Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study

Courcoulas, Anita P.; King, Wendy C.; Belle, Steven H.; Berk, Paul D.; Flum, David R.; Garcı́a, Luis; Gourash, William; Horlick, Mary; Mitchell, James E.; Pomp, Alfons; Pories, Walter J.; Purnell, Jonathan Q.; Singh, Ashima; Spaniolas, Konstantinos; Thirlby, Richard C.; Wolfe, Bruce M.; Yanovski, Susan Z.

doi:10.1001/jamasurg.2017.5025

Cited by 535 publications

(496 citation statements)

References 18 publications

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“…Overall, the trends of individual ADM de‐escalation are consistent with a previous study in the 12 months following BS that showed proportional decreases in each type of ADM . However, we identified a small increase in metformin, sulfonylurea, and insulin from 12 months after BS, which may be due to worsening blood glucose control associated with weight regain …”

Section: Discussionsupporting

confidence: 89%

“…The likelihood of being off ADM was highest for those who had DS and lowest for those who had LAGB. De‐escalation of ADM may parallel weight loss because LAGB is associated with the least weight loss and DS is associated with the most . Overall, the trends of individual ADM de‐escalation are consistent with a previous study in the 12 months following BS that showed proportional decreases in each type of ADM .…”

Section: Discussionsupporting

confidence: 86%

“…a 30‐day supply of a medication must be filled in the 45 days prior to the interval). We explored ADM utilization up to 36 months following BS to assess for potential ADM de‐escalation and potential ADM re‐escalation due to weight regain …”

Section: Methodsmentioning

confidence: 99%

“…We explored ADM utilization up to 36 months following BS to assess for potential ADM de-escalation and potential ADM re-escalation due to weight regain. 5,6…”

Section: Methodsmentioning

confidence: 99%

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Antidiabetic medication de‐escalation following bariatric surgery

Vouri

Chen

Sparkman

et al. 2018

Journal of Diabetes

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 86%

Section: Methodsmentioning

confidence: 99%

“…We explored ADM utilization up to 36 months following BS to assess for potential ADM de-escalation and potential ADM re-escalation due to weight regain. 5,6…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Antidiabetic medication de‐escalation following bariatric surgery

Vouri

Chen

Sparkman

et al. 2018

Journal of Diabetes

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“…Our study’s sample of only 11 SG‐treated participants is too small to draw conclusions about its efficacy. Additional long‐term safety and efficacy data are needed for SG, as was provided for RYGB and LAGB by the Longitudinal Assessment of Bariatric Surgery (LABS) cohort . LABS also provided a more reliable estimate of the risks of adverse perioperative outcomes accompanying RYGB and LAGB, as compared with our small sample (in which some reported AEs were not independently verified).…”

Section: Discussionmentioning

confidence: 99%

End‐of‐Trial Health Outcomes in Look AHEAD Participants who Elected to have Bariatric Surgery

Wadden

Chao

Bahnson

et al. 2019

Obesity

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Objective This study examined end‐of‐trial health outcomes in participants in the Action for Health in Diabetes (Look AHEAD) trial who had bariatric surgery during the approximately 10‐year randomized intervention. Methods Data were obtained from the Look AHEAD public access database of 4,901 individuals with type 2 diabetes and overweight/obesity who were assigned to intensive lifestyle intervention (ILI) or a diabetes support and education (DSE) control group. Changes in outcomes in participants who had bariatric surgery were compared with those in participants with BMI ≥ 30 kg/m2 who remained in the ILI and DSE groups. Results A total of 99 DSE and 97 ILI participants had bariatric surgery. At randomization, these 196 participants were significantly younger and more likely to be female and to have higher BMI than the remaining ILI (N = 1,972) and DSE (N = 2,009) participants. At trial’s end, surgically treated participants lost 19.3% of baseline weight, compared with 5.8% and 3.3% for the ILI and DSE groups, respectively, and were more likely to achieve partial or full remission of their diabetes. Conclusions The large, sustained improvements in weight and diabetes observed in this self‐selected sample of surgically treated participants are consistent with results of multiple randomized trials.

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Long-term Outcomes Following Bariatric Surgery

Shubeck

Dimick

Telem

2018

JAMA

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The 7-year results from the Longitudinal Assessment of Bariatric Surgery (LABS) study were published online on December 6, 2017, in JAMA Surgery. 1 In this study of 1738 patients who underwent Roux-en-Y gastric bypass (RYGB) and 610 patients who underwent laparoscopic adjustable gastric banding (LAGB), Courcoulas and colleagues 1 assessed the outcomes and adverse effects associated with bariatric procedures by measuring rates of postoperative complications, operative revisions, weight change and trajectory, and effect on comorbid conditions.At 7 years after the operation, patients who had undergone RYGB had significant mean weight loss from baseline (28.4%) with minimal weight regain between years 3 and 7 (3.9%). Patients who had undergone LAGB had substantially lower mean weight loss from baseline (14.9%) and minimal weight regain between years 3 and 7 (1.4%). In addition to durable weight loss, patients who had undergone RYGB benefitted from high rates of long-term relief from all 5 comorbidities evaluated (diabetes mellitus, high low-density lipoprotein cholesterol level, high level of triglycerides, low highdensity lipoprotein cholesterol level, and hypertension) at 7 years, whereas those who had undergone LAGB had lower rates.Postprocedure mortality was very low with 3 deaths within 30 days of surgery and 7-year death rates of 3.7/700 person-years after RYGB (59 deaths) and 2.7/700 person-years after LAGB (15 deaths). Rates of operative revisions and reversals were low for patients in the RYGB group (0.92/700 person-years), but were significantly higher among patients in the LAGB group (30.29/700 person-years). These operations after initial surgery included reversal of bypass to normal anatomy after RYGB, port revisions, band replacements, revisions of bands other than replacements, reversal of LAGB through removal of band, and subsequent bariatric procedures.

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Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study

Abstract: clinicaltrials.gov Identifier: NCT00465829.

Cited by 535 publications

References 18 publications

Antidiabetic medication de‐escalation following bariatric surgery

Antidiabetic medication de‐escalation following bariatric surgery

End‐of‐Trial Health Outcomes in Look AHEAD Participants who Elected to have Bariatric Surgery

Long-term Outcomes Following Bariatric Surgery

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