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Levaillant L, Levaillant M, Sfeir N, Bouhours-Nouet N, Amsellem-Jager J, Beaumesnil M, Coutant R, Riquin É, Schmitt F. Factors Associated With Weight Loss After Laparoscopic Adjustable Gastric Banding in Adolescents With Severe Obesity. JPGN REPORTS 2023; 4:e296. [PMID: 37200715 PMCID: PMC10187845 DOI: 10.1097/pg9.0000000000000296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/27/2022] [Indexed: 05/20/2023]
Abstract
Childhood obesity is associated with many comorbidities. Bariatric surgery is known to be efficient for reducing weight in adolescents. Objectives The primary outcome was to identify somatic or psychosocial factors associated with success at 24 months after a laparoscopic adjustable gastric banding (LAGB) procedure in our cohort of adolescents with severe obesity. Secondary endpoints were to describe weight loss outcomes, comorbidity resolution, and complications. Methods We have retrospectively reviewed medical records of patients who had LAGB placed between 2007 and 2017. Factors associated with success at 24 months after LAGB were researched, with success being defined as positive percentage of excess weight loss (%EWL) at 24 months. Results Forty-two adolescents underwent a LAGB procedure, the mean %EWL was 34.1% at 24 months, with improvement in most comorbidities and without major complications. Having lost weight before surgery was associated with success, whereas a high body mass index at surgery was associated with a higher risk of failure. No other factor was found to be associated with success. Conclusion Comorbidities mostly improved 24 months after LAGB and no major complication occurred. Having lost weight before surgery was associated with a successful surgery, whereas a high body mass index at surgery increases the risk of failure.
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Affiliation(s)
- Lucie Levaillant
- From the Department of Paediatric Endocrinology and Diabetology, University Hospital of Angers, Angers, France
| | - Mathieu Levaillant
- Department of Methodology and Biostatistics, University Hospital of Angers, Angers, France
- University of Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Nathalie Sfeir
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France
| | - Natacha Bouhours-Nouet
- From the Department of Paediatric Endocrinology and Diabetology, University Hospital of Angers, Angers, France
| | - Jessica Amsellem-Jager
- From the Department of Paediatric Endocrinology and Diabetology, University Hospital of Angers, Angers, France
| | - Marion Beaumesnil
- Department of Paediatric Physical and Rehabilitation Medicine, Centre des Capucins, Angers, France
| | - Régis Coutant
- From the Department of Paediatric Endocrinology and Diabetology, University Hospital of Angers, Angers, France
| | - Élise Riquin
- Department of Child and Adolescent Psychiatry, University Hospital of Angers, Angers, France
- Mitovasc Unit, UMR CNRS 6015-INSERM, Angers, France
- Laboratory of Psychology, LPPL EA4638, University of Angers, Angers, France
| | - Françoise Schmitt
- Department of Paediatric Surgery, University Hospital of Angers, Angers, France
- Univ Angers, HIFIH, SFR ICAT, Angers, France
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Lee JH, Park JH, Kim SM. Comparison of Dietary Quality and Surgical Satisfaction Between Patients With Suboptimal and Optimal Weight Loss After Sleeve Gastrectomy Using Food Tolerance Score and Bariatric Analysis and Reporting Outcome System Questionnaires. JOURNAL OF METABOLIC AND BARIATRIC SURGERY 2022; 11:54-62. [PMID: 36926675 PMCID: PMC10011672 DOI: 10.17476/jmbs.2022.11.2.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 03/11/2023]
Abstract
Purpose This study aimed to assess the association of dietary quality and surgical satisfaction with the amount of total weight loss (TWL) 1 year after laparoscopic sleeve gastrectomy (LSG) using the food tolerance score (FTS) and Bariatric Analysis and Reporting Outcome System (BAROS) questionnaires. Materials and Methods This single-center retrospective study included patients who underwent LSG due to morbid obesity. Only those who have 1-year follow-up data were included and divided into 2 groups: suboptimal TWL (STWL) ≤20% and optimal TWL (OTWL) >20%. Clinical data and questionnaires recorded 1 year after surgery were collected. FTS was used to evaluate the degree of food tolerance, and BAROS assessed surgical outcomes, including weight loss, comorbidity changes, and quality of life (QoL). The total FTS and BAROS scores of the 2 groups were compared. Results Of 580 patients, 159 were included. Patients in STWL (n=17) were significantly older than those in OTWL (n=142) (42.24±9.28 vs. 35.92±8.71 years old, P=0.006). The total FTS (1-30 points) for STWL and OTWL were 24.88±3.43 and 25.04±3.14, respectively (P=0.845). Although the total BAROS scores (maximum: 9 points) were significantly lower in STWL than in OTWL (5.96±1.48 vs. 7.20±1.40, P<0.001). The only variable that made this difference was weight loss. There were no significant differences in other variables, such as medical conditions, QoL, and complications. Conclusion In terms of FTS and BAROS score, there is no difference in postoperative satisfaction and QoL between STWL and OTWL after LSG, except for the degree of weight loss.
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Affiliation(s)
- Joo Hoon Lee
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Ji-Hyeon Park
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Seong Min Kim
- Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.,Department of Surgery, Gachon University of Medicine and Science, Incheon, Korea
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Shahwan S, Oochit K, Campbell E, Kourounis G. Reporting of Weight Loss Outcomes in Bariatric Surgery Following Introduction of 2015 ASMBS Guidelines. Surg Obes Relat Dis 2022; 18:1195-1198. [DOI: 10.1016/j.soard.2022.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/26/2022] [Indexed: 10/17/2022]
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Kourounis G, Kong CY, Logue J, Gibson S. Weight loss in adults following bariatric surgery, a systematic review of preoperative behavioural predictors. Clin Obes 2020; 10:e12392. [PMID: 32691530 DOI: 10.1111/cob.12392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 12/23/2022]
Abstract
Bariatric surgery is effective in treating obesity in many cases, yet as many as 50% of patients may not achieve the desired weight reduction. Preoperative modifiable behavioural factors could help patient selection and intervention design to improve outcomes. Medline, EMBASE, Cochrane Library and PsychINFO were searched to identify studies published between 1 January 2008 and 14 February 2019 reporting on preoperative modifiable behavioural factors associated with postoperative weight loss, with minimum 2 years follow-up. A total of 6888 articles were screened, 34 met the inclusion criteria. Maladaptive eating behaviours (MEB), preoperative weight loss (PWL), and tobacco use were reported 21, 18, and 3 times respectively. Physical activity and substance abuse were each reported once. Most articles on PWL (72.2%) and MEB (52.4%) reported no association. Positive associations were reported in 22.2% and 14.3% of articles for PWL and MEB respectively. Negative associations were reported in 5.6% and 33.3% of articles for PWL and MEB, respectively. Marked heterogeneity in outcome reporting hindered quantitative synthesis. The current paucity of evidence amenable to synthesis leads to ongoing uncertainty regarding the size and direction of association between PWL and MEB with outcomes following bariatric surgery. Long-term studies with common reporting of outcomes are needed.
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Affiliation(s)
- Georgios Kourounis
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Chia Yew Kong
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Department of General Surgery, Monklands Hospital, Airdrie, UK
| | - Jennifer Logue
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Simon Gibson
- Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK
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Funk LM, Grubber JM, McVay MA, Olsen MK, Yancy WS, Voils CI. Patient predictors of weight loss following a behavioral weight management intervention among US Veterans with severe obesity. Eat Weight Disord 2018; 23:587-595. [PMID: 28853051 PMCID: PMC6985907 DOI: 10.1007/s40519-017-0425-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/29/2017] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Identification of patient characteristics that are associated with behavioral weight loss success among bariatric surgery candidates could inform selection of optimal bariatric surgery candidates. We examined the associations between psychosocial characteristics and weight loss in a group of Veterans with severe obesity who participated in a behavioral weight loss intervention. METHODS The MAINTAIN trial involved a 16-week weight loss program followed by randomization among participants losing at least 4 kg to a maintenance intervention or usual care. This secondary analysis was performed on Veterans who participated in the 16-week weight loss program and met NIH criteria for bariatric surgery (body mass index [BMI] 35.0-39.9 with at least 1 obesity-related comorbidity or BMI ≥ 40). Unadjusted and adjusted associations between baseline patient characteristics and weight loss during the 16-week induction phase were evaluated with linear regression. Missing weight measurements were multiply imputed, and results combined across ten imputations. RESULTS Among the 206 patients who met inclusion criteria, mean initial BMI was 40.8 kg/m2 (SD 6.0), and mean age was 59.2 years (SD 9.4). Approximately 20% of participants were female, 51.5% were Black, and 44.7% were White. Estimated mean 16-week weight loss was 5.16 kg (SD 4.31). In adjusted analyses, greater social support and older age were associated with greater weight loss (p < 0.05). None of the nine psychosocial characteristics we examined were associated with greater weight loss. CONCLUSIONS Understanding and strengthening the level of social support for bariatric surgery candidates may be important given that it appears to be strongly correlated with behavioral weight loss success. LEVEL OF EVIDENCE Level II, Evidence obtained from well-designed controlled trials without randomization. TRIAL REGISTRATION ClinicalTrials.gov NCT01357551 http://clinicaltrials.gov/show/NCT01357551 .
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Affiliation(s)
- Luke M Funk
- William S. Middleton VA, Madison, WI, USA. .,Department of Surgery, University of Wisconsin, Madison, WI, USA.
| | - Janet M Grubber
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Megan A McVay
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA.,Department of Psychiatry, Duke University Medical Center, Durham, NC, USA
| | - Maren K Olsen
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA.,Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - William S Yancy
- Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA.,Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Corrine I Voils
- William S. Middleton VA, Madison, WI, USA.,Department of Surgery, University of Wisconsin, Madison, WI, USA
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