Meta-analysis of the effect of bariatric surgery on physical function

Adil, Tanveer; Jain, Vigyan; Rashid, Farhan; Al-Taan, Omer; Whitelaw, Douglas; Jambulingam, Periyathambi

doi:10.1002/bjs.10880

Cited by 28 publications

(11 citation statements)

References 71 publications

(117 reference statements)

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“…After BS, many aspects are modified and imply a reduction in the risk of obesity-associated disorders as well as of all-cause mortality (9–11). Some of the beneficial effects of BS are improved physical function (12), sustained weight loss, reduction of comorbidities such as osteoarthritis and respiratory dysfunction (13), a more favorable metabolic profile, which implies an improvement in quality of life, and the resolution of cardiovascular risk factors (14–19) with lower triglyceride levels and higher HDL-C levels in most patients 1 year after surgery (20, 21).…”

Section: Bariatric Surgery (Bs): a Treatment For Obesitymentioning

confidence: 99%

Metabolic and Endocrine Consequences of Bariatric Surgery

2019

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Obesity is one of the most serious worldwide epidemics of the twenty-first century according to the World Health Organization. Frequently associated with a number of comorbidities, obesity threatens and compromises individual health and quality of life. Bariatric surgery (BS) has been demonstrated to be an effective treatment to achieve not only sustained weight loss but also significant metabolic improvement that goes beyond mere weight loss. The beneficial effects of BS on metabolic traits are so widely recognized that some authors have proposed BS as metabolic surgery that could be prescribed even for moderate obesity. However, most of the BS procedures imply malabsorption and/or gastric acid reduction which lead to nutrient deficiency and, consequently, further complications could be developed in the long term. In fact, BS not only affects metabolic homeostasis but also has pronounced effects on endocrine systems other than those exclusively involved in metabolic function. The somatotropic, corticotropic, and gonadal axes as well as bone health have also been shown to be affected by the various BS procedures. Accordingly, further consequences and complications of BS in the long term in systems other than metabolic system need to be addressed in large cohorts, taking into account each bariatric procedure before making generalized recommendations for BS. In this review, current data regarding these issues are summarized, paying special attention to the somatotropic, corticotropic, gonadal axes, and bone post-operative health.

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Section: Bariatric Surgery (Bs): a Treatment For Obesitymentioning

confidence: 99%

Metabolic and Endocrine Consequences of Bariatric Surgery

2019

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“…A number of structured or systematic reviews have shown that the HRQoL of patients suffering from obesity improved after surgery. [28][29][30][31][32][33] However, these studies are mainly comprised of disease-specific (e.g., Moorehead-Ardelt II questionnaire [MA-II]) or non-preference-based (e.g., Short Form [SF]-36) data that are unsuitable for cost-utility comparisons because they do not generate a utility value. An emerging literature has shown that HSUs have been used as a metric for quantifying HRQoL improvements regarding bariatric surgery, nevertheless, meta-analyses of bariatric surgery-related HSUs have not been conducted to date.…”

Section: Bariatric Surgery-related Hrqol and Research Gapsmentioning

confidence: 99%

Health state utilities for economic evaluation of bariatric surgery: A comprehensive systematic review and meta‐analysis

et al. 2020

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Health-state utilities (HSUs) are health economic metrics that capture and assess health-related quality of life (HRQoL). They are essential in health-economic evaluations when calculating quality-adjusted life years. We investigated published studies reporting bariatric surgeryrelated HSUs elicited through direct or indirect (multi-attribute utility instrument [MAUI]) patient-reported methods (PROSPERO registration number: CRD42019131725). Mean HSUs for different time points and HSU changes over time (where feasible) were meta-analysed using random-effects models. Of the 950 potentially relevant identified studies, n=28 (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) qualified for data extraction, with n=85 unique HSUs elicited mainly from the EQ-5D (88%).Most (75%) studies were published after 2013. The follow-up duration varied between studies and was often limited to 12 months. The pooled mean HSU was 0.72 (0.67-0.76) at baseline/pre-surgery (n=18) and 0.84 (0.79-0.89) one-year post-surgery (n=11), indicating a 0.11 (0.09-0.14) utility unit increment. EQ-5D showed the similar results. This positive difference can be partially explained by BMI and/or co-morbidities status improvement. This study provides a valuable summary of HSUs to future bariatric surgery-related cost-utility models. However, more well-designed higher-quality bariatric-related HSU studies are expected for future reviews to improve the available evidence. We suggest that researchers select a MAUI that is preferentially sensitive to the study population.

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“…The physical fitness actually is prognostically more important than adiposity in obese individuals [31]. After bariatric surgery the functional capacity (as assessed by the 6-min walking test (6MWT)) or self-reported physical fitness increases significantly [32,33]. However, this does not indicate that exercise capacity (as preferentially assessed by ergospirometry to measure peak oxygen uptake (VO2peak)) is actually improved.…”

Section: Importance Of Physical Activity and Exercise Intervention After Bariatric Surgerymentioning

confidence: 99%

Towards Optimized Care After Bariatric Surgery by Physical Activity and Exercise Intervention: a Review

Hansen

Decroix

Devos³

et al. 2020

OBES SURG

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Although there is growing evidence on the importance of physical activity and exercise intervention after bariatric surgery, it remains to be clarified why and how post-operative exercise intervention should be implemented. In this narrative and practically-oriented review, it is explained why exercise interventions and physical activity are important after bariatric surgery, how to prescribe exercise and monitor physical activity, and how and when physical fitness, muscle strength, fat(-free) mass and bone mineral density could be assessed during follow-up. It is suggested that the inclusion of physical activity and exercise training in the clinical follow-up trajectory could be of great benefit to bariatric surgery patients, since it leads to greater improvements in body composition, bone mineral density, muscle strength and physical fitness.

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Meta-analysis of the effect of bariatric surgery on physical function

Abstract: Bariatric surgery improves physical function significantly within 6 months of the procedure and this effect persists over time to 36 months after surgery, whether measured objectively or by self-reporting.

Cited by 28 publications

References 71 publications

Metabolic and Endocrine Consequences of Bariatric Surgery

Metabolic and Endocrine Consequences of Bariatric Surgery

Health state utilities for economic evaluation of bariatric surgery: A comprehensive systematic review and meta‐analysis

Towards Optimized Care After Bariatric Surgery by Physical Activity and Exercise Intervention: a Review

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