Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

King, Wendy C.; Chen, Jia Yuh; Belle, Steven H.; Courcoulas, Anita P.; Dakin, Gregory; Elder, Katherine A.; Flum, David R.; Hinojosa, Marcelo W.; Mitchell, James E.; Pories, Walter J.; Wolfe, Bruce M.; Yanovski, Susan Z.

doi:10.1001/jama.2016.3010

Cited by 137 publications

(110 citation statements)

References 38 publications

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“…However, larger studies with higher number of patients are needed to further analyze these data. Nevertheless, we demonstrated that significant weight loss after RYGB improves daily physical activities and has a positive impact on accompanying comorbidities and existing cardiovascular risk factors [8, 9, 13, 16, 31, 44-46]. In addition to morbidity and premature mortality, obesity and physical inactivity are responsible for a large economic burden [47].…”

Section: Discussionmentioning

confidence: 99%

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Nedeljkovic‐Arsenovic¹,

Banović²,

Radenković³

et al. 2019

Obes Facts

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Background: Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become the most frequently used therapy for morbid obesity. Objectives: The aim of this study was to examine the effects of surgically induced weight loss on cardiopulmonary function 6 months after the procedure, as well as the effect of such an intervention on well-known risk factors for cardiovascular diseases. Methods: This is a cross-sectional study on 66 morbidly obese patients (BMI ≥40 or ≥35 kg/m² with present comorbidities), comparing their cardiopulmonary function prior to and 6 months after RYGB surgery. Results: The substantial amount of weight loss (29.80 ± 13.27 kg) after RYGB surgery was associated with significant reduction of comorbidities, especially diabetes and sedentary lifestyle (p = 0.005 and p = 0.002, respectively). Regarding functional capacity, there was significant increase in peak oxygen uptake (VO₂ peak, p = 0.003), duration of exercise testing, metabolic equivalents (exercise time and METs, p < 0.001), and in peak O₂ pulse. These findings were particularly pronounced in a group of patients who had lost more than 18% of initial weight. Conclusions: Reduction of body weight after RYGB surgery is associated with significantly improved cardiorespiratory function 6 months after surgery, especially in patients who lost more than 18% of their initial body weight. In addition, substantial decreases in body weight were also associated with a reduction of cardiovascular risk factors such as diabetes, smoking, hypertriglyceridemia, and sedentary lifestyle.

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Section: Discussionmentioning

confidence: 99%

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Nedeljkovic‐Arsenovic¹,

Banović²,

Radenković³

et al. 2019

Obes Facts

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“…17 Sensitivity analyses were performed to examine the robustness of results with respect to the missing at random assumption (eAppendix 1, supplement). …”

Section: Methodsmentioning

confidence: 99%

Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study

King

Chen

Courcoulas

et al. 2017

Surgery for Obesity and Related Diseases

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156

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Background Empirical evidence suggests Roux-en-Y gastric bypass (RYGB) increases risk of developing alcohol use disorder (AUD). However, prospective assessment of substance use disorders (SUD) following bariatric surgery is limited. Objective To report SUD-related outcomes following RYGB and laparoscopic adjustable gastric banding (LAGB). To identify factors associated with incident SUD-related outcomes. Setting Ten US hospitals. Methods The Longitudinal Assessment of Bariatric Surgery-2 is an observational cohort study. Participants self-reported past-year AUD symptoms (determined by the Alcohol Use Disorders Identification Test), illicit drug use (cocaine, hallucinogens, inhalants, phencyclidine, amphetamines, or marijuana), and SUD treatment (counseling or hospitalization for alcohol or drugs) presurgery and annually postsurgery for up to seven years through January 2015. Results Of 2348 participants who underwent RYGB or LAGB, 2003 completed baseline and follow-up assessments (79.2% women, baseline median age 47 years, median body mass index 45.6). The year-5 cumulative incidence of postsurgery onset AUD symptoms, illicit drug use, and SUD treatment were 20.8% (95%CI, 18.5-23.3), 7.5% (95%CI, 6.1-9.1), and 3.5% (95%CI, 2.6-4.8), respectively, post-RYGB, and 11.3% (95%CI, 8.5-14.9), 4.9% (95%CI, 3.1-7.6), and 0.9% (95%CI, 0.4-2.5) post-LAGB. Undergoing RYGB vs. LAGB was associated with higher risk of incident AUD symptoms (AHR=2.08 [95%CI, 1.51-2.85]), illicit drug use (AHR=1.76 [95%CI, 1.07-2.90]) and SUD treatment (AHR=3.56 [95%CI, 1.26-10.07]). Conclusions Undergoing RYGB vs. LAGB was associated with twice the risk of incident AUD symptoms. One-fifth of participants reported incident AUD symptoms within 5 years post-RYGB. AUD education, screening, evaluation, and treatment referral should be incorporated in pre- and postoperative care.

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“…Models used all available data, and controlled for baseline characteristics related to missing follow-up data (i.e., age, race [white vs. non-white], and rates of diabetes, hypertension, and ischemic heart disease). 32 …”

Section: Methodsmentioning

confidence: 99%

“…Simulation was used to adjust for multiple comparisons. 32,33 With a sample size of 183, there was 80% power to detect a difference of: 1) 5% between prevalence rates for uncommon eating behaviors (e.g. 6% baseline prevalence) and 14% for common eating behaviors (e.g.…”

Section: Methodsmentioning

confidence: 99%

Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3‐year follow‐up

Devlin

King

Kalarchian

et al. 2016

Intl J Eating Disorders

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Objective Bariatric surgery results in significant long-term weight loss, albeit with considerable variability. This study examines the prognostic significance of eating pathology as determined by a structured interview, the Eating Disorder Examination-Bariatric Surgery Version (EDE-BSV). Method Participants (N=183) in this sub-study of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium were assessed using the EDE-BSV, independent of clinical care, pre-surgery and annually post-surgery. We examined eating pathology and experiences at several frequency thresholds (present, ≥ monthly, ≥ weekly) over 3 years, and utilized mixed models to test their associations with percentage weight loss from baseline at years 1, 2 and 3. Results The prevalence of several forms of eating pathology declined pre- to 1-year post-surgery, including ≥ weekly objective bulimic episodes (11.6% to 1.3%), loss of control (LOC) eating (18.3% to 6.2%) and picking/nibbling (36.0% to 20.2%) (p for all<.01), and regular evening hyperphagia (16.5% to 5.0%, p=.01), but not cravings (p=.93). Mean EDE global score, and hunger and enjoyment scores, also declined (p for all<.01). These metrics remained lower than baseline through year-3 (p for all<.01). Pre-surgery eating variables were not related to weight loss (p for all≥.05). However, post-surgery higher EDE global score and greater hunger were independently associated with less weight loss post-surgery (p for both≤.01), while cravings were associated with greater weight loss (p=.03). Conclusion Pathological eating behaviors and experiences are common pre-surgery and improve markedly following surgery. Post-surgery pathological eating-related experiences and attitudes and hunger may contribute to suboptimal weight loss.

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Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

Cited by 137 publications

References 38 publications

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study

Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3‐year follow‐up

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