Dietary and medical therapy of obesity

Assessment of the application of the intragastric balloon together with sibutramine: a prospective clinical study

BACKGROUND

The aim of this study is the prospective evaluation of the results of Bioenterics intragastric balloon (BIB) with sibutramine and BIB placement alone in the treatment of obesity.

METHODS

The patients evaluated between March 2006 and January 2007 and enrolled in this study were assessed in two groups as group A (BIB + sibutramine) and group B (BIB). After the follow-up of the patients for 6 months, body mass index (BMI), weight loss, excess weight loss (EWL%), and excess body mass index loss (EBMIL%) values of the patients in both groups were compared.

RESULTS

According to the comparison of the weights of the patients in groups A and B at 6 months with the beginning weights of the patients in both groups, there was statistically significant weight loss (p < 0.01). The total weight loss at 6 months in group A was statistically significantly higher than that in group B (p < 0.05). The patients in group A had a mean BMI 34.53 +/- 6.63 kg/m(2), EWL% 38.77 +/- 11.88%, EBMIL% 49.93 +/- 21.52% after 6 months; the patients in group B had a mean BMI 35.29 +/- 6.36 kg/m(2), EWL% 29.06 +/- 17.82%, EBMIL% 36.51 +/- 23.69% after 6 months. There was no statistically significant difference between group A and group B according to the BMI, EWL%, and EBMIL% values (p > 0.05).

CONCLUSION

In the management of obesity, using BIB together with sibutramine before the treatment in the patient group who are planned to have surgery, compared with using only BIB, provides more effective weight loss.

High and low fat food selection with reported frequency intolerance following Roux-en-Y gastric bypass

BACKGROUND

This research compared both food selection and food intolerance frequency of High-fat grouped foods versus Low-fat grouped foods in Roux-en-Y bariatric clients during their dietary adaptation phase (DAP).

METHODS

Thirty-eight bariatric surgery patients in their dietary transition phase (3 months-2.5 years) filled out a 236-food item questionnaire. From the larger set of primary data, 24 high-fat (30% or greater fat) and 22 low/lower-fat food items were itemized by selection frequency and food intolerance frequency for comparison.

RESULTS

High-fat food selection was 38.3% against low fat at 50.4% (p = .0002). For comparison, the complete questionnaire's 236-item food selection percentage was 41%. Frequency of "Never" experiencing food intolerance was similar between both groups with a combined mean of 1.92%. "Seldom to Sometimes" intolerance in low-fat foods was 13.3%, and 24.9% in high fat (p = .002). Finally, "Often to Always" experiencing food intolerance in the Low-fat food group was 85.5% versus 72.2% for the High-fat group (p = .002).

CONCLUSION

Roux-en-Y bariatric patients in the DAP demonstrated typical "dieting behavior" by selecting low-fat foods at a greater frequency than high-fat foods. Although selected more, these low-fat foods also showed significantly worse intolerance frequencies. Thus, current dietary/nutrition professional recommendations to avoid high-fat foods during this postsurgery transition time are problematic. Future bariatric studies are needed to further explore this and other commonly practiced "dieting behaviors" in bariatric patients.