Heterogeneity of weight loss after gastric bypass, sleeve gastrectomy, and adjustable gastric banding

Azagury, Dan E.; Mokhtari, Tara E.; Garcia, Luis; Rosas, Ulysses S.; Garg, Trit; Rivas, Homero; Morton, John M.

doi:10.1016/j.surg.2018.08.023

Cited by 24 publications

(19 citation statements)

References 12 publications

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“…It is worth noting that the improvement of sexual function in the 5 domains by only using the GB surgical method is lower than the overall result, which may indicate that the effect of the GB surgical method is inferior to other surgical methods. However, to our confusion, studies have shown that GB is not only as effective as or even better than other surgical methods in reducing weight and alleviating obesity-related complications, but also has a higher success rate 46, 48, 49. Due to the inadequacy of our data and the potential impact of ethnicity and initial BMI on outcomes, large RCTs are needed to further validate the effect of different surgical procedures on sexual function and its 5 domains.…”

Section: Discussionmentioning

confidence: 86%

“…According to the results of the subgroup analysis, we excluded the possible bias caused by different study types and control types, determined the stability of the results, and determined the effect of using only GB surgical method. Currently, there are 4 kinds of bariatric surgery, including GB, sleeve gastrectomy, and biliopancreatic diversion and gastric banding 48 . It is worth noting that the improvement of sexual function in the 5 domains by only using the GB surgical method is lower than the overall result, which may indicate that the effect of the GB surgical method is inferior to other surgical methods.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review

Zhang

et al. 2019

Sexual Medicine

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Introduction Obesity is a worldwide public health issue with serious psychological and social impacts. Erectile dysfunction is also a common clinical condition, and obesity is one of its main risk factors. Objective The objective of this study was to systematically evaluate the effect of bariatric surgery on male sexual function. Methods A systematical research was carried out in Medline via PubMed, EMBASE, Cochrane Library, and Web of Science up to March 16, 2019, to identify published articles related to bariatric surgery and male sexual function in men. Two reviewers screened literature, extracted data, and assessed the quality of included studies. I 2 index was applied to estimate the heterogeneity. All analyses were done using RevMan5.3 and Stata14. Results A total of 12 studies involving 420 participants were included. Analysis showed that bariatric surgery significantly reduced body mass index in morbidly obese patients (mean difference [MD] = -13.73; 95% CI -17.23 to -10.22; P < .00001). From 10 studies that reported the International Index of Erectile Function (IIEF) score, bariatric surgery led to a significant increase in IIEF-total score (MD = 8.2; 95% CI = 5.52−10.88; P < .00001), and erectile function score (MD = 3.76; 95% CI = 2.34−5.19; P < .00001), sexual desire (MD = 0.93; 95% CI = 0.55−1.32; P < .00001), sexual intercourse satisfaction (MD = 1.73; 95% CI = 0.43−3.03; P < .01), and total satisfaction (MD = 1.28; 95% CI = 0.56−2.00; P = .0005) were also significantly improved. However, bariatric surgery did not affect orgasm function (MD = 0.26; 95% CI = -0.15 to 0.68; P = .21). Three studies that reported the IIEF-5 score also showed a significant improvement of erectile function (MD = 5.45; 95% CI = 3.38−7.52; P < .00001). Conclusions Bariatric surgery could improve the erectile function, sexual desire, sexual intercourse satisfaction, and total satisfaction in morbidly obese men. Due to limited data on body mass index and hormone levels, our meta-analysis had some limitations. More clinical studies are needed to further explore the relationship between bariatric surgery and male sexual function. Xu J, Wu Q, Zhang Y, et al. Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review. Sex Med 2019;7:270–281.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review

Zhang

et al. 2019

Sexual Medicine

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“…6 Weight loss after surgery is typically achieved during the first and second year, followed by weight maintenance or moderate regain 5-10 years after surgery. 7 However, despite good overall results, the response and durability of surgically induced weight loss are heterogeneous [8][9][10] and surgical treatment failure has been recognised as a potential clinical problem. [11][12][13] Strengths and limitations of this study ► A large prospective cohort of nearly 6000 patients from bariatric surgery centres with a minimum of 60% retention rate at year 5 after bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of insufficient weight loss 5 years after Roux-en-Y gastric bypass: metabolic consequences and prediction estimates: a prospective registry study

et al. 2021

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ObjectiveThe study aimed to investigate the heterogeneity of weight loss 5 years after Roux-en-Y gastric bypass (RYGB) and the association with cardiometabolic health as well as to model prediction estimates of surgical treatment failure.DesignRetrospective analysis of prospectively collected data from the Scandinavian Obesity Surgery Registry (SOReg).Setting29 surgical units from the whole of Sweden contributed data. Inclusion was restricted to surgical units with a retention rate of >60% five years postsurgery.Participants10 633 patients were extracted from SOReg. In total 5936 participants were included in the final sample, 79.1% females. The mean age of participants before surgery was 39.4±9 years and mean body mass index (BMI) 42.9±5.1. 2322 were excluded (death before the 5-year follow-up (n=148), other types of surgery or reoperations (n=637), age at surgery <18 or >55 years (n=1329), presurgery BMI <35 kg/m2 (n=208)). In total, 2375 (29%) of eligible individuals were lost to the 5-year follow-up.Main outcomeThe occurrence of surgical treatment failure 5 years after surgery was based on the three previously published definitions: per cent excess BMI loss <50%, total weight loss <20% or BMI >35 where initial BMI was <50, or >40 where initial BMI was >50. In addition, we report the association between surgical treatment failure and biochemical markers of obesity-related comorbidity. We also developed predictive models to identify patients with a high risk of surgical treatment failure 5 years postsurgery.ResultsIn total, 23.1% met at least one definition of surgical treatment failure at year 5 which was associated with (adjusted OR) with 95% CI): type 2 diabetes (T2D, OR 2.1; 95% CI 1.6 to 2.7), dyslipidaemia (OR 1.8; 95% CI 1.6 to 2.1) and hypertension (OR 1.9; 95% CI 1.6 to 2.2). Surgical treatment failure at 5 years was predicted by combined demographic and anthropometric measures from baseline, 1 and 2 years postsurgery (area under the curve=0.874).ConclusionLaparoscopic RYGB leads to a marked and sustained weight loss with improvement of obesity-related comorbidity in most patients. However, 23% met at least one definition of surgical treatment failure, which was associated with a greater risk of relapse and a higher incidence of T2D, dyslipidaemia and hypertension 5 years after surgery. Poor initial weight loss and early weight regain are strong predictors of long-term treatment failure and may be used for early identification of patients who require additional weight loss support.

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“…Regarding the degree of obesity found in the present study, there was a divergence from another study 31 , in which the majority of patients (59.6%) evaluated were in Grade 3. In two other studies, the mean BMI value is within the Class 3 Obesity classification 32,33 . However, the authors state that there are benefits of surgery for individuals with grades of obesity 1 and 2, or even overweight when associated with comorbidities occurrence 31 .…”

Section: ■ Discussionmentioning

confidence: 91%

Comparative analysis between patients undergoing Gastric Bypass and Sleeve Gastroplasty in a private hospital in Sao Luis-MA

Lima

Oliveira²,

Pereira³

et al. 2020

Acta Cir. Bras.

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To compare the satisfaction levels about the surgery and anesthesia management, and to analyze the postoperative outcomes of patients undergoing Gastric Bypass and Sleeve Gastroplasty surgeries in a private hospital in Sao Luís-MA. Methods: The sample consisted of patients undergoing Bypass and Sleeve bariatric surgeries from August 2018 to August 2019, who were in the range of 18 and 70 years old and had not used drugs or presented cardiac arrhythmias, dilated cardiomyopathy, and conduction disorder heart. Data were collected from the evaluation forms and recorded in a form with closed questions. Results: Most patients were female (Bypass-56% and Sleeve-67.4%) and aged between 30 and 39 years old (Bypass-32% and Sleeve-55.8%). Information (Bypass-92% and Sleeve-86.1%) was the highest satisfaction index found. Sleepiness in the immediate postoperative period (Bypass-92% and Sleeve-93%) was the main side effect. There were no postoperative complications in patients between the two types of surgery. Conclusions: Patients submitted to Bypass and Sleeve were completely satisfied with the perioperative management. There was no statistically significant difference when comparing adverse effects between the techniques.

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Heterogeneity of weight loss after gastric bypass, sleeve gastrectomy, and adjustable gastric banding

Cited by 24 publications

References 12 publications

Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review

Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review

Prevalence of insufficient weight loss 5 years after Roux-en-Y gastric bypass: metabolic consequences and prediction estimates: a prospective registry study

Comparative analysis between patients undergoing Gastric Bypass and Sleeve Gastroplasty in a private hospital in Sao Luis-MA

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