BAS patients was significantly lower than controls (0.4±0.8 versus 2.5±2.6, p = 0.04); LVEF improved significantly in BAS patients (35±15%, p = 0.005), but not in controls (29±14%, p = not significant [NS]). The NYHA class improved in BAS patients (2.3±0.5, p = 0.02), but deteriorated in controls (3.3±0.9, p = 0.02). One BAS patient was successfully transplanted, and another listed for transplantation. Conclusions: Bariatric surgery is safe and effective in patients with MO and severe systolic CHF, and should be considered in patients who have failed conventional therapy to improve clinical status.

show abstract

Bariatric surgery. A systematic review and meta-analysis

Cited by 1,278 publications

References 0 publications

Changes in fat-free mass during significant weight loss: a systematic review

Changes in fat-free mass during significant weight loss: a systematic review

Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Contact Info

Product

Resources

About