Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Sasaki, Akira; Yokote, Koutaro; Naitoh, Takeshi; Fujikura, Junji; Hayashi, Karin; Hirota, Yushi; Inagaki, Nobuya; Ishigaki, Yasushi; Kasama, Kazunori; Kikkawa, Eri; Koyama, Hidenori; Masuzaki, Hiroaki; Miyatsuka, Takeshi; Nozaki, Tomoyoshi; Ogawa, Wataru; Ohta, Masayuki; Okazumi, Shinichi; Shimabukuro, Michio; Shimomura, Iichiro; Nishizawa, Hitoshi; Saiki, Atsuhito; Seki, Yosuke; Shojima, Nobuhiro; Tsujino, Motoyoshi; Ugi, Satoshi; Watada, Hiroaki; Yamauchi, Toshimasa; Yamaguchi, Takashi; Ueki, Katsuji; Kadowaki, Takashi; Tatsuno, Ichiro

doi:10.1007/s13340-021-00551-0

Cited by 16 publications

(11 citation statements)

References 211 publications

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“…Furthermore, in a meta-analysis, patients with binge eating disorders were suggested to have less post-operative weight loss and greater psychosocial distress after MBS [ 39 ]. Therefore, current guidelines worldwide [ 40 ], including in Japan [ 6 ], recommend the assessment of candidates for MBS in order to identify potential psychological factors that may compromise surgical outcomes. Emotional eating is an eating behavior that transfers psychological stress to food intake and has been indicated to reflect multiple negative emotions such as depression and anxiety, thereby leading to uncontrolled overeating [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

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Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

et al. 2023

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Background: Metabolic and bariatric surgery (MBS) has been established to provide long-term weight loss in severe obesity. In this study, we investigated the factors that affect post-operative weight loss, with a particular focus on changes in eating behaviors. Methods: Time-course changes in body weight and eating behaviors were examined in 49 Japanese patients who underwent laparoscopic sleeve gastrectomy from the first visit to 12 months after surgery. Each eating behavior was evaluated via the questionnaire of the Japan Society for the Study of Obesity. Results: Pre-operative weight reduction mediated by dietary and lifestyle interventions showed significant positive correlations with weight loss outcomes at 12 months after surgery. We observed significant decreases in scores for most of the eating behaviors 12 months after surgery. However, “emotional eating behavior” scores declined temporarily in the early post-operative period of one month but thereafter returned to the pre-operative level at 12 months. Furthermore, increases in the scores for “emotional eating behavior” and “sense of hunger” from 1 to 12 months post-operatively were significantly associated with poor weight loss. Conclusions: Our results demonstrate the beneficial effects of MBS on obesity-related eating behaviors, as well as highlighting “emotional eating behavior” as requiring particular attention.

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Section: Discussionmentioning

confidence: 99%

“…In addition, its benefits for weight loss and obesity-related comorbidities, including diabetes mellitus, have been established [ 3 , 4 , 5 ]. However, the weight loss effect varies widely in individual cases, and post-surgical problems with psychiatric disorders, such as anxiety and depression, have been pointed out [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

et al. 2023

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“…All the patients met the following inclusion criteria for LSG treatment, as established by Japanese insurance practices: 18–65 years of age, severe obesity (BMI ≥ 35 kg/m 2 ), and the presence of at least one comorbidity with resistance to medical treatment (e.g., hypertension, T2DM, dyslipidemia, or obstructive sleep apnea). The exclusion criteria were a history of alcohol abuse, secondary obesity (drug-induced or due to endocrine disease), and the presence of major psychiatric disorders [ 11 ]. In this study, we enrolled 63 qualified patients ( Figure 2 ).…”

Section: Methodsmentioning

confidence: 99%

The Concept of Indeterminable NASH Inducted by Preoperative Diet and Metabolic Surgery: Analyses of Histopathological and Clinical Features

et al. 2022

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Practitioners routinely perform intraoperative liver biopsies during laparoscopic sleeve gastrectomy (LSG) to evaluate nonalcoholic fatty liver disease (NAFLD). In some patients, hepatocyte ballooning, inflammation, and fibrosis without steatosis are observed, even in the absence of other etiologies. We call this finding indeterminable nonalcoholic steatohepatitis (Ind-NASH). In this study, we clarified the prevalence, as well as histopathological and clinical features, of Ind-NASH through intraoperative liver biopsy in Japanese patients presenting with severe obesity. We enrolled 63 patients who had undergone LSG and intraoperative liver biopsy. In patients diagnosed with histopathological NASH, we performed protocol liver biopsies at 6 and 12 months after LSG. We statistically analyzed these histopathological findings and clinical parameters and found the prevalence rate of Ind-NASH discovered through intraoperative biopsy to be 15.9%. Protocol liver biopsy also revealed that Ind-NASH was an intermediate condition between NASH and normal liver. The clinical features of patients with Ind-NASH are a higher body weight compared to NASH (134.9 kg vs. 114.7 kg; p = 0.0245), stronger insulin resistance compared to nonalcoholic fatty liver (homeostasis model assessment–insulin resistance: 7.1 vs. 4.9; p = 0.0188), and mild liver dysfunction compared to NASH. Patients with Ind-NASH observed positive weight-loss effects from a preoperative diet compared to the postoperative course (percentage total weight loss: 32.0% vs. 26.7%; p < 0.0001). Patients with Ind-NASH may also be good candidates for metabolic surgery owing to their good treatment response; therefore, efforts should be made by specialists in the near future to deeply discuss and define Ind-NASH.

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“…Twenty severely obese patients who underwent LSG at Iwate Medical University Hospital between February 2020 and March 2021 were enrolled independently for this study. Patients were included if they met the insurance criteria for LSG along with the consensus statements on indication criteria for performing LSG for severely obese patients published in 2021 [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Identification of a Fatty Acid for Diagnosing Non-Alcoholic Steatohepatitis in Patients with Severe Obesity Undergoing Metabolic Surgery

et al. 2022

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The prevalence of nonalcoholic steatohepatitis (NASH) in severely obese Japanese patients is extremely high. However, there are currently no methods other than liver biopsy to assess hepatic steatosis and fibrosis. The purpose of this study was to comprehensively analyze changes in fatty acid (FA) and serum-free fatty acid (FFA) metabolism in severely obese Japanese patients to determine whether these could be surrogate markers. In this study, we enrolled 20 Japanese patients who underwent laparoscopic sleeve gastrectomy (LSG) for severe obesity and intraoperative liver biopsy. Serum FFAs were analyzed with liquid chromatography-mass spectrometry, and FAs in liver tissue were assessed using matrix-assisted laser desorption/ionization-imaging mass spectrometry to determine FAs that may be indicative of a positive NASH diagnosis. All patients showed significant weight loss and metabolic improvement following LSG. Regarding weight loss and metabolic improvement indices, 23 FFAs showed significant correlations with the baseline data. Narrowing down the phospholipids to commonly detected FAs detected in liver tissue, PC(18:1e_20:4) was significantly changed in the NASH group, suggesting that it could be used as a surrogate marker for NASH diagnosis. The results suggest that specific postoperative changes in blood phospholipids could be used as surrogate markers for NASH treatment.

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Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity

Cited by 16 publications

References 211 publications

Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

The Concept of Indeterminable NASH Inducted by Preoperative Diet and Metabolic Surgery: Analyses of Histopathological and Clinical Features

Identification of a Fatty Acid for Diagnosing Non-Alcoholic Steatohepatitis in Patients with Severe Obesity Undergoing Metabolic Surgery

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