Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy

Golomb, Inbal; David, Matan Ben; Glass, Adi; Kolitz, Tamara; Keidar, Andrei

doi:10.1001/jamasurg.2015.2202

Cited by 151 publications

(66 citation statements)

References 43 publications

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“…At 10 years, 8.8% of RYGB patients and 25.0% of AGB patients had lost less than 5% of their original weight, , and at 15 years postsurgery, RYGB patients had regained an average 5% from their highest weight loss and AGB patients had regained 7%. Golomb et al reported similar regain and weight loss failure in VSG, with average excess weight loss of 76.8% at 1 year, 69.7% after 3 years and 56.1% at 5 years postsurgery, and excess weight loss of <50% at 13.3% at 1 year, 21.1% at 3 years and 38.5% at 5 years. Multiple determinants, including biological, surgical, social, behavioural and psychological factors such as problematic and disordered eating behaviours, have been linked to poor weight loss and weight regain .…”

Section: Discussionmentioning

confidence: 80%

Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre‐post studies

2016

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Despite differences in their mechanisms and outcomes, little is known about whether postsurgical changes in eating behaviours also differ by bariatric procedure. Following a systematic search, 23 studies on changes in binge eating disorder (BED) and related behaviours, bulimia nervosa and related behaviours, night eating syndrome, grazing and emotional eating after Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB) and vertical sleeve gastrectomy (VSG) were reviewed. Significant methodological problems and a dearth of literature regarding many behaviours and VSG were seen. Regarding BED and related behaviours, although later re-increases were noted, short to medium-term reductions after RYGB were common, and reported changes after AGB were inconsistent. Short to medium-term reductions in emotional eating, and from a few studies, short to long-term reductions in bulimic symptoms, were reported after RYGB. Reoccurrences and new occurrences of problem and disordered eating, especially BED and binge episodes, were apparent after RYGB and AGB. Further conclusions and comparisons could not be made because of limited or low-quality evidence. Long-term comparison studies of changes to problematic and disordered eating in RYGB, AGB and VSG patients are needed. It is currently unclear whether any bariatric procedure leads to long-term improvement of any problematic or disordered eating behaviours.

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Section: Discussionmentioning

confidence: 80%

Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre‐post studies

2016

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“…However, adverse effects of some and the transient weight losses associated with others[27] mean that the pharmacological management of obesity remains suboptimal. The only proven treatment to achieve and maintain weight loss in obesity is bariatric surgery[28-30]. However, surgical and anaesthetic risks associated with overweight and obese status sees these invasive procedures reserved to those patients classed morbidly obese (BMI ≥ 40 kg/m 2 ) or as a last resort in those failing more conservative management[20,31,32].…”

Section: Introductionmentioning

confidence: 99%

Glucagon-like peptide 1 in the pathophysiology and pharmacotherapy of clinical obesity

Anandhakrishnan

Korbonits

2016

WJD

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Though the pathophysiology of clinical obesity is undoubtedly multifaceted, several lines of clinical evidence implicate an important functional role for glucagon-like peptide 1 (GLP-1) signalling. Clinical studies assessing GLP-1 responses in normal weight and obese subjects suggest that weight gain may induce functional deficits in GLP-1 signalling that facilitates maintenance of the obesity phenotype. In addition, genetic studies implicate a possible role for altered GLP-1 signalling as a risk factor towards the development of obesity. As reductions in functional GLP-1 signalling seem to play a role in clinical obesity, the pharmacological replenishment seems a promising target for the medical management of obesity in clinical practice. GLP-1 analogue liraglutide at a high dose (3 mg/d) has shown promising results in achieving and maintaining greater weight loss in obese individuals compared to placebo control, and currently licensed anti-obesity medications. Generally well tolerated, provided that longer-term data in clinical practice supports the currently available evidence of superior short- and long-term weight loss efficacy, GLP-1 analogues provide promise towards achieving the successful, sustainable medical management of obesity that remains as yet, an unmet clinical need.

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“…Although Golomb et al had retrospectively doubted the dominant role of bariatric surgery at 5-year follow-up [38], its contrastive efficacy against non-surgical interventions remains advantageous according to our pooled analysis, especially concerning the long-term durability of weight loss and hyperglycemic remission. It is experimentally explanatory that physiological adaptation instead of mechanical reconstruction seems to mainly contribute to the prolonged impacts on energy homeostasis.…”

Section: Discussionmentioning

confidence: 84%

The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials

et al. 2016

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BackgroundBariatric surgery has emerged as a competitive strategy for obese patients. However, its comparative efficacy against non-surgical treatments remains ill-defined, especially among nonseverely obese crowds. Therefore, we implemented a systematic review and meta-analysis in order for an academic addition to current literatures.MethodsLiteratures were retrieved from databases of PubMed, Web of Science, EMBASE and Cochrane Library. Randomized trials comparing surgical with non-surgical therapies for obesity were included. A Revised Jadad's Scale and Risk of Bias Summary were employed for methodological assessment. Subgroups analysis, sensitivity analysis and publication bias assessment were respectively performed in order to find out the source of heterogeneity, detect the outcome stability and potential publication bias.Results25 randomized trials were eligibly included, totally comprising of 1194 participants. Both groups displayed well comparability concerning baseline parameters (P > 0.05). The pooled results of primary endpoints (weight loss and diabetic remission) revealed a significant advantage among surgical patients rather than those receiving non-surgical treatments (P < 0.05). Furthermore, except for certain cardiovascular indicators, bariatric surgery was superior to conventional arms in terms of metabolic secondary parameters (P < 0.05). Additionally, the pooled outcomes were confirmed to be stable by sensitivity analysis. Although Egger's test (P < 0.01) and Begg's test (P<0.05) had reported the presence of publication bias among included studies, “Trim-and-Fill” method verified that the pooled outcomes remained stable.ConclusionBariatric surgery is a better therapeutic option for weight loss, irrespective of follow-up duration, surgical techniques and obesity levels.

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Long-term Metabolic Effects of Laparoscopic Sleeve Gastrectomy

Cited by 151 publications

References 43 publications

Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre‐post studies

Changes in problematic and disordered eating after gastric bypass, adjustable gastric banding and vertical sleeve gastrectomy: a systematic review of pre‐post studies

Glucagon-like peptide 1 in the pathophysiology and pharmacotherapy of clinical obesity

The comprehensive summary of surgical versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomized controlled trials

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