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Vanegas SM, Curado S, Gujral A, Valverde G, Parraga S, Aleman JO, Reid M, Elbel B, Schmidt AM, Heffron SP, Segal E, Li H, Abrams C, Sevick MA, Popp C, Armijos E, Merriwether EN, Ivezaj V, Ren-Fielding C, Parikh M, Jay M. Cohort profile: study design and baseline characteristics of an observational longitudinal weight loss cohort and biorepository of patients undergoing sleeve gastrectomy in the USA. BMJ Open 2024; 14:e081201. [PMID: 39181563 PMCID: PMC11344502 DOI: 10.1136/bmjopen-2023-081201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 07/19/2024] [Indexed: 08/27/2024] Open
Abstract
PURPOSE We developed a comprehensive sleeve gastrectomy (SG) weight loss study cohort and biorepository to uncover mechanisms, biomarkers and predictive factors of weight loss, weight maintenance and amelioration of obesity-related comorbidities. For this purpose, we collected psychosocial, anthropometric, clinical data and a variety of samples pre-surgery, intraoperatively and 1.5, 3, 12 and 24 months post-surgery. For longer-term assessment, the collection of psychosocial and anthropometric data was extended to 10 years. Here, we present in-depth characterisation of the cohort and detailed overview of study procedures as a foundation for future analyses. PARTICIPANTS We consented 647 participants between June 2017 and March 2020 from two bariatric surgery clinics in New York City-one major urban hospital and one private hospital. Of 355 participants who provided baseline data, 300 underwent SG. Of these, 79% are females with an average age of 38 years, 68% are Hispanic, 20% are non-Hispanic Black and 11% are non-Hispanic White. FINDINGS TO DATE We collected intraoperative adipose and stomach tissues from 282 patients and biosamples (blood, urine, saliva, stool) from 245 patients at 1.5 months, 238 at 3 month, 218 at 12 months and 180 at 24 months post-surgery. We are currently collecting anthropometric and psychosocial data annually until 10 years post-surgery. Data analysis is currently underway. FUTURE PLANS Our future research will explore the variability in weight loss outcomes observed in our cohort, particularly among Black and Hispanic patients in comparison to their White counterparts. We will identify social determinants of health, metabolic factors and other variables that may predict weight loss success, weight maintenance and remission of obesity-related comorbidities. Additionally, we plan to leverage our biorepository for collaborative research studies. We will complete long-term follow-up data by December 2031. We plan to apply for funding to expand biosample collection through year 10 to provide insights into the mechanisms of long-term weight maintenance.
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Affiliation(s)
- Sally M Vanegas
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Silvia Curado
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, USA
- Department of Cell Biology, New York University Grossman School of Medicine, New York, New York, USA
| | - Akash Gujral
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Gabriela Valverde
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Susan Parraga
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Jose O Aleman
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Laboratory of Translational Obesity Research, New York University Grossman School of Medicine, New York, New York, USA
| | - Migdalia Reid
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Laboratory of Translational Obesity Research, New York University Grossman School of Medicine, New York, New York, USA
| | - Brian Elbel
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
- Wagner Graduate School of Public Service, New York University, New York, New York, USA
| | - Ann Marie Schmidt
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Sean P Heffron
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Eran Segal
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Huilin Li
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Courtney Abrams
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Mary A Sevick
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Collin Popp
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Evelyn Armijos
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Ericka N Merriwether
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Physical Therapy Education, and Human Development, New York University, New York, New York, USA
| | - Valentina Ivezaj
- Department of Medicine, Yale University, New Haven, Connecticut, USA
| | - Christine Ren-Fielding
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Manish Parikh
- Department of Surgery, New York University Grossman School of Medicine, New York, New York, USA
| | - Melanie Jay
- Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA
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Ivezaj V, Dilip A, Duffy AJ, Grilo CM. Racial differences after bariatric surgery: 24-month follow-up of a randomized, controlled trial for postoperative loss-of-control eating. Surg Obes Relat Dis 2024; 20:261-266. [PMID: 37949690 PMCID: PMC10922356 DOI: 10.1016/j.soard.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/01/2023] [Accepted: 09/10/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND While some bariatric surgery outcomes vary by race/ethnicity, less is known about racial/ethnic differences in loss-of-control (LOC) eating and psychosocial outcomes post-surgery. OBJECTIVE This prospective study examined and extended initial short-term findings regarding racial differences in post-bariatric surgery LOC eating and weight loss to longer-term outcomes through 24-month follow-ups. SETTING Academic medical center in the United States. METHODS Participants were 140 patients (46.4% non-White) in a 3-month randomized, controlled trial for LOC eating performed about 6 months after bariatric surgery. Participants were reassessed at 6, 12, 18, and 24 months after treatment ended (about 33 mo after surgery). Doctoral assessors administered the Eating Disorder Examination-Bariatric Surgery Version interview to assess LOC eating and eating-disorder psychopathology at 12- and 24-month follow-ups. The Beck Depression Inventory II was repeated, and measured weight was obtained at all follow-ups. RESULTS White patients had significantly greater percent excess weight loss at all follow-ups than non-White patients (p < .03). White patients reported significantly more LOC eating at 12- (p = .004) and 24-month (p = .024) follow-ups and significantly greater eating disorder psychopathology at 12-month follow-up (p < .028). Racial groups did not differ significantly in eating disorder psychopathology at 24-month follow-ups or in Beck Depression Inventory II depression scores at any follow-ups. CONCLUSIONS Our findings suggest that among patients with LOC eating after bariatric surgery, non-White patients attain a lower percent excess weight loss than White patients but have comparable or better outcomes in LOC eating, associated eating disorder psychopathology, and depression over time.
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Affiliation(s)
- Valentina Ivezaj
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
| | - Abhaya Dilip
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Andrew J Duffy
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Department of Psychology, Yale University, New Haven, Connecticut
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Weitzner ZN, Kim KH, Kim Y, Seo KW, Choi YS, Dutson EP. Comparison of Eastern and Western patients undergoing bariatric surgery at two US and Korean institutions: a retrospective analysis of differing bariatric patient populations. Surg Endosc 2024; 38:129-135. [PMID: 37934296 DOI: 10.1007/s00464-023-10549-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Currently, there are differences in both demographics and indications for bariatric surgery between Eastern and Western countries. We compared postoperative outcomes between Korean and American bariatric programs in order to assess how bariatric surgery differently affects these populations. METHODS We enrolled 540 patients who underwent bariatric surgery at University of California, Los Angeles (UCLA) and 85 patients who underwent surgery at Kosin University Gospel Hospital (KUGH) between January 2019 and December 2020. We compared demographics, complications, weight loss, and metabolic parameters between these groups. RESULTS There was a difference in age between the UCLA and KUGH patient groups (44.3 years vs 37.6 years, P < 0.01). Frequencies of T2DM and OSA were also different (4.2% vs 50.6%, 34.1% vs 85.9% P < 0.01. Length of hospital stay varied (1.55 days vs 6.68 days, P < 0.01), but there was no difference in operating time and complications. There was no difference in percent of excess weight loss between the two groups at 6 months (29.7 vs 33.8, P = 0.13). Hepatic steatosis index (HSI) was higher in the UCLA group both before (54.2 vs 51.5, P < 0.01) and after (44.4 vs 40.0, P = 0.02) surgery. LSG was the most frequently performed operation, and robotic surgery and revisions were performed only in the UCLA program. CONCLUSION There were differences in age, BMI, length of stay, and choice of operation between Korean and American bariatric patients. Also, there were differences in the degree of fatty liver disease using HSI and liver enzymes before and after surgery. There was no significant differences in operation time and complications. These findings suggest differences in bariatric practices and reactions to bariatric surgery in Eastern and Western settings.
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Affiliation(s)
- Zachary N Weitzner
- Department of Surgery, UCLA Section of Minimally Invasive and Bariatric Surgery, David Geffen School of Medicine at University of California, 72-239 CHS, BOX 956904, Los Angeles, CA, 90095, USA
| | - Ki Hyun Kim
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea
| | - Yoonhong Kim
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea
| | - Kyung Won Seo
- Department of Surgery, College of Medicine, Kosin University, 262 Gamcheon-ro, Seo-gu, Busan, 49267, Republic of Korea.
| | - Young Sik Choi
- Department of Internal Medicine, College of Medicine, Kosin University, Busan, Republic of Korea
| | - Erik P Dutson
- Department of Surgery, UCLA Section of Minimally Invasive and Bariatric Surgery, David Geffen School of Medicine at University of California, 72-239 CHS, BOX 956904, Los Angeles, CA, 90095, USA.
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Haley EN, Loree AM, Maye M, Coleman KJ, Braciszewski JM, Snodgrass M, Harry ML, Carlin AM, Miller-Matero LR. Racial Differences in Psychiatric Symptoms, Maladaptive Eating, and Lifestyle Behaviors After Bariatric Surgery. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01835-8. [PMID: 37874488 DOI: 10.1007/s40615-023-01835-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
There are several psychological and behavioral factors associated with poorer outcomes following bariatric surgery, yet it is unknown whether and how these factors may differ by race. In this cross-sectional study, individuals who underwent bariatric surgery from 2018 to 2021 and up to 4 years post-surgery were invited to complete an online survey. Psychiatric symptoms, maladaptive eating patterns, self-monitoring behaviors, and exercise frequency were examined. Participants (N = 733) were 87% women, 63% White, with a mean age of 44 years. Analyses of covariance demonstrated that White individuals endorsed greater anxiety symptoms (p =.01) and emotional eating due to depression (p = .01), whereas Black individuals endorsed greater depression severity (p = .02). Logistic regression analyses demonstrated that White individuals were more likely to experience loss of control eating (OR= 1.7, p = .002), grazing (OR= 2.53, p <.001), and regular self-weighing (OR= 1.41, p <.001) than Black individuals, and were less likely to skip meals (OR= .61, p = .04), or partake in nighttime eating (OR= .40, p <.001). There were no racial differences in binge eating, emotional eating due to anxiety or frustration, use of a food diary, or exercise. Thus, depressive symptoms, skipping meals, and nighttime eating may be important, modifiable intervention targets to optimize the benefits of bariatric surgery and promote equitable outcomes.
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Affiliation(s)
- Erin N Haley
- Behavioral Health, Henry Ford Health, Detroit, USA.
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA.
| | - Amy M Loree
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Melissa Maye
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | | | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health, Detroit, USA
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | | | - Melissa L Harry
- Essentia Institute of Rural Health, Essentia Health, Duluth, USA
| | | | - Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, Detroit, USA
- Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
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Catania J, Spirou D, Gascoigne M, Raman J. Loss of control as a transdiagnostic feature in obesity-related eating behaviours: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2023; 31:24-45. [PMID: 35801968 PMCID: PMC10084033 DOI: 10.1002/erv.2936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non-clinical populations. METHOD Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality. RESULTS Thirty-four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct. CONCLUSION Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi-method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.
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Affiliation(s)
- Justin Catania
- Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Michael Gascoigne
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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Sarwer DB, Wadden TA, Ashare RL, Spitzer JC, McCuen-Wurst C, LaGrotte C, Williams NN, Edwards M, Tewksbury C, Wu J, Tajeu G, Allison KC. Psychopathology, disordered eating, and impulsivity in patients seeking bariatric surgery. Surg Obes Relat Dis 2021; 17:516-524. [PMID: 33341423 PMCID: PMC8212387 DOI: 10.1016/j.soard.2020.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Most patients who undergo bariatric surgery experience significant weight loss and improvements in obesity-related co-morbidities in the first 6-18 months after surgery. However, 20%-30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. Psychosocial functioning may contribute to suboptimal weight loss and/or postoperative psychosocial distress. OBJECTIVE Assess psychosocial functioning, eating behavior, and impulsivity in patients seeking bariatric surgery. SETTING Two university hospitals. METHODS Validated interviews and questionnaires. Impulsivity assessed via computer program. RESULTS The present study included a larger (n = 300) and more racially diverse (70% non-White) sample than previous studies of these relationships. Forty-eight percent of participants had a current psychiatric diagnosis and 78% had at least 1 lifetime diagnosis. Anxiety disorders were the most common current diagnosis (25%); major depressive disorder was the most common lifetime diagnosis (44%). Approximately 6% of participants had a current alcohol or substance use disorder; 7% had a positive drug screen before surgery. A current psychiatric diagnosis was associated with greater symptoms of food addiction and night eating. Current diagnosis of alcohol use disorder or a lifetime diagnosis of anxiety disorders was associated with higher delay discounting. CONCLUSION The study identified high rates of psychopathology and related symptoms among a large, diverse sample of bariatric surgery candidates. Psychopathology was associated with symptoms of disordered eating and higher rates of delay discounting, suggesting impulse control issues.
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Affiliation(s)
- David B Sarwer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rebecca L Ashare
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacqueline C Spitzer
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Courtney McCuen-Wurst
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Caitlin LaGrotte
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | | | - Colleen Tewksbury
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | - Jingwei Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Gabriel Tajeu
- Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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