Pre-surgical Weight Loss Predicts Post-surgical Weight Loss Trajectories in Adolescents Enrolled in a Bariatric Program

Fennig, Uriel; Snir, Avigal; Halifa-Kurzman, Irit; Sela, Adi; Hadas, Arie; Fennig, Silvana

doi:10.1007/s11695-018-03649-8

Cited by 11 publications

(5 citation statements)

References 43 publications

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“…It is true that prevention is the mainstay in the fight against obesity and this means to encourage a healthy lifestyle with constant balanced diet and moderate physical activity. Still, the intense application of nonsurgical treatment modalities -radical behavior shift and diet change -in the obese and extremely obese adolescents has only proven to have unsatisfactory and short term results, while bariatric and metabolic surgery emerges as the most effective treatment option (6,7,8,9).…”

Section: Introduction/backgroundmentioning

confidence: 99%

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Dobritoiu¹,

Buza²,

Catanescu³

et al. 2019

chr

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RezumatBackground: Obezitatea la copil este o problemă cu care ne confruntăm din ce în ce mai des. Deşi chirurgia metabolică aplicată copiilor a fost iniţial privită cu scepticism, numărul articolelor ştiinţifice care abordează această problemă şi susţin intervenţia cât mai rapidă este deja coniderabil. Cu toate acestea există, încă multe controverse legate de indicaţia de intervenţie chirurgicală şi rezultatele pe termen lung la aceşti pacienţi. Scop: Analizarea rezultatelor chirurgiei bariatrice la un grup de adolescenţi cu obezitate operaţi în spitalul nostru. Metoda: Am analizat retrospectiv datele tuturor pacienţilor adolescenţi cu obezitate care au fost operaţi -gastrectomie longitudinală laparoscopică sau gastric by pass în perioada 2013noiembrie 2019 într-un Centru de Excelenţă în Chirurgia Bariatrică, urmărind prezenţa preoperator a comorbidităţilor legate de obezitate, evoluţia BMI şi a comorbidităţilor la 12 şi 36 luni postoparator. Rezultate: Şaizeci şi patru de pacienţi au fost incluşi în studiu, 62 cu gastrectomie longitudinală (SG) şi doi cu bypass gastric (GBP). Vârsta medie la momentul operator a fost de 15 ani şi 5 luni (SD 18 luni). Indexul BMI mediu înainte de operaţie a fost 39.45 kg/m 2 (SD 6.9) şi a scăzut la 24.92 kg/m 2 şi 22.7kg/m 2 la 12 respectiv 36 de luni de la intervenţie. Nu s-au înregistrat complicaţii majore perioperatorii, consemnând doar un caz de disfagie prelungită, tranzitorie postoperator. Durata medie de spitalizare a fost de 3.2 zile. În primul an de monitorizare postoperatorie s-au înregistrat doar complicaţii minore, ce au putut fi controlate medical: anemie (6/61), deficit de folaţi (5/61), constipaţie (22/61), căderea părului (12/61). Concluzii: Chirurgia bariatrică şi metabolică este sigură şi eficientă în tratamentul obezităţii la adolescent, atunci când este efectuată în centre cu experienţă. AbstractBackground: Childhood obesity is becoming more frequent and the age of diagnosis has decreased. Although initially sceptic about bariatric surgery in children and adolescents the number of papers to advocate earlier bariatric interventions in this age group is now considerable. However, there are still a lot of controversies about bariatric surgery's indications and long-term results in these patients. Aim/Objective: To analyze the outcomes of bariatric surgery in a group of adolescents with obesity operated in our hospital. Methods: We analyzed retrospectively all the consecutive adolescent patients who underwent laparoscopic gastric sleeve or gastric bypass between 2013 and November 2019 in a Bariatric Center of Excellence, tracking the perioperative morbidity, the changes of BMI and comorbidities at 12 and 36 PO months. Results: Sixty-four adolescent patients were included in the study, 62 with sleeve gastrectomy (SG) and two with gastric bypass (GBP). Mean age at operation was 15 years and 5 months (SD 18 months). Mean BMI before operation was 39.45 kg/m 2 (SD 6.9) and decreased to 24.92 kg/m 2 and 22.7kg/m 2 by 12 and 36 months respectively. There were no major pe...

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Section: Introduction/backgroundmentioning

confidence: 99%

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Dobritoiu¹,

Buza²,

Catanescu³

et al. 2019

chr

View full text Add to dashboard Cite

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“…A total of 36 studies were found that met the search criteria. The majority of studies were reviews ( n = 16, Table ), 8 were observational, 7 were case‐control studies, 3 were quasi‐experimental/case‐control studies, and 2 were RCTs (1 was a methods paper only) (Table ). No studies that tested the combination of pharmacotherapy interventions with MBS were found.…”

Section: Resultsmentioning

confidence: 99%

“…The search revealed seven longitudinal cohort design studies that included some combination of lifestyle interventions and MBS. None of the studies included pharmacotherapy support for MBS.…”

Section: Resultsmentioning

confidence: 99%

Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity

Messiah

Sacher

Yudkin

et al. 2019

Obesity

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Objective Rates of adolescents with severe obesity continue to rise worldwide, with concurrent increases in metabolic and bariatric surgery (MBS) uptake. The gap between support (lifestyle, pharmacotherapy) interventions and MBS as treatment options for adolescents has been understudied. This review, couched in a socio‐ecological framework, investigates how support interventions for adolescents with severe obesity could be combined or sequenced with MBS to optimize health outcomes. Methods A comprehensive search revealed 36 published articles between 1995 and 2019 that included the combination of support interventions and MBS among adolescents. Results There were no studies that specifically reported outcomes or effect sizes for the combination of lifestyle intervention with MBS. Previous studies have reported individual results for either lifestyle intervention or MBS but not for their compound effect. Conclusions As rates of adolescents with severe obesity are on the rise globally, future research should focus on how partnering support interventions with MBS can amplify positive short‐ and long‐term health outcomes and within a socio‐ecological framework. Understanding the sequence of these approaches will be of particular importance. High‐risk and vulnerable populations such as ethnic minorities who have suffered a disproportionate burden of the obesity epidemic must be included in rigorously tested future trials of combination interventions to maximize health outcomes worldwide.

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“…In adolescents, the Pediatric Bariatric Study Group described 37% of BMI reduction 1 year after RYGB [ 40 ], while Inge TH et al reported a 26% TWL 5 years after RYGB, a weight loss magnitude similar to the one observed in adults (29%) [ 39 ]. Moreover, weight loss with lifestyle interventions before surgery was shown to predict post-surgical weight loss in adolescents [ 41 ]. So, bariatric surgery can be considered a treatment option in adolescents with obesity, as long as close post-surgical monitoring can be provided in order to ensure optimal adherence to nutritional recommendations and maximize the surgical results.…”

Section: Predictors Of Success In Bariatric Surgerymentioning

confidence: 99%

Towards precision medicine in bariatric surgery prescription

Pereira

Guimarães

Monteiro

2023

Rev Endocr Metab Disord

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Obesity is a complex, multifactorial and chronic disease. Bariatric surgery is a safe and effective treatment intervention for obesity and obesity-related diseases. However, weight loss after surgery can be highly heterogeneous and is not entirely predictable, particularly in the long-term after intervention. In this review, we present and discuss the available data on patient-related and procedure-related factors that were previously appointed as putative predictors of bariatric surgery outcomes. In addition, we present a critical appraisal of the available evidence on which factors could be taken into account when recommending and deciding which bariatric procedure to perform. Several patient-related features were identified as having a potential impact on weight loss after bariatric surgery, including age, gender, anthropometrics, obesity co-morbidities, eating behavior, genetic background, circulating biomarkers (microRNAs, metabolites and hormones), psychological and socioeconomic factors. However, none of these factors are sufficiently robust to be used as predictive factors. Overall, there is no doubt that before we long for precision medicine, there is the unmet need for a better understanding of the socio-biological drivers of weight gain, weight loss failure and weight-regain after bariatric interventions. Machine learning models targeting preoperative factors and effectiveness measurements of specific bariatric surgery interventions, would enable a more precise identification of the causal links between determinants of weight gain and weight loss. Artificial intelligence algorithms to be used in clinical practice to predict the response to bariatric surgery interventions could then be created, which would ultimately allow to move forward into precision medicine in bariatric surgery prescription.

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Pre-surgical Weight Loss Predicts Post-surgical Weight Loss Trajectories in Adolescents Enrolled in a Bariatric Program

Cited by 11 publications

References 43 publications

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Excellent Short- and Medium-term Result of Bariatric Surgery in Adolescence. A Single Center Study

Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity

Towards precision medicine in bariatric surgery prescription

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