Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass

Kenler, Hallis A.; Brolin, Robert E.; Cody, Ronald P.

doi:10.1093/ajcn/52.1.87

Cited by 183 publications

(131 citation statements)

References 22 publications

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“…As mentioned above, several studies have investigated the differences in food consumption between patients submitted to various restrictive surgical techniques (Näslund et al, 1988;Brolin et al, 1994;Kenler et al, 1990), whereas to our knowledge no study has analyzed the differences in energy intake among a group of patients who underwent the same surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing energy intake and body weight loss after gastric bypass

et al. 2002

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Objective: The gastric bypass-induced quantitative and qualitative modifications of energy intake (En In, kcal=day) and their impact on body weight (bw) loss were evaluated. The factors influencing energy intake and body weight loss were also investigated. Design: Longitudinal study. Setting: University Hospital of Geneva. Subjects: Fifty obese women undergoing a Roux-en-Y gastric bypass. Results: The reduction of EnIn was significantly related to bw loss expressed either in kg or as percentage correction of excess bw (P < 0.01 for both), whereas the post-operative modifications of diet composition did not play a role. Age and initial bw significantly influenced bw loss (P < 0.0001 and P < 0.001, respectively), as shown by multiple regression analysis. Patients were divided into four sub-groups according to their age (under or over 35 y) and initial bw (under or over 120 kg). ANOVA showed that under 35-y-old subjects reduced their EnIn significantly more than their older counterparts having similar bw (P < 0.02 and P < 0.05); consequently, bw loss, expressed in kg, was significantly (P < 0.0001 and P < 0.0005) larger in younger patients. Subjects with an initial bw over 120 kg lost significantly (P < 0.001 and P < 0.02) more weight as compared to patients with a smaller degree of obesity (under 120 kg) and similar age. Conclusions: Gastric bypass-induced body weight loss is mainly due to the reduction of EnIn, whereas the qualitative modifications of the diet do not play a role. Younger subjects have a greater capacity to reduce EnIn and, therefore, lose more weight. Pre-operative high degree of obesity leads to a larger weight reduction, probably because of a greater energy deficit.

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Section: Introductionmentioning

confidence: 99%

Factors influencing energy intake and body weight loss after gastric bypass

et al. 2002

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“…Five RCTs [39][40][41][42]46 compared surgical interventions to non-surgical interventions. Four of the five were done in an adult population [40][41][42]46 and one RCT was done in an adolescent population 39 .…”

Section: Interventionsmentioning

confidence: 99%

“…Four of the five were done in an adult population [40][41][42]46 and one RCT was done in an adolescent population 39 . Of the five RCTS, three compared adjustable gastric banding to conventional therapy 39,41,42 , one compared laparoscopic Roux-en-Y gastric bypass (LRYGB) with conventional therapy 40 , and the fifth RCT compared biliopancreatic diversion to diet 46 .…”

Section: Interventionsmentioning

confidence: 99%

“…b) Randomization Three trials 46,47,55 poorly addressed randomization; all other trials were either "well covered" or "adequately addressed". c) Allocation concealment Seven trials 41,46,47,49,52,55,56 did not address concealment methods, all other trials were either "well covered" or "adequately addressed".…”

Section: Quality Of the Included Studies 341 Sign 50mentioning

confidence: 99%

“…Five trials had a complete follow up in both groups 40,46,[52][53][54] , one trial 49 reported complete follow up in an earlier report but this information was not provided in the latest report.…”

Section: Incomplete Outcome Datamentioning

confidence: 99%

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Obesity is the fifth leading cause of global deaths. The efficacy and safety of obesity treatment is still controversial. The objective of the thesis is to evaluate the efficacy and safety of bariatric surgery, through a systematic review of the current evidence and metaanalysis of important outcomes. Nineteen (19) randomized controlled trials (RCTs) with 1346 participants were included. Bariatric surgery resulted in greater weight loss when compared to non-surgical treatment. Weight loss was also associated with resolution and/or improvement of obesity related comorbidites such as diabetes, hypertension, hyperlipidemia, and sleep apnea. Weight loss and safety varied across the surgical procedures. Biliopancreatic diversion/duodenal switch had the greatest weight loss, followed by sleeve gastrectomy and Roux-en-Y gastric bypass, purely restrictive procedures such as vertical banded gastroplasty and adjustable gastric banding resulted in the least weight loss. Long term, high quality, and adequately powered trials are still needed to support the available evidence.P a g e | II

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Roles for Ghrelin in the Regulation of Appetite and Body Weight

Cummings

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142

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besity is a global epidemic that has proven daunting to prevent and treat. The prevalences of obesity (body mass index [BMI] Ͼ30) and morbid obesity (BMI Ͼ40) among American adults are about 30% and 5%, respectively. 1 Obesity is so strongly associated with medical comorbidities and mortality that it has begun to overtake infectious diseases as the most significant contributor to ill health worldwide. 2,3 Overweight persons are also frequently stigmatized and consequently suffer from low self-esteem. Their motivation to achieve and maintain weight loss is often Herculean. In 1 study of 47 patients who had durably lost 45 kg or more after bariatric surgery, 100% preferred to be deaf, dyslexic, diabetic, or have heart disease rather than be obese again; leg amputation and blindness were preferred by 91.5% and 89.4%, respectively. 4 The traditional treatment paradigm of diet, exercise, and medication generally achieves no more than a 5% to 10% reduction in body weight, 5,6 and recidivism after such weight loss exceeds 90% within 5 years. 7,8 This failure arises because a robust homeostatic system of body weight regulation compensates for weight loss with increased hunger and decreased energy expenditure. [9][10][11] The molecular mediators of these compensatory responses to weight loss are potential targets for antiobesity treatments. Ghrelin is a potent orexigenic (appetite-stimulating) peptide that seems to participate in the adaptive response to weight loss. Therefore, ghrelin holds promise as a target for both medical and surgical approaches to obesity.

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Changes in eating behavior after horizontal gastroplasty and Roux-en-Y gastric bypass

Cited by 183 publications

References 22 publications

Factors influencing energy intake and body weight loss after gastric bypass

Factors influencing energy intake and body weight loss after gastric bypass

Bariatric Surgery for Obesity: A Systematic Review and Meta-Analysis

Roles for Ghrelin in the Regulation of Appetite and Body Weight

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