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Heeren FAN, Ayzengart A, Menon S, Bernier AV, Cardel MI. Adolescent Bariatric Surgery: The Need for Tailored Educational Materials. Child Obes 2024; 20:221-226. [PMID: 37676982 DOI: 10.1089/chi.2023.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Rates of class III, or greater, obesity have risen among adolescents in the United States. Metabolic and bariatric surgery (MBS) is a safe and effective treatment option for severe obesity among teenagers that results in improvements in cardiometabolic and psychosocial health. Despite its effectiveness, MBS remains largely underutilized and misconceptions exist among providers, parents/guardians, and adolescents. In addition, adolescents who have undergone MBS procedures report there are some topics they wish they had known more about before surgery and express concern that their unique needs are not understood. One potential solution to address these concerns includes preoperative educational materials tailored for adolescents. Currently, there are no standardized recommendations for preoperative educational materials. This editorial suggests the use of community-engaged research, and qualitative methodology, to consult with the primary stakeholder groups of preoperative adolescents, postoperative adolescents, parents/guardians, and clinicians to develop tailored materials that address the unique needs of adolescents undergoing surgical treatment for obesity.
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Affiliation(s)
- Faith Anne N Heeren
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | | | - Sarada Menon
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Angelina V Bernier
- Pediatric Endocrinology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Michelle I Cardel
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
- WW International, Inc., New York, NY, USA
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Bejarano CM, Gowey M, Reiter-Purtill J, Ley S, Mitchell JE, Zeller MH. Trajectories of Psychopathology and Dysregulation 2-4 Years following Adolescent Bariatric Surgery. J Pediatr Psychol 2023; 48:479-489. [PMID: 36898044 PMCID: PMC10199728 DOI: 10.1093/jpepsy/jsad009] [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: 08/01/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE This study examined psychopathology and weight over 4 years following bariatric surgery in adolescents with obesity, as compared to a nonsurgical group. The role of psychological dysregulation in relation to psychopathology in the 2-4 year "maintenance phase" following surgery was also examined. METHODS Adolescent participants (122 surgical and 70 nonsurgical) completed height/weight and psychopathology assessments annually for 4 years, with dysregulation assessed at Year 2. Analyses examined the association of "High" and "Low" psychopathology with weight over time using logistic regression. Mediation analyses in the surgical group examined indirect effects of dysregulation on percent weight loss through Year 4 psychopathology. RESULTS There were lower odds of "High" internalizing symptoms in the surgical group versus the nonsurgical group from baseline (presurgery) to Year 4 (OR = .39; p < .001; 42.3% "High" internalizing in surgical; 66.7% in nonsurgical) and during the 2-4 year maintenance phase (OR = .35, p < .05; 35.1% "High" internalizing in surgical; 60.8% in nonsurgical). There was a significant mediation effect in the surgical group: higher dysregulation was associated with greater Year 4 internalizing symptoms (β = .41, p < .001) which in turn was associated with less Year 4 percent weight loss (β = -.27, p < .05). CONCLUSIONS While the surgical group was less likely to experience internalizing symptoms, internalizing psychopathology was related to less percent weight loss in this group. Internalizing symptoms mediated the relationship between dysregulation and percent weight loss in the surgical group. Postoperative mental health follow-up is needed for adolescents into young adulthood.
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Affiliation(s)
- Carolina M Bejarano
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | | | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Sanita Ley
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - James E Mitchell
- Department of Clinical Neuroscience, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Meg H Zeller
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Zeller MH, Strong H, Reiter-Purtill J, Jenkins TM, Mitchell JE, Michalsky MP, Helmrath MA. Marijuana, e-cigarette, and tobacco product use in young adults who underwent pediatric bariatric surgery. Surg Obes Relat Dis 2023; 19:512-521. [PMID: 36567232 PMCID: PMC10461174 DOI: 10.1016/j.soard.2022.11.008] [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: 08/04/2022] [Revised: 10/16/2022] [Accepted: 11/14/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The postoperative course after pediatric metabolic and bariatric surgery (MBS) cuts across a developmental phase when substance-use behaviors emerge as significant public health concerns. OBJECTIVE We examined use of marijuana, conventional cigarettes, and alternate tobacco products/devices (e.g., e-cigarettes, hookah, smokeless, dissolvable) in young adults (YA) to 6 years postsurgery. SETTING Five academic medical centers. METHODS In a prospective observational cohort series, 139 surgical (Mage = 16.9, Mbody mass index [BMI] = 51.5, 80% female, 66% white) and 83 nonsurgical comparisons (Mage = 16.1, MBMI = 44.9, 82% female, 54% white) completed assessments at presurgery/baseline and postsurgery years 2, 4, and 6 (year 6 [2014-2018]: surgical n = 123 [89%], Mage = 23.0, MBMI = 39.8; nonsurgical n = 63 [76%], Mage = 22.4, MBMI = 53.6). Lifetime and current (past 30 days) use were reported. RESULTS Consistent with national YA trends (2014-2018), the most commonly used were (1) conventional cigarettes (30% surgical, 41% nonsurgical, nonsignificant [ns]); (2) marijuana (25% surgical, 27% nonsurgical, ns); and (3) e-cigarettes (12% surgical, 10% nonsurgical). A sizable minority (26% surgical, 18% nonsurgical) used one or more alternate tobacco product/device. Many YA reported persistent and/or heavy use (e.g., >50% marijuana at year 6 and year 2 or 4; ≈50% ≥.5 pack/d of cigarettes), suggesting more established (versus intermittent) health risk behaviors. For the surgical group at year 6, current tobacco product/device use was associated with lower BMI (P < .001) and greater percent weight loss (P = .002). CONCLUSIONS Pediatric MBS demonstrates promise in lowering risks for adult chronic disease, which may be diminished by age-typical health risk behaviors. Developmentally salient and holistic pediatric postoperative care guidelines are needed.
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Affiliation(s)
- Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Heather Strong
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Todd M Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota
| | - Marc P Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Michael A Helmrath
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Cuda SE, Pratt JS, Santos M, Browne A. Obesity Pillars roundtable: Metabolic and bariatric surgery in children and adolescents. OBESITY PILLARS (ONLINE) 2022; 3:100023. [PMID: 37990731 PMCID: PMC10661994 DOI: 10.1016/j.obpill.2022.100023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/23/2023]
Abstract
Background Obesity is a chronic disease which frequently begins in childhood and requires a life-long multidisciplinary approach. Metabolic-bariatric surgery (MBS) is a key component of the treatment of severe obesity in children, adolescents and adults. Children and adolescents who have class II obesity and a complication of obesity or have class III obesity should be considered for MBS, regardless of age, race, sex, or gender. Children and adolescents with cognitive disabilities, a history of mental illness, a treated eating disorder, immature bone growth, or low Tanner Stage should not be denied treatment. Early intervention can reduce the risk of persistent obesity, end organ damage, and sequelae from long-standing complications of obesity. Methods This roundtable discussion includes three pediatric obesity specialists with experience in the medical and surgical management of children and adolescents with obesity. Included are citations regarding metabolic-bariatric surgery in children and adolescents. Results MBS in pediatric patients is increasingly recognized as an essential part of managing the disease of obesity in combination with medication, nutrition, behavioral training, and physical activity. Vertical sleeve gastrectomy or Roux-en-Y gastric bypass in patients meeting criteria for severe obesity should be considered, especially when children have complications such as poor quality of life, orthopedic disease, idiopathic intracranial hypertension, type 2 diabetes mellitus, obstructive sleep apnea, or cardiovascular risk. Children and adolescents with autism, developmental delay, or syndromic obesity should be considered for MBS on a case-by-case basis. Early intervention may result in improved long-term outcomes, and referral for MBS should not be conditional based on stage of pubertal development (Tanner Staging), bone age, or prior weight loss attempts. Conclusions Children and adolescents who suffer from severe obesity need the entire spectrum of treatment modalities available to achieve a healthy weight and control obesity-related complications. This treatment spectrum should include MBS. These children and adolescents should be cared for by a pediatric weight management team prepared to care for them until they transition to adult care.
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Affiliation(s)
- Suzanne E. Cuda
- American Board of Obesity Medicine, Alamo City Healthy Kids & Families, 1919 Oakwell Farms Parkway, Suite 145, San Antonio, TX, 78218, USA
| | - Janey S.A. Pratt
- American Society of Metabolic and Bariatric Surgery Committee on Pediatrics, Adolescent Bariatric Surgery, Lucille Packard Children's Hospital, Stanford University School of Medicine, Center for Academic Medicine, 4th Floor Division of Pediatric Surgery, 453 Quarry Rd, Palo Alto, CA, 94304, USA
| | - Melissa Santos
- Pediatrics Obesity Center at Connecticut Children's, 282 Washington St, Hartford, CT, 06106, USA
| | - Allen Browne
- American Board of Obesity Medicine, LLC, 25 Andrews Ave, Falmouth, Maine, 04105, USA
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Li MK, Sathiyamoorthy T, Regina A, Strom M, Toulany A, Hamilton J. "Your own pace, your own path": perspectives of adolescents navigating life after bariatric surgery. Int J Obes (Lond) 2021; 45:2546-2553. [PMID: 34385587 PMCID: PMC8359630 DOI: 10.1038/s41366-021-00928-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Bariatric surgery, an established weight-loss tool, may be offered to some adolescents with severe obesity. However, few studies explore adolescents' postoperative experiences beyond physical and metabolic outcomes and quality-of-life measures. METHODS Between 2016 and 2021, 45 semi-structured interviews were conducted with adolescents (16-20 years) at 6 months (N = 15), 12 months (N = 15), and 24 months (N = 15) following bariatric surgery. A deductive thematic analysis framework was applied by two independent coders (Cronbach's α = 0.84). Themes were identified and refined iteratively, and discrepancies were resolved through discussion. RESULTS Five major themes emerged related to: (1) weight-loss expectations vs. reality, (2) social landscape, (3) body image, (4) eating and moving, and (5) challenges for long-term success. The pace of and satisfaction with weight loss and side effects was heterogenous among participants, with most changes occurring early and stabilizing by 24 months. Adolescents adapted over time to their new social landscapes (e.g., relationships) and reported improved body image and confidence, yet persistently struggled to reconcile their internal identity with evolving external perceptions and discomfort with new attention. Participants experienced changes to lifestyle routines after surgery (e.g., eating, moving, habits), which introduced distress at 6 months but resolved over time. Life transitions in early adulthood (e.g., moving away, university/college, employment), concurrent with their evolving and increasing autonomy, physical, social, and financial independence, imposed unexpected challenges to postoperative routines and support systems. Participants unanimously reaffirmed that bariatric surgery is a lifelong journey and that they were committed to long-term success. CONCLUSION Our findings provide insight into optimizing adolescent selection for bariatric surgery and perioperative support. Specifically, important life transitions during this developmental period impact postoperative experiences and outcomes and adolescents may benefit from postoperative counseling focused on managing weight-loss expectations and adapting to evolving nutritional needs and changing social circumstances.
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Affiliation(s)
- Ming K Li
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Andrea Regina
- Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.,Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michele Strom
- Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alene Toulany
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jill Hamilton
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Division of Endocrinology, The Hospital for Sick Children, Toronto, ON, Canada.
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Boyce TM, Neiterman E. Women in larger bodies' experiences with contraception: a scoping review. Reprod Health 2021; 18:89. [PMID: 33926501 PMCID: PMC8082612 DOI: 10.1186/s12978-021-01139-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/12/2021] [Indexed: 01/29/2023] Open
Abstract
Background As the prevalence of obesity increases and the age of onset decreases, more women of reproductive age will be living in larger bodies. Research on weight-related efficacy and safety has informed clinical guidelines for routine and emergency contraceptive use by women with a higher body mass index; however, patient perspectives are needed to understand women in larger bodies’ experiences with contraception and contraceptive care. This scoping review summarizes the literature on women in larger bodies’ experiences with contraception with the goal of gaining a better understanding of the nature of these experiences and identifying gaps in the existing research. Methods Following Arksey and O’Malley’s framework, a scoping review of the literature was conducted. Four databases (PubMed, PsycINFO, SCOPUS, and CINAHL) were searched for peer-reviewed, empirical articles published in English between 2010 and 2020, with a focus on North America, Europe, Australia, and New Zealand. Data were summarized by identifying key themes in the reviewed literature. Results Twenty-nine articles meeting the eligibility criteria were reviewed. The literature was predominantly quantitative (n = 27), with only one qualitative study and one systematic review, respectively. Five themes were identified, including (1) use of contraception among women in larger bodies; (2) knowledge, attitudes towards and beliefs about contraception; (3) contraceptive (dis)satisfaction among women in larger bodies; (4) contraceptive counseling; and (5) barriers to contraception. The findings revealed that women in larger bodies may have unmet contraceptive care needs. Despite many articles addressing the need to improve contraceptive counseling for women in larger bodies (n = 26), few explored how women felt about their care (n = 2). Finally, only two articles focused on emergency contraception, indicating a need for further research. Conclusion This scoping review emphasizes the pressing need for qualitative research to explore women in larger bodies’ experiences with routine and emergency contraception, as well as receiving contraceptive counseling and care. Future research exploring the lived experiences of women in larger bodies is necessary to better characterize their contraceptive needs and identify avenues to improve patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01139-2. As obesity becomes more prevalent, more women of reproductive age will be living in larger bodies. This review highlights what is known about women in larger bodies’ experiences with contraception and suggests where future research is needed. We searched four databases for papers published in English from 2010 to 2020. Our review included 29 articles. Nearly all of the studies were quantitative, with one qualitative study and one review. Most articles talked about contraceptive use, but few of them included emergency contraception. Some papers highlighted women’s knowledge and opinions about contraception, whereas others talked about their contraceptive (dis)satisfaction. Many articles discussed contraceptive counseling. Finally, some papers considered potential barriers to contraception. Our findings suggest that women in larger bodies have unmet contraceptive needs. Notably, this review aimed to focus on patient experiences but women’s voices were rarely represented. Future qualitative research on women’s lived experiences will provide a better understanding of women in larger bodies’ contraceptive needs and suggest how care can be improved.
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Affiliation(s)
- Tierney M Boyce
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Elena Neiterman
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Zeller MH, Kidwell KM, Reiter-Purtill J, Jenkins TM, Michalsky MP, Mitchell JE, Courcoulas AP, Inge TH. Cigarette Use and Adolescent Metabolic and Bariatric Surgery. Obesity (Silver Spring) 2021; 29:579-586. [PMID: 33528876 PMCID: PMC8023426 DOI: 10.1002/oby.23084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to track conventional cigarette smoking behaviors and associated correlates in adolescents with severe obesity who did or did not undergo metabolic and bariatric surgery to 4 years after surgery/baseline. METHODS Utilizing a prospective controlled design, surgical (n = 153; mean BMI = 52) and nonsurgical (n = 70; mean BMI = 47) groups that completed assessments before surgery/at baseline and at Years 2 and 4 post surgery (Year 4: n = 117 surgical [mean BMI = 38]; n = 56 nonsurgical [mean BMI = 48]) were compared. Separate logistic regression models tested correlates of Year 4 current smoking. RESULTS More than half of participants (surgical: 55%; nonsurgical: 60%) had ever smoked a cigarette, with current smoking increasing with time. Groups did not differ in Year 4 current smoking (surgical: 23%; nonsurgical: 33%), with ≈ 50% meeting criteria for "heavy" smoking (≥ half pack/day) and ≈ 40% smoking their first cigarette before ninth grade. Factors associated with higher odds of Year 4 current smoking included dysregulation (P < 0.001), internalizing symptoms (P = 0.01), alcohol use (P = 0.04), caregiver smoking (P < 0.001), friend smoking (P = 0.001), and perceiving low harm (P = 0.02), plus greater percent weight loss (P = 0.03) in the surgical group. CONCLUSIONS Smoking is a clinical health challenge for adolescents and young adults with severe obesity, including those who have undergone metabolic and bariatric surgery. Upstream identification, monitoring, and intervention to prevent smoking uptake and escalation in youth with obesity across settings should be prioritized.
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Affiliation(s)
- Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Katherine M Kidwell
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Todd M Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Marc P Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota, USA
| | - Anita P Courcoulas
- Division of Minimally Invasive General and Bariatric Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Thomas H Inge
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
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Riedinger CJ, Zite NB, Overby DW, Robinson EF, Moulder JK. Optimizing contraceptive access for women undergoing bariatric surgery. Surg Obes Relat Dis 2020; 16:2082-2087. [PMID: 33004300 DOI: 10.1016/j.soard.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/27/2020] [Accepted: 08/12/2020] [Indexed: 10/23/2022]
Abstract
With the dramatic increase in the prevalence of obesity, there is a corresponding increase in surgical procedures to treat obesity. Reproductive aged women (18-45 years old) undergo half of the bariatric surgical procedures performed in the United States each year. These women experience profound physiologic changes in response to bariatric surgery, including dramatic changes in reproductive function. Current guidelines recommend delaying attempts at conception for 12-24 months after bariatric surgery during the time of most profound weight loss. Despite these recommendations, many women report unprotected intercourse during this time, and many use less efficacious contraceptive options. Herein, we address contraceptive considerations in women of reproductive age who undergo bariatric surgery and opportunities to maximize a multidisciplinary surgical approach to optimize their overall health.
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Affiliation(s)
- Courtney J Riedinger
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee.
| | - Nikki B Zite
- Department of Obstetrics and Gynecology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - David Wayne Overby
- Department of Surgery, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Erica F Robinson
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Janelle K Moulder
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Jäger P, Wolicki A, Spohnholz J, Senkal M. Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2734. [PMID: 32326591 PMCID: PMC7216185 DOI: 10.3390/ijerph17082734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 12/20/2022]
Abstract
This systematic literature review aims to point out sex-specific special features that are important in the bariatric treatment of women suffering from severe obesity. A systematic literature search was carried out according to Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. After the literature selection, the following categories were determined: sexuality and sexual function; contraception; fertility; sex hormones and polycystic ovary syndrome; menopause and osteoporosis; pregnancy and breastfeeding; pelvic floor disorders and urinary incontinence; female-specific cancer; and metabolism, outcome, and quality of life. For each category, the current status of research is illuminated and implications for bariatric treatment are determined. A summary that includes key messages is given for each subsection. An overall result of this paper is an understanding that sex-specific risks that follow or result from bariatric surgery should be considered more in aftercare. In order to increase the evidence, further research focusing on sex-specific differences in the outcome of bariatric surgery and promising treatment approaches to female-specific diseases is needed. Nevertheless, bariatric surgery shows good potential in the treatment of sex-specific aspects for severely obese women that goes far beyond mere weight loss and reduction of metabolic risks.
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Affiliation(s)
- Pia Jäger
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Annina Wolicki
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Johannes Spohnholz
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
| | - Metin Senkal
- Department of General and Visceral Surgery, Marien Hospital Witten, Teaching hospital of the Ruhr-University Bochum, Marienplatz 2, 58452 Witten, Germany
- Department of General and Visceral Surgery, Marien Hospital Herne, University hospital of the Ruhr-University Bochum, Hölkeskampring 40, 44625 Herne, Germany
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