Weight Loss and Weight Regain—5-Year Follow-Up for Circular- vs. Linear-Stapled Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Bypass

Langer, Felix B.; Prager, Gerhard; Poglitsch, M.; Kefurt, Ronald; Shakeri-Leidenmühler, Soheila; Ludvik, Bernhard; Schindler, Karin; Bohdjalian, Arthur

doi:10.1007/s11695-013-0892-4

Cited by 24 publications

(16 citation statements)

References 45 publications

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“…The amount of weight loss achieved with AT (∼ 19% of initial body weight) was much greater than that usually observed with intensive lifestyle therapy alone 8,9 or obesity pharmacotherapy 10 and nearly the same as that observed after laparoscopic adjustable gastric banding. 21 Weight regain, which is typically seen after 1 year of intensive weight loss therapy 8,9 and at 1 to 10 years after bariatric surgery, 22-24 was not seen in this study. In addition, although serious complications and death occur in 2.5% to 4.2% and 0.04% to 0.3% of patients who undergo bariatric surgery, respectively, 25-27 these events did not occur in any subject in the AT group.…”

Section: Discussioncontrasting

confidence: 58%

Aspiration Therapy Leads to Weight Loss in Obese Subjects: A Pilot Study

et al. 2013

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Background & Aims Obese patients rarely achieve long-term weight loss with only lifestyle interventions. We evaluated the use of endoscopic aspiration therapy for obesity. Aspiration therapy involves endoscopic placement of a gastrostomy tube (A-Tube) and the AspireAssist siphon assembly (Aspire Bariatrics, King of Prussia, PA) to aspirate gastric contents 20 minutes after meal consumption. Methods We performed a pilot study of 18 obese subjects who were randomly assigned (2:1) to groups that underwent aspiration therapy for 1 year plus lifestyle therapy (n = 11; mean body mass index, 42.6 ± 1.4 kg/m2) or lifestyle therapy only (n = 7; mean body mass index, 43.4 ± 2.0 kg/m). Lifestyle intervention comprised a 15-session diet and behavioral education program. Results Ten of the 11 subjects who underwent aspiration therapy and 4 of the 7 subjects who underwent lifestyle therapy completed the first year of the study. After 1 year, subjects in the aspiration therapy group lost 18.6% ± 2.3% of their body weight (49.0% ± 7.7% of excess weight loss [EWL]) and those in the lifestyle therapy group lost 5.9% ± 5.0% (14.9% ± 12.2% of EWL) (P < .04). Seven of the 10 subjects in the aspiration therapy group completed an additional year of therapy and maintained a 20.1% ± 3.5% body weight loss (54.6% ± 12.0% of EWL). There were no adverse effects of aspiration therapy on eating behavior and no evidence of compensation for aspirated calories with increased food intake. No episodes of binge eating in the aspiration therapy group or serious adverse were reported. Conclusions In a pilot study, aspiration therapy appears to be a safe and effective long-term weight loss therapy for obesity. ClinicalTrials.gov, Number: NCT00773903.

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Section: Discussioncontrasting

confidence: 58%

Aspiration Therapy Leads to Weight Loss in Obese Subjects: A Pilot Study

et al. 2013

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“…Inclusion criteria were male or female, aged 18 years or over, able to speak and understand English, minimum of 2 years post‐RYGB as a primary procedure and WR of 10% or more of total weight lost based on Langer et al .’s formula (%WR = (100/(initial weight/weight nadir)) × WR (kg)) . This cut‐off recommended by Karmali et al .…”

Section: Methodsmentioning

confidence: 99%

“…Following local research ethics committee approval (13/LO/1491), participants were recruited from a UK Hospital Trust bariatric surgery unit over a 6-week period. Inclusion criteria were male or female, aged 18 years or over, able to speak and understand English, minimum of 2 years post-RYGB as a primary procedure and WR of 10% or more of total weight lost based on Langer et al's formula (%WR = (100/(initial weight/weight nadir)) × WR (kg)) (15). This cut-off recommended by Karmali et al is considered reasonable for identifying individuals whose WR has impacted their lives (7).…”

Section: Recruitmentmentioning

confidence: 99%

Maintaining weight loss after bariatric surgery: when the spectator role is no longer enough

2016

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Bariatric (weight loss) surgery is the gold standard treatment for severe obesity. Concern exists that patients are regaining weight in the longer term. Success and cost-effectiveness of surgery are threatened due to the re-emergence of related conditions such as diabetes. This exploratory qualitative study investigates patients' expectations and experiences of weight regain (WR) 2 years or more after Roux-en-Y gastric bypass (RYGB). Ten participants (two men and eight women) who experienced WR were interviewed between 2 and 6 years following surgery. Findings highlight that participants reacted to initial weight loss as passive spectators and were unprepared for subsequent WR. Their tolerability of WR reduced as the amount of regain increased, suggesting a 'line of tolerance' for WR. WR was influenced by a new vulnerability arising from weight loss over time, and participants struggled to manage their own weight actively as surgical effects waned. They considered self-management skills, and carer and professional support to be limited at the time when WR was most likely to occur. Degrees of tolerability are noted in individuals regaining weight after RYGB. More studies are needed to further understand these problems. Pre- and post-operative support and teaching patients self-management skills may be helpful to minimize WR.

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“…In spite of the possibility of unsatisfactory weight loss or weight regain [2,3], bariatric surgery remains as the most effective treatment for severe obesity [4], with patients usually achieving their total weight loss in the first and second year of surgery [5]. Weight loss subsequent to bariatric surgeries frequently results in several medical benefits and in the resolution or improvement in obesity-related comorbidities [6], as well as in significant improvement in psychosocial functioning [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes

et al. 2015

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An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.

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Weight Loss and Weight Regain—5-Year Follow-Up for Circular- vs. Linear-Stapled Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Bypass

Abstract: CSA and LSA lead to comparable weight loss in this 5-year follow-up. More patients in the CSA group had WR. Weight regain of more than 10 kg was found in one out of seven patients within 5 years postoperatively.

Cited by 24 publications

References 45 publications

Aspiration Therapy Leads to Weight Loss in Obese Subjects: A Pilot Study

Aspiration Therapy Leads to Weight Loss in Obese Subjects: A Pilot Study

Maintaining weight loss after bariatric surgery: when the spectator role is no longer enough

Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes

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