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Khattab R. Weight Loss Programs: Why Do They Fail? A Multidimensional Approach for Obesity Management. Curr Nutr Rep 2024; 13:478-499. [PMID: 38861120 DOI: 10.1007/s13668-024-00551-x] [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] [Accepted: 06/04/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE OF REVIEW Despite the prevalence of weight loss programs, their success rates remain discouraging, with around half of individuals regaining lost weight within two years. The primary objective of this review is to explore the factors contributing to the failure of weight loss programs and to provide insights into effective weight management strategies. RECENT FINDINGS Factors contributing to the failure of weight loss programs include the impracticality of restrictive diets, potential metabolic impacts, limited focus on lifestyle changes, genetic predispositions, psychological influences, socioeconomic status, and medical conditions. A holistic approach considering these factors is crucial for safe and sustainable weight loss. Key findings indicate the importance of holistic approaches to weight management, including lifestyle modifications, medical interventions, and behavioral and psychological strategies. Effective weight loss strategies emphasize low-calorie, nutrient-rich diets, regular physical activity, and interventions tailored to individual needs. Combining multiple approaches offers the best chance of successful weight management and improved health outcomes. This review provides insights into the complexities of obesity management and the factors contributing to the failure of weight loss programs. It highlights the necessity of adopting a holistic approach that addresses dietary habits, physical activity, genetic factors, psychological well-being, and socioeconomic influences. Recommendations include implementing lifestyle modifications, medical interventions when necessary, and integrating behavioral and psychological support to achieve sustainable weight loss and mitigate the global health challenge posed by obesity.
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Affiliation(s)
- Rabie Khattab
- Clinical Nutrition Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
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2
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Papakostas P, Tzikos G, Pyankova G, Menni AE, Pourtoulidou DF, Shrewsbury AD, Lidoriki I, Stelmach V, Fyntanidou B, Grosomanidis V, Stavrou G, Kotzampassi K. Changes in Food Preferences Before and After Intragastric Balloon Placement. Obes Surg 2024; 34:2091-2100. [PMID: 38703243 DOI: 10.1007/s11695-024-07233-1] [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: 08/18/2023] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUNDS In recent years, numerous studies have tried to decode the way bariatric surgery works toward weight reduction by the use of food preference questionnaires. The intragastric balloon has gained popularity, mainly due to its limited invasiveness, in patients with obesity not fulfilling criteria for bariatric surgery. However, there is no study assessing the changes in food preferences [FP]. We decided to analyze the FP of individuals prior to intragastric balloon insertion and following its removal, on the strict condition that participants must complete the 6-month treatment period and attend at least 4 of the 7 follow-up interviews. METHODS Patients were asked to rate the frequency of consumption of 63 food items before balloon insertion, at monthly intervals and after balloon removal. The food categories were protein, carbohydrates, fruit and vegetables, and sweets and fats. RESULTS The questionnaires of 320 participants were analyzed. A reduced frequency in consumption of meat and meat products, high-fat, and high-carbohydrate/sugary products and an increase in raw vegetables and fruit was found in all individuals. CONCLUSION The intragastric balloon seems to exert analogically similar mechanisms to bariatric surgery for weight loss, both functioning through alterations in FP. These are dictated by the anatomical re-configuration of the stomach, but mainly by counseling of dieticians and the self-education of the patient after experiencing unpleasant postprandial discomfort.
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Affiliation(s)
- Pyrros Papakostas
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Georgios Tzikos
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Gerry Pyankova
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | | | | | - Anne D Shrewsbury
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Irene Lidoriki
- First Department of Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Veroniki Stelmach
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Barbara Fyntanidou
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Vasilis Grosomanidis
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - George Stavrou
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle Univesity of Thessaloniki, 54636, Thessaloniki, Greece.
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Li H, Dai W, Zhang X, Lu J, Song F, Li H. Chemical components of Fu brick tea and its potential preventive effects on metabolic syndrome. Food Sci Nutr 2024; 12:35-47. [PMID: 38268870 PMCID: PMC10804099 DOI: 10.1002/fsn3.3771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/27/2023] [Accepted: 10/04/2023] [Indexed: 01/26/2024] Open
Abstract
As living standards advance, an escalating emphasis is placed on health, particularly in relation to prevalent chronic metabolic disorders. It is necessary to explore safe and effective functional foods or drugs. Fu brick tea (FBT) is a kind of dark tea fermented by fungi. The extracts are rich in compounds that can effectively relieve metabolic diseases such as hyperglycemia and hyperlipidemia, protect the liver, improve human immunity, enhance antioxidant activity, and regulate intestinal flora. This paper summarizes the biological activities and mechanisms of the extracts, polysaccharides, and small molecular compounds of FBT, which provides a certain theoretical basis for the rational, systematic, comprehensive development and utilization of the FBT resources. It is expected to develop and apply these active substances in health care products and natural medicines and provide more beneficial and diversified FBT products for human beings.
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Affiliation(s)
- Honghua Li
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education of ChinaSchool of Light IndustryBeijing Technology and Business UniversityBeijingChina
| | - Wei Dai
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education of ChinaSchool of Light IndustryBeijing Technology and Business UniversityBeijingChina
| | - Xinjun Zhang
- Key Laboratory of Forest Ecology in Tibet Plateau (Ministry of Education), Institute of Tibet Plateau EcologyTibet Agriculture & Animal Husbandry UniversityNyingchiTibetChina
| | - Jie Lu
- Key Laboratory of Forest Ecology in Tibet Plateau (Ministry of Education), Institute of Tibet Plateau EcologyTibet Agriculture & Animal Husbandry UniversityNyingchiTibetChina
| | - Fuhang Song
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education of ChinaSchool of Light IndustryBeijing Technology and Business UniversityBeijingChina
| | - Hua Li
- Key Laboratory of Geriatric Nutrition and Health, Ministry of Education of ChinaSchool of Light IndustryBeijing Technology and Business UniversityBeijingChina
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Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management. Cancers (Basel) 2023; 15:cancers15020485. [PMID: 36672434 PMCID: PMC9857053 DOI: 10.3390/cancers15020485] [Citation(s) in RCA: 116] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Obesity or excess body fat is a major global health challenge that has not only been associated with diabetes mellitus and cardiovascular disease but is also a major risk factor for the development of and mortality related to a subgroup of cancer. This review focuses on epidemiology, the relationship between obesity and the risk associated with the development and recurrence of cancer and the management of obesity. METHODS A literature search using PubMed and Google Scholar was performed and the keywords 'obesity' and cancer' were used. The search was limited to research papers published in English prior to September 2022 and focused on studies that investigated epidemiology, the pathogenesis of cancer, cancer incidence and the risk of recurrence, and the management of obesity. RESULTS About 4-8% of all cancers are attributed to obesity. Obesity is a risk factor for several major cancers, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancer. Excess body fat results in an approximately 17% increased risk of cancer-specific mortality. The relationship between obesity and the risk associated with the development of cancer and its recurrence is not fully understood and involves altered fatty acid metabolism, extracellular matrix remodeling, the secretion of adipokines and anabolic and sex hormones, immune dysregulation, and chronic inflammation. Obesity may also increase treatment-related adverse effects and influence treatment decisions regarding specific types of cancer therapy. Structured exercise in combination with dietary support and behavior therapy are effective interventions. Treatment with glucagon-like peptide-1 analogues and bariatric surgery result in more rapid weight loss and can be considered in selected cancer survivors. CONCLUSIONS Obesity increases cancer risk and mortality. Weight-reducing strategies in obesity-associated cancers are important interventions as a key component of cancer care. Future studies are warranted to further elucidate the complex relationship between obesity and cancer with the identification of targets for effective interventions.
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Song EJ, Shin NR, Jeon S, Nam YD, Kim H. Impact of the herbal medicine, Ephedra sinica stapf, on gut microbiota and body weight in a diet-induced obesity model. Front Pharmacol 2022; 13:1042833. [DOI: 10.3389/fphar.2022.1042833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Obesity is a chronic metabolic disease caused by excessive body fat and has become a global public health problem. Evidence suggests that obesity and obesity-induced metabolic disorders are closely related to gut microbiota. Bupropion (BP), an antidepressant medicine, and Ephedra sinica Stapf [Ephedraceae; Ephedrae Herba], a herbal medicine, are sympathetic stimulants and have weight loss effects. However, to our best knowledge, no studies have simultaneously assessed the effects of drugs and herbal medicines on obesity and gut microbiota. This study aimed to determine the effects of BP and ES on weight loss and re-modulation of host gut microbiota. To test this hypothesis, we fed C57BL/6J mice with a high-fat diet supplemented with bupropion (BP; 30 mg/kg/day) and Ephedra sinica Stapf extract (ES; 150 mg/kg/day) via oral gavage for eight weeks. Further, we evaluated the effects of BP and ES on body weight and fat accumulation. In addition, we evaluated the effects of BP and ES on gut microbiota using 16S rRNA amplicon sequencing. Our results showed that weight loss was confirmed in both BP and ES; however, it was more pronounced in ES. ES changed the overall composition of the gut microbiota by restoring the relative abundance of Oscillospiraceae, Lachnospiraceae, and the Firmicutes/Bacteroidetes ratio, an indicator of gut microbiota dysbiosis. Nine amplicon sequence variants (ASVs) of the gut microbiome were significantly recovered by BP and ES treatment, of which eight ASVs correlated with body weight and fat accumulation. Additionally, three ASVs were significantly recovered by ES treatment alone. In conclusion, the anti-obesity effects of BP and ES, especially fat accumulation, are related to the regulation of gut microbiota. Moreover, ES had a greater influence on the gut microbiota than BP.
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Campos-Pérez W, Ramírez-Plascencia L, Pérez-Robles M, Rivera-Valdés JJ, Sánchez-Muñoz P, Pérez-Vargas L, González-Landeros D, Cuevas JHM, Martínez-López E. A comparison of opioid-containing anesthesia versus opioid-free anesthesia using the Cortínez-Sepúlveda model on differential cytokine responses in obese patients undergoing gastric bypass surgery: a randomized controlled trial. BMC Anesthesiol 2022; 22:294. [PMID: 36114460 PMCID: PMC9479242 DOI: 10.1186/s12871-022-01838-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Background Opioid anesthetic agents can modulate the impaired immune response in obese patients through mechanisms that involve the expression and release of cytokines. For this reason, anesthetic care for obese patients remains controversial. Therefore, the aim of the study was to compare the effect of opioid-containing anesthesia (OCA) vs opioid-free anesthesia (OFA) using the Cortínez-Sepúlveda model on IL-6, IL-1β and TNF-α serum levels before and after surgery in obese patients undergoing bypass surgery. Methods This randomized cross-sectional study conducted among 40 unrelated obese adults was performed in the Civil Hospital of Guadalajara “Dr. Juan I. Menchaca”. Before undergoing laparoscopic Roux-en-Y gastric bypass, patients were randomly assigned to two anesthesia groups: OCA (n = 20) or OFA (n = 20). Fentanyl was the opioid used in the OCA group. The Cortínez-Sepúlveda pharmacokinetic model was used to characterize the disposition of intravenous propofol for the target-controlled infusion technique in obese patients. Body mass was determined to the nearest 0.05 kg using a balance scale (Seca 703; Seca, Hamburg, Germany). Blood samples were taken before and immediately after surgery and cytokine concentrations were determined by ELISA. Pain was assessed using a numerical pain rating scale. Adverse effects were collected within the first 24 h after surgery. Results A total of 6 men and 34 women were included (37.9 ± 10.6 years). Pre-surgery IL-6 and TNF-α serum levels were not detected in study subjects. However, IL-1β levels significantly decreased after surgery (49.58 pg/mL (18.50–112.20)-before surgery vs 13 pg/mL (5.43–22)-after surgery, p = 0.019). IL-6 concentrations were significantly higher in subjects who received OCA (with fentanyl) compared to subjects with OFA (224.5 pg/mL (186.3–262.8) vs 99.5 pg/mL (60.8–138.2), respectively, p < 0.001; adjusted by age, gender, and BMI). In addition, the use of opioids confers an increased risk for higher IL-6 levels in obese patients (OR = 2.95, 95% CI: 1.2–7.2, p = 0.010). A linear regression model showed that the operative time (in hours) of bypass surgery and anesthetic technique were positively correlated with IL-6 levels. Conclusion Anesthesia with opioids correlated positively with IL-6 serum levels in obese patients undergoing bypass surgery. This finding could have clinical relevance when an appropriate anesthetic management plan is selected for bariatric surgical patients. Trial registration The study was retrospectively registered at ClinicalTrials.gov Identification Number: NCT04854252, date 22/04/2021.
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Liljegard S, Fredriksson Å, Manke T, Kylebäck A, Larsson PA, Haraldsson E. The Outcome of Laparoscopy-Assisted Transgastric Rendezvous ERCP During Cholecystectomy After Roux-en-Y Gastric Bypass Compared to Normal Controls. Obes Surg 2022; 32:3398-3402. [DOI: 10.1007/s11695-022-06246-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/08/2022] [Accepted: 08/17/2022] [Indexed: 11/24/2022]
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Shao Y, Tian J, Yang Y, Hu Y, Zhu Y, Shu Q. Identification of key genes and pathways revealing the central regulatory mechanism of brain-derived glucagon-like peptide-1 on obesity using bioinformatics analysis. Front Neurosci 2022; 16:931161. [PMID: 35992905 PMCID: PMC9389235 DOI: 10.3389/fnins.2022.931161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/07/2022] [Indexed: 12/01/2022] Open
Abstract
Objective Central glucagon-like peptide-1 (GLP-1) is a target in treating obesity due to its effect on suppressing appetite, but the possible downstream key genes that GLP-1 regulated have not been studied in depth. This study intends to screen out the downstream feeding regulation genes of central GLP-1 neurons through bioinformatics analysis and verify them by chemical genetics, which may provide insights for future research. Materials and methods GSE135862 genetic expression profiles were extracted from the Gene Expression Omnibus (GEO) database. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) enrichment analyses were carried out. STRING database and Cytoscape software were used to map the protein-protein interaction (PPI) network of the differentially expressed genes (DEGs). After bioinformatics analysis, we applied chemogenetic methods to modulate the activities of GLP-1 neurons in the nucleus tractus solitarius (NTS) and observed the alterations of screened differential genes and their protein expressions in the hypothalamus under different excitatory conditions of GLP-1 neurons. Results A total of 49 DEGs were discovered, including 38 downregulated genes and 11 upregulated genes. The two genes with the highest expression scores were biglycan (Bgn) and mitogen-activated protein kinase activated protein kinase 3 (Mapkapk3). The results of GO analysis showed that there were 10 molecular functions of differential genes. Differential genes were mainly localized in seven regions around the cells, and enriched in 10 biology processes. The results of the KEGG signaling pathway enrichment analysis showed that differential genes played an important role in seven pathways. The top 15 genes selected according to the Cytoscape software included Bgn and Mapkapk3. Chemogenetic activation of GLP-1 in NTS induced a decrease in food intake and body mass, while chemogenetic inhibition induced the opposite effect. The gene and protein expression of GLP-1 were upregulated in NTS when activated by chemogenetics. In addition, the expression of Bgn was upregulated and that of Mapkapk3 was downregulated in the hypothalamus. Conclusion Our data showed that GLP-1 could modulate the protein expression of Bgn and Mapkapk3. Our findings elucidated the regulatory network in GLP-1 to obesity and might provide a novel diagnostic and therapeutic target for obesity.
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Affiliation(s)
- Yuwei Shao
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun Tian
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yanan Yang
- Department of Traditional Chinese Medicine, China Resources Wugang General Hospital, Wuhan, China
| | - Yan Hu
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ye Zhu
- College of Health Sciences, Wuhan Sports University, Wuhan, China
| | - Qing Shu
- Department of Rehabilitation, Zhongnan Hospital of Wuhan University, Wuhan, China
- *Correspondence: Qing Shu,
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Biomaterial-Based Therapeutic Strategies for Obesity and Its Comorbidities. Pharmaceutics 2022; 14:pharmaceutics14071445. [PMID: 35890340 PMCID: PMC9320151 DOI: 10.3390/pharmaceutics14071445] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is a global public health issue that results in many health complications or comorbidities, including type 2 diabetes mellitus, cardiovascular disease, and fatty liver. Pharmacotherapy alone or combined with either lifestyle alteration or surgery represents the main modality to combat obesity and its complications. However, most anti-obesity drugs are limited by their bioavailability, target specificity, and potential toxic effects. Only a handful of drugs, including orlistat, liraglutide, and semaglutide, are currently approved for clinical obesity treatment. Thus, there is an urgent need for alternative treatment strategies. Based on the new revelation of the pathogenesis of obesity and the efforts toward the multi-disciplinary integration of materials, chemistry, biotechnology, and pharmacy, some emerging obesity treatment strategies are gradually entering the field of preclinical and clinical research. Herein, by analyzing the current situation and challenges of various new obesity treatment strategies such as small-molecule drugs, natural drugs, and biotechnology drugs, the advanced functions and prospects of biomaterials in obesity-targeted delivery, as well as their biological activities and applications in obesity treatment, are systematically summarized. Finally, based on the systematic analysis of biomaterial-based obesity therapeutic strategies, the future prospects and challenges in this field are proposed.
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10
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Damer A, El Meniawy S, McPherson R, Wells G, Harper ME, Dent R. Association of muscle fiber type with measures of obesity: A systematic review. Obes Rev 2022; 23:e13444. [PMID: 35293095 DOI: 10.1111/obr.13444] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/18/2022]
Abstract
Obesity derives from an extended period of positive energy imbalance due to a complex interplay of environmental and biological factors. Muscle fiber type and physiology have been hypothesized to affect metabolism and energy expenditure and thus to affect an individual's propensity to gain weight. However, there have been conflicting reports regarding a relationship between muscle fiber type and obesity. Here, we systematically reviewed literature investigating this topic from PubMed, Web of Science, and EMBASE. Of these, 32 articles were included in our final review and analysis. Most studies (22/32) reported a significant relationship between muscle fiber-type proportion and a measure of obesity. Overall, there was a significant negative relationship between the proportion of type I fibers and body mass index (BMI) and a significant positive relationship between the proportion of type IIX fibers and BMI. Moreover, between-group comparisons indicated a greater prevalence of type IIX fibers and a lower prevalence of type I fibers in patients living with obesity relative to lean individuals. These significant relationships were confirmed in a meta-analysis of these data. The causal nature of these associations remains to be evaluated.
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Affiliation(s)
- Alameen Damer
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Ruth McPherson
- Atherogenomics Laboratory, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - George Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Mary-Ellen Harper
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, Ottawa Institute of Systems Biology, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert Dent
- Department of Medicine, Division of Endocrinology, University of Ottawa, Ottawa, Ontario, Canada
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Ying J, Dai S, Fu R, Hong J, Dai C, Jin Q. Effect of ursodeoxycholic acid on gallstone formation after bariatric surgery: An updated meta-analysis. Obesity (Silver Spring) 2022; 30:1170-1180. [PMID: 35475596 DOI: 10.1002/oby.23427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/23/2022] [Accepted: 02/28/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Bariatric surgery increases the risk of postoperative gallstone formation. Many studies have proposed ursodeoxycholic acid (UDCA) as a preventive agent for postoperative gallstone formation. This study aimed to investigate the effect of UDCA on gallstone formation after bariatric surgery in patients without preoperative gallstones. METHODS PubMed, the Web of Science, the Cochrane Library, and EBSCO were searched for articles assessing the effect of UDCA on gallstone formation after bariatric surgery. The outcome was the incidence of postoperative gallstones. Odds ratios were used to assess dichotomous variables, and random-effects models were used for statistical analyses. RESULTS A total of 18 studies including 4,827 participants met the inclusion criteria. The statistical results showed that the incidence of gallstones in the UDCA group was significantly lower than in the control group. Furthermore, the occurrence of symptomatic gallstones and cholecystectomy was significantly reduced. CONCLUSIONS In patients without preoperative gallstones, UDCA can effectively prevent the formation of gallstones after bariatric surgery. In addition, UDCA can significantly reduce the occurrence of symptomatic gallstones and the risk of postoperative cholecystectomy. Doses of 500 to 600 mg/d can be used as a measure to prevent postoperative gallstone formation.
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Affiliation(s)
- Jingjing Ying
- Department of Pharmacy, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
| | - Senjie Dai
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rongrong Fu
- The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jiaze Hong
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chenglong Dai
- School of Medical Imaging, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Qiong Jin
- Emergency Medical Center, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang, China
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Khan IA, K AA, Asghar M, Abbas K. Comparative Effectiveness of Laparoscopic Sleeve Gastrectomy in Morbidly Obese and Super Obese Patients. Cureus 2021; 13:e20767. [PMID: 35111452 PMCID: PMC8794445 DOI: 10.7759/cureus.20767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/05/2022] Open
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13
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Clements JN, Albanese NP, D'Souza JJ, Misher A, Reece S(M, Trujillo J, Whitley HP. Clinical review and role of clinical pharmacists in obesity management: An opinion of the endocrine and metabolism practice and research network of the American College of Clinical Pharmacy. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Jennifer N. Clements
- Diabetes Transition Spartanburg Regional Healthcare System Spartanburg South Carolina USA
| | - Nicole P. Albanese
- University at Buffalo School of Pharmacy and Pharmaceutical Sciences Buffalo New York USA
| | - Jennifer J. D'Souza
- Midwestern University Chicago College of Pharmacy Downers Grove Illinois USA
| | - Anne Misher
- Patient Health Support Pharmacist Caromont Health Gastonia North Carolina USA
| | | | - Jennifer Trujillo
- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado USA
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Abstract
The purpose of this American Society for Reproductive Medicine Practice Committee report is to provide clinicians with principles and strategies for the evaluation and treatment of couples with infertility associated with obesity. This revised document replaces the Practice Committee document titled "Obesity and reproduction: an educational bulletin" last published in 2015 (Fertil Steril 2015;104:1116-26).
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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15
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Boutari C, Polyzos SA, Mantzoros CS. Addressing the epidemic of fatty liver disease: A call to action, a call to collaboration, a call to moving the field forward. Metabolism 2021; 122:154781. [PMID: 33901501 DOI: 10.1016/j.metabol.2021.154781] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Chrysoula Boutari
- Second Propedeutic Department of Internal Medicine, School of Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Medicine, Boston VA Healthcare System, Boston, MA, USA.
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Bariatric surgery in a patient with cystinuria. Clin Nephrol Case Stud 2021; 9:54-58. [PMID: 33981533 PMCID: PMC8111402 DOI: 10.5414/cncs110496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/24/2021] [Indexed: 11/23/2022] Open
Abstract
We recently encountered concern about the safety of bariatric surgery for a patient with cystinuria. Bariatric surgery procedures include those that cause malabsorption, like the Roux-en-Y gastric bypass procedure, and restrictive operations, such as the sleeve gastrectomy. These procedures produce beneficial effects on health and life expectancy, though whether kidney stones are prevented, as well as promoted, is not established. Although the importance of body weight to metabolic stone activity in patients with cystinuria is not established, the patient’s physicians were concerned about whether any bariatric surgery procedure would affect her ability to drink sufficient quantities of water in order to reduce stone activity. Here we report the experience of a genetically defined patient with cystinuria who underwent a gastric sleeve procedure. In the months after the procedure, she lost 45 kg, though with time she regained 23 kg of that loss. She was able to maintain a urine volume of 4.0 L per day and has had no stone recurrence.
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Duodenal-Jejunal Bypass Liner (DJBL) Improves Cardiovascular Risk Biomarkers and Predicted 4-Year Risk of Major CV Events in Patients with Type 2 Diabetes and Metabolic Syndrome. Obes Surg 2021; 30:1200-1210. [PMID: 31898040 DOI: 10.1007/s11695-019-04324-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The duodenal-jejunal bypass liner (DJBL) represents a novel endoscopic minimally invasive treatment option for obesity-associated type 2 diabetes (T2D), affecting body weight and metabolic control. Until now, the effects of DJBL on cardiovascular risk have never been investigated. METHODS Between 2012 and 2017, 71 patients with T2D and metabolic syndrome (MS) were recruited for implantation of DJBL for 9-12 months. Within DJBL treatment and a follow-up period of 6 months, patients were analysed for dynamics of cardiovascular biomarkers. Overall cardiovascular risk was estimated by the ADVANCE Risk Engine at time of implantation, explantation and 6 months after explantation of DJBL. RESULTS DJBL-induced weight loss and improvements in blood sugar control were accompanied by significant decreases of the cardiovascular biomarkers high-sensitive CRP, lipoprotein-associated phospholipase A2 and small dense lipoprotein fraction LDL-4 (p = 0.001, p < 0.001 and p = 0.04, respectively). Estimated overall cardiovascular risk decreased significantly after DJBL implantation and remained stable within 6 months after explantation. CONCLUSIONS In addition to beneficial effects of DJBL on weight loss, glycaemic control and lipid parameters in patients with MS, this is the first study that could further reveal significant impact on serological cardiovascular biomarkers and estimated CV risk, suggesting putative protective effects of DJBL on CV outcome.
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18
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Whitfield EP, Leeds SG, Kerlee KR, Ward MA. Endoscopic sleeve gastroplasty requiring emergent partial gastrectomy. Proc (Bayl Univ Med Cent) 2020; 33:635-636. [PMID: 33100552 DOI: 10.1080/08998280.2020.1775483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Bariatric surgery has become an accepted and effective treatment for morbid obesity. Laparoscopic sleeve gastrectomy is the most common weight loss procedure, in which patients on average lose 60% of their excess body weight. Recently, a completely endoscopic approach was developed that takes advantage of an endoscopic suturing device to plicate the greater curvature of the stomach into sleeve-like anatomy. The endoscopic sleeve gastroplasty has been shown to be safe with minimal complications and good weight loss outcomes. We present a case of a rare and dangerous complication of endoscopic sleeve gastroplasty that required emergent surgical intervention.
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Affiliation(s)
| | - Steven G Leeds
- College of Medicine, Texas A&M Health Science Center, Dallas, Texas.,Center for Advanced Surgery, Baylor Scott and White Health, Dallas, Texas.,Department of Minimally Invasive Surgery, Baylor University Medical Center, Dallas, Texas
| | - Kacie R Kerlee
- College of Medicine, Texas A&M Health Science Center, Dallas, Texas
| | - Marc A Ward
- College of Medicine, Texas A&M Health Science Center, Dallas, Texas.,Center for Advanced Surgery, Baylor Scott and White Health, Dallas, Texas.,Department of Minimally Invasive Surgery, Baylor University Medical Center, Dallas, Texas
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19
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Mari A, Khoury T, Daud G, Lubany A, Safadi M, Sbeit W, Pellicano R, Mahamid M. The yield, effectiveness and safety of gastroscopy in management of early postbariatric upper gastrointestinal pain. MINERVA CHIR 2020; 75:164-168. [PMID: 32550725 DOI: 10.23736/s0026-4733.20.08282-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Upper gastrointestinal (GI) symptoms are prevalent among patients after -bariatric surgeries. Gastroscopy is an important procedure to investigate symptoms. Our primary aim was to evaluate the yield, effectiveness and safety of gastroscopy procedure obtained in a 3-months period after bariatric operation for exploring upper GI symptoms origin. METHODS Single center, retrospective study at the EMMS Nazareth Hospital from 2010 to 2018. All patients who underwent gastric-bypass (either Roux-en-Y[R-en-Y] or Mini-gastric bypass [MGB]) and who experienced early upper GI symptoms were included in the study. RESULTS A total of 428 were included in the study. Among them, 154 patients (36%) underwent R-en-Y surgery and 274 (64%) underwent MGB. Baseline characteristics were similar in the two groups. The mean age in the R-en-Y group was 42.3±10.8 vs. 42.8±11.2 in the MGB group. Thirty-nine patients underwent gastroscopy, more in the R-en-Y group compared to MGB group (11.6% vs. 7.6%, P<0.005). In the MGB group, more patients had normal surgical anatomy (23.1%) vs. 12.8% in the R-en-Y group, and the prevalence of erosive esophagitis was 14.2% in the MBG group vs. 5.5% in the R-en-Y group, P<0.005. On the other hand, marginal ulcer was more frequent after R-en-Y than MGB surgery (16.6% vs. 9.5%, P<0.005). No procedural related complication was observed in both groups. CONCLUSIONS Upper GI symptoms in the early postbariatric surgery period are common with most endoscopic examination revealing normal postsurgical anatomy. In this setting, gastroscopy is safe, without procedural related complications.
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Affiliation(s)
- Amir Mari
- Department of Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel - .,Faculty of Medicine, Bar-Ilan University, Safed, Israel -
| | - Tawfik Khoury
- Department of Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel.,Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - George Daud
- Department of Bariatric Surgery, The Nazareth Hospital, EMMS, Nazareth, Israel
| | - Ahmad Lubany
- Department of Bariatric Surgery, The Nazareth Hospital, EMMS, Nazareth, Israel
| | - Mohammad Safadi
- Department of Bariatric Surgery, The Nazareth Hospital, EMMS, Nazareth, Israel
| | - Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Nahariya, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | | | - Mahmud Mahamid
- Department of Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel.,Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Department of Gastroenterology, Sharee Zedek Medical Center, Jerusalem, Israel
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20
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Wen J, Bo T, Zhang X, Wang Z, Wang D. Thermo-TRPs and gut microbiota are involved in thermogenesis and energy metabolism during low temperature exposure of obese mice. J Exp Biol 2020; 223:jeb218974. [PMID: 32341176 DOI: 10.1242/jeb.218974] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/17/2020] [Indexed: 12/15/2022]
Abstract
Ambient temperature and food composition can affect energy metabolism of the host. Thermal transient receptor potential ion channels (thermo-TRPs) can detect temperature signals and are involved in the regulation of thermogenesis and energy homeostasis. Further, the gut microbiota have also been implicated in thermogenesis and obesity. In the present study, we tested the hypothesis that thermo-TRPs and gut microbiota are involved in reducing diet-induced obesity (DIO) during low temperature exposure. C57BL/6J mice in obese (body mass gain >45%), lean (body mass gain <15%) and control (body mass gain <1%) groups were exposed to high (23±1°C) or low (4±1°C) ambient temperature for 28 days. Our data showed that low temperature exposure attenuated DIO, but enhanced brown adipose tissue (BAT) thermogenesis. Low temperature exposure also resulted in increased noradrenaline (NA) concentrations in the hypothalamus, decreased TRP melastatin 8 (TRPM8) expression in the small intestine, and altered composition and diversity of gut microbiota. In DIO mice, there was a decrease in overall energy intake along with a reduction in TRP ankyrin 1 (TRPA1) expression and an increase in NA concentration in the small intestine. DIO mice also showed increases in Oscillospira, [Ruminococcus], Lactococcus and Christensenella and decreases in Prevotella, Odoribacter and Lactobacillus at the genus level in fecal samples. Together, our data suggest that thermos-TRPs and gut microbiota are involved in thermogenesis and energy metabolism during low temperature exposure in DIO mice.
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Affiliation(s)
- Jing Wen
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Tingbei Bo
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xueying Zhang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zuoxin Wang
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL 32306-1270, USA
| | - Dehua Wang
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China
- CAS Center for Excellence in Biotic Interactions, University of Chinese Academy of Sciences, Beijing 100049, China
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21
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Mintziori G, Nigdelis MP, Mathew H, Mousiolis A, Goulis DG, Mantzoros CS. The effect of excess body fat on female and male reproduction. Metabolism 2020; 107:154193. [PMID: 32119876 DOI: 10.1016/j.metabol.2020.154193] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
The dramatic increase in the prevalence of obesity coincides with a decline in reproductive health indices in both sexes. Energy excess mediates changes to the regulatory mechanisms of the reproductive system. Obese individuals exhibit increased estrogen concentrations, due to the overexpression of aromatase in the adipose tissue; via a negative feedback loop, men present with symptoms of hypogonadotropic hypogonadism. These hormonal changes, along with increased oxidative stress, lipotoxicity and disturbances in the concentrations of adipokines, directly affect the gonads, peripheral reproductive organs and the embryo. Clinical evidence is somewhat contradicting, with only some studies advocating worse semen parameters, increased incidence of erectile dysfunction, increased doses of ovulation induction medications, and worse live birth rates in assisted reproductive technology (ART) cycles in obese individuals compared with those of normal weight. Similar conclusions are drawn about patients with insulin resistance syndromes, namely polycystic ovary syndrome (PCOS). As far as treatment options are concerned, lifestyle changes, medical therapy and bariatric surgery may improve the reproductive outcome, although the evidence remains inconclusive. In this review, we summarize the evidence on the association of obesity and reproductive health on both the molecular and the clinical level, and the effect of weight-loss interventions on reproductive potential.
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Affiliation(s)
- Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Hannah Mathew
- Department of Medicine Boston VA Healthcare System and Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Athanasios Mousiolis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Christos S Mantzoros
- Department of Medicine Boston VA Healthcare System and Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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22
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Laiginhas R, Esteves-Leandro J, Cardoso P, Santos-Sousa H, Preto J, Falcão-Reis F, Falcão M. Central Retinal Vein Occlusion after Gastric Bypass Surgery. Obes Surg 2020; 30:4618-4620. [PMID: 32462435 DOI: 10.1007/s11695-020-04735-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Rita Laiginhas
- Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Pedro Cardoso
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal
| | - Hugo Santos-Sousa
- Department of Surgery, Centro Hospitalar e Universitário São João, Porto, Portugal
- Department of Surgery, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
| | - John Preto
- Department of Surgery, Centro Hospitalar e Universitário São João, Porto, Portugal
- Department of Surgery, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
| | - Manuel Falcão
- Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal.
- Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal.
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23
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Makarawung DJS, Monpellier VM, van den Brink F, Woertman L, Zijlstra H, Mink van der Molen AB, van Ramshorst B, Geenen R. Body Image as a Potential Motivator for Bariatric Surgery: a Case-Control Study. Obes Surg 2020; 30:3768-3775. [PMID: 32451911 DOI: 10.1007/s11695-020-04685-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Not every eligible person opts for bariatric surgery. Body image concerns might be a reason to choose surgery. This case-control study evaluated differences in body image between a pre-bariatric surgery population and a weight-matched control group from the general population. We hypothesized that the pre-bariatric group would show less satisfaction with appearance, defined as a discrepancy between evaluating one's appearance as less attractive while attaching more importance to appearance. METHODS Data from 125 pre-bariatric patients were compared with 125 body weight-matched controls from the general population. The Multidimensional Body-Self Relations Questionnaire-Appearance Scales was used to assess appearance evaluation (AE), appearance orientation (AO), and their discrepancy score. Both groups were compared with norms from the non-body weight-matched general population. RESULTS The pre-bariatric group had lower AE scores (mean 2.23 ± 0.65 vs. mean 2.54 ± 1.06) and higher AO scores (mean 3.33 ± 0.69 vs. mean 3.04 ± 0.90) than the control group. The discrepancy between AE and AO was larger in the pre-bariatric group (p < 0.001). Compared with the general population, both groups showed lower AE scores (d = - 1.43 and d = - 1.12, p < 0.001) and lower AO scores (d = - 0.23 and d = - 0.58, p < 0.001). CONCLUSIONS People with morbid obesity have on average less body image satisfaction. The results indicate that part of the motivation of people that choose bariatric surgery may be due to relatively low global appearance evaluation combined with considering appearance more important. Knowledge about motivations can be used to communicate realistic expectations regarding treatment outcome.
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Affiliation(s)
- D J S Makarawung
- Department of Plastic Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands. .,Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis ter Heide, the Netherlands.
| | - V M Monpellier
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis ter Heide, the Netherlands
| | - F van den Brink
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - L Woertman
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
| | - H Zijlstra
- Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | | | - B van Ramshorst
- Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - R Geenen
- Department of Psychology, Utrecht University, Utrecht, the Netherlands
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24
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Saglam K, Kayaalp C, Aktas A, Sumer F. Educational Video Addition to the Bariatric Surgery Informed Consent Process: a Randomized Controlled Trial. Obes Surg 2020; 30:2693-2699. [PMID: 32279184 DOI: 10.1007/s11695-020-04552-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Bariatric surgery is not a risk-free procedure and requires lifelong patient compliance in the postoperative period. Although the risks involved in bariatric surgery and the importance of lifelong follow-ups in the postoperative period are explained to patients in detail through verbal and written informed consent, the strong desire for weight loss can sometimes cause patients and their families to be ignorant of the mentioned issues preoperatively. The objective of this study is to evaluate the effectiveness of preoperative informational videos at improving the comprehension of informed consent content in bariatric surgery candidates. MATERIALS AND METHODS A total of 74 bariatric surgery candidates were randomized into two groups. The first group was given a usual verbal-written informed consent. The second group got an additional informing video presentation informed consent, in addition to the usual verbal-written informed consent. Then, both groups got a questionnaire evaluating their knowledge of bariatric surgery informed consent. The correct response scores and their relationship with patient demographics were analyzed. RESULTS Both groups had similar demographic features. Video-presented group had higher scores in questionnaire (11.3 ± 2.3 versus 9.4 ± 1.7, p = 0.001). Subgroup analysis showed that health care workers (12.5 ± 1.9 versus 10.3 ± 2.2, p = 0.005) and university graduates (11.6 ± 2.4 versus 10.1 ± 2.1, p = 0.03) got better results in the questionnaire. In multivariate analysis, video-assisted informing was found to be the only independent variable for high questionnaire scores (p = 0.0001). CONCLUSIONS This study showed that video-assisted informed consent improves patients' comprehension prior to bariatric surgery. We recommend routine preoperative video-assisted informing for bariatric surgery candidates in addition to usual verbal-written informed consent.
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Affiliation(s)
- Kutay Saglam
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
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25
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Lonardo A, Baldelli E. Methodological Tools for Exploring Novel Biopharmaceutical Approaches to the Metabolic Syndrome and Related Disorders : A Commentary on: Translational Research Methods in Diabetes, Obesity, and Nonalcoholic Fatty Liver Disease. A Focus on Early Phase Clinical Drug Development, Second Edition. Diabetes Ther 2020; 11:773-777. [PMID: 32146692 PMCID: PMC7136372 DOI: 10.1007/s13300-020-00794-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 02/07/2023] Open
Affiliation(s)
- Amedeo Lonardo
- Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
| | - Enrica Baldelli
- Università degli Studi di Modena e Reggio Emilia, Modena, Italy
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26
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Ayoub F, Brar TS, Banerjee D, Abbas AM, Wang Y, Yang D, Draganov PV. Laparoscopy-assisted versus enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) in Roux-en-Y gastric bypass: a meta-analysis. Endosc Int Open 2020; 8:E423-E436. [PMID: 32118116 PMCID: PMC7035133 DOI: 10.1055/a-1070-9132] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023] Open
Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in patients with Roux-en-Y gastric bypass (RYGB) anatomy, which is increasing in frequency given the rise of obesity. Laparoscopy-assisted ERCP (LA-ERCP) and enteroscopy-assisted ERCP (EA-ERCP) are distinct approaches with their respective strengths and weaknesses. We conducted a meta-analysis comparing the procedural time, rates of success and adverse events of each method. Patients and methods A search of PubMed, EMBASE and the Cochrane library was performed from inception to October 2018 for studies reporting outcomes of LA or EA-ERCP in patients with RYGB anatomy. Studies using single, double, 'short' double-balloon or spiral enteroscopy were included in the EA-ERCP arm. Outcomes of interest included procedural time, papilla identification, papilla cannulation, therapeutic success and adverse events. Therapeutic success was defined as successful completion of the originally intended diagnostic or therapeutic indication for ERCP. Results A total of 3859 studies were initially identified using our search strategy, of which 26 studies met the inclusion criteria. The pooled rate of therapeutic success was significantly higher in LA-ERCP (97.9 %; 95 % CI: 96.7-98.7 %) with little heterogeneity (I 2 = 0.0 %) when compared to EA-ERCP (73.2 %; 95 % CI: 62.5-82.6 %) with significant heterogeneity (I 2 : 80.2 %). Conversely, the pooled rate of adverse events was significantly higher in LA-ERCP (19.0 %; 95 % CI: 12.6-26.4 %) when compared to EA-ERCP (6.5 %; 95% CI: 3.9-9.6 %). The pooled mean procedure time for LA-ERCP was 158.4 minutes (SD ± 20) which was also higher than the mean pooled procedure time for EA-ERCP at 100.5 minutes (SD ± 19.2). Conclusions LA-ERCP is significantly more effective than EA-ERCP in patients with RYGB but is associated with a higher rate of adverse events and longer procedural time.
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Affiliation(s)
- Fares Ayoub
- Section of Gastroenterology, Hepatology & Nutrition, University of Chicago, Illinois, United States
| | - Tony S. Brar
- Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Florida, United States
| | - Debdeep Banerjee
- Department of Medicine, University of Florida, Gainesville, Florida, United States
| | - Ali M. Abbas
- Brigham and Women's Hospital, Division of Gastroenterology, Harvard Medical School, Boston, Massachusetts, United States
| | - Yu Wang
- Department of Biostatistics, University of Florida, Gainesville, Florida, United States
| | - Dennis Yang
- Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Florida, United States
| | - Peter V. Draganov
- Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Florida, United States,Corresponding author Peter V. Draganov, MD Professor of MedicineDivision of Gastroenterology, Hepatology & NutritionUniversity of Florida1329 SW 16th StreetGainesville, FL 32608+1-352-627-9002
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27
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Haidar Ahmad H, Saliba C, Nicolas G, Ghandour MA, Zeaiter NM, Alzein H, Kassem A, Houmani A, Abtar HK, Karake M, Akil MH, Ballout H. Unexpected Gastric Ectopic Pancreas During Sleeve Gastrectomy: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1966-1968. [PMID: 31885033 PMCID: PMC6956835 DOI: 10.12659/ajcr.916366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Patient: Female, 30-year-old Final Diagnosis: Gastric ectopic pancreas Symptoms: — Medication: — Clinical Procedure: Laparscopic sleeve gastrectomy Specialty: Surgery
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Affiliation(s)
| | | | | | | | | | - Hassan Alzein
- Division of Surgery, Saint George Hospital, Hadath, Lebanon
| | - Ali Kassem
- Division of Surgery, Saint George Hospital, Hadath, Lebanon
| | - Ali Houmani
- Department of Radiology, Saint George Hospital, Hadath, Lebanon
| | | | - Mohamad Karake
- Division of Surgery, Saint George Hospital, Hadath, Lebanon
| | | | - Hajar Ballout
- Division of Endocrinology, Saint George Hospital, Hadath, Lebanon
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28
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Jarak I, Pereira SS, Carvalho RA, Oliveira PF, Alves MG, Guimarães M, Wewer Albrechtsen NJ, Holst JJ, Nora M, Monteiro MP. Gastric Bypass with Different Biliopancreatic Limb Lengths Results in Similar Post-absorptive Metabolomics Profiles. Obes Surg 2019; 30:1068-1078. [DOI: 10.1007/s11695-019-04294-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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29
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Farr OM, Pilitsi E, Mantzoros CS. Of mice and men: incretin actions in the central nervous system. Metabolism 2019; 98:121-135. [PMID: 31173757 DOI: 10.1016/j.metabol.2019.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 02/06/2023]
Abstract
Incretins have risen to the forefront of therapies for obesity and related metabolic complications, primarily because of their efficacy and relatively few side effects. Importantly, their efficacy in altering energy balance and decreasing body weight is apparently through actions in the central nervous system (CNS); the latter may have implications beyond obesity per se, i.e. in other disease states associated with obesity including CNS-related disorders. Here, we first describe the role of the CNS in energy homeostasis and then the current state of knowledge in terms of incretin physiology, pathophysiology and efficacy in preclinical and clinical studies. In the future, more clinical studies are needed to fully map mechanistic pathways underlying incretin actions and outcomes in the human CNS. Additionally, future research will likely lead to the discovery of additional novel incretins and/or more efficacious medications with less side effects through the improvement of current compounds with properties that would allow them to have more favorable pharmacokinetic and pharmacodynamic profiles and/or by combining known and novel incretins into safe and more efficacious combination therapies leading ultimately to more tangible benefits for our patients.
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Affiliation(s)
- Olivia M Farr
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, United States of America.
| | - Eleni Pilitsi
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, United States of America
| | - Christos S Mantzoros
- Division of Endocrinology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA 02215, United States of America; Section of Endocrinology, VA Boston Healthcare System, Boston, MA 02130, United States of America
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30
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Sun W, Zhang Y, Shen Q, Zhang W, Yao Q, Yang Y. Prevalence and risk factors for symptoms suggestive of hypoglycemia and early dumping syndrome after sleeve gastrectomy. Surg Obes Relat Dis 2019; 15:1439-1446. [DOI: 10.1016/j.soard.2019.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023]
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31
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Zhang Y, Nagarajan N, Portwood C, Smith KR, Kamath V, Carnell S, Moran TH, Steele KE. Does taste preference predict weight regain after bariatric surgery? Surg Endosc 2019; 34:2623-2629. [PMID: 31376009 DOI: 10.1007/s00464-019-07033-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 07/20/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND While bariatric surgery is well established as a means of inducing sustained weight loss, the rate of weight loss typically declines after a year, and weight regain has been observed. Preoperative taste preferences have been suspected to play a role in weight regain, possibly by influencing post-operative dietary practices. We sought to investigate the association between preoperative taste preferences and weight regain following bariatric surgery. METHODS Patients who underwent bariatric surgery with at least 2 years of follow-up were included. Demographics and weight were collected in follow-up visits; while patient recall of preoperative taste preference was assessed, using a multiple-choice question in the study survey administered at least 6 months post-surgery. Weight regain was calculated as weight at 2 years minus weight at 1 year post-surgery, with weight regain denoted by positive values and weight loss by negative. Linear regression models were utilized to study associations between weight regain and preoperative taste preferences with and without adjusting for demographic factors and surgery type. RESULTS Patients undergoing RYGB had less weight regain (- 4.5 kg, p = 0.033) compared to patients undergoing VSG. Compared to patients with no preferences, patients with sweet food or salty food preferences had 5.5 kg (p = 0.038) and 6.1 kg (p = 0.048) weight regain, respectively, at 2 years post-surgery. After adjustment, patients with salty food preference had 6.8 kg (p = 0.027) weight regain compared to patients with no preferences. CONCLUSIONS Preoperative salty taste preference was associated with weight regain at 2 years post-surgery in patients undergoing bariatric surgery. Findings of this project might have implications for predicting long-term weight loss maintenance for patients with known preoperative taste preferences. Our study suggests that patients with preoperative salty taste preference may need further post-operative psychosocial support and resources to prevent weight regain and to ensure healthy and sufficient weight loss.
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Affiliation(s)
- Yuxi Zhang
- University of Kentucky College of Medicine, 800 Rose Street MN 150, Lexington, KY, 40506, USA.
| | - Neeraja Nagarajan
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cecilia Portwood
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kimberly R Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kimberley E Steele
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Boutari C, Polyzos SA, Mantzoros CS. Of mice and men: Why progress in the pharmacological management of obesity is slower than anticipated and what could be done about it? Metabolism 2019; 96:vi-xi. [PMID: 30910448 DOI: 10.1016/j.metabol.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 03/16/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Chrysoula Boutari
- Second Propedeutic Department of Internal Medicine, Faculty of Medicine, Aristotle University, Hippokration Hospital, Thessaloniki, Greece; Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Stergios A Polyzos
- First Department of Pharmacology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA, USA.
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Casimiro I, Sam S, Brady MJ. Endocrine implications of bariatric surgery: a review on the intersection between incretins, bone, and sex hormones. Physiol Rep 2019; 7:e14111. [PMID: 31134746 PMCID: PMC6536581 DOI: 10.14814/phy2.14111] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/25/2022] Open
Abstract
Bariatric surgery is now the most widely used intervention for the treatment of human obesity. A large body of literature has demonstrated its efficacy in sustained weight loss and improvement in its associated comorbidities. Here, we review the effect of bariatric surgery in gut hormone physiology, bone remodeling and the reproductive axis. Rapid improvements in insulin release and sensitivity appear to be weight loss independent and occur immediately after surgery. These effects on pancreatic beta cells are mostly due to increased gut hormone secretion due to augmented nutrient delivery to the small intestine. Bone remodeling is also affected by gut hormones. Phenotypic skeletal changes observed in mice deficient in GLP-1 or GIP suggest that increased incretins may improve bone density. However, these positive effects may be counterbalanced by the association between weight loss and a reduction in bone density. Finally, studies have shown a marked improvement following bariatric surgery in infertility and PCOS in women and hypogonadism in men. Thus, the net effect on endocrine systems after bariatric surgery will likely vary on an individual basis and depend on factors such as comorbidities, peri-menopausal state, amount of weight loss, and likelihood to adhere to vitamin supplementation after surgery.
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Affiliation(s)
- Isabel Casimiro
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
| | - Susan Sam
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
| | - Matthew J. Brady
- Section of Endocrinology, Diabetes & MetabolismUniversity of ChicagoChicagoIllinois
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