Do reasons for undergoing bariatric surgery influence weight loss and health-related quality of life?-A Swedish mixed method study

Patients experience with preoperative use of anti-obesity medications and associations with bariatric surgery expectations

BACKGROUND

Few studies have investigated the use of anti-obesity medications (AOMs) before bariatric surgery and how prior use impacts patients' goals and expectations for surgery.

OBJECTIVES

This study investigated associations between patients' experiences with AOMs and weight loss expectations before bariatric surgery.

SETTINGS

Single tertiary university hospital.

METHODS

Patients were electronically surveyed with a 31-item questionnaire via email or the patient portal with a primary predictor variable of AOMs presurgery. Outcomes included degree of weight loss and weight regain and motivation for seeking surgery.

RESULTS

A total of 346 persons were invited to complete the survey; 112 surveys (32.4%) were completed, with 7 excluded because of not answering the AOM question. 73% reported AOM use. Among those who took AOMs before seeking bariatric surgery, average weight loss was 13 kg (SD 10) corresponding to a 4.4-kg/m2 decrease in BMI. Of past AOM recipients, 87% reported weight regain on stopping AOMs. Average weight regain was 18 kg (SD 13; 126% increase). Patients reported improved longevity and quality of life as motivation for seeking surgery, with AOM use history having no effect. Subjects reported an average weight loss goal of 65.8 kg (39% of baseline weight) from bariatric surgery.

CONCLUSIONS

AOMs were commonly used in those seeking bariatric surgery, but motivation for surgery did not differ by AOM use history. Motivations were most often related to goals for better overall health.

Associations of food addiction symptomatology with bariatric surgical attrition: a cross-sectional analysis

BACKGROUND

Despite the effectiveness of bariatric surgery, there remains a high rate of attrition from surgical programs, highlighting the need to understand factors that influence presurgical attrition rates.

OBJECTIVES

To investigate the association between food addiction (FA) symptomatology and attrition from bariatric surgery.

SETTING

Surgical weight-loss program at a single academic medical center.

METHODS

Data for this analysis were collected from August 2020 until August 2022. Measures included sociodemographic variables, mental health, eating assessments, and FA symptomatology. Data were analyzed using a combination of descriptive statistics, univariable logistic regressions, and a multivariable stepwise logistic regression model.

RESULTS

A total of 505 adult patients were included (76.98% female, mean age 42.61 years, 263 [52.08%] undergoing surgery). FA scores were significantly and positively correlated with surgical attrition, current food insecurity, anxiety and depression symptoms, internalized weight bias, lower dietary quality, and distress and impairment due to FA. In the multivariable model, only current food insecurity, depressive symptoms, internalized weight bias, and impairment caused by FA were significant predictors of surgical attrition.

CONCLUSIONS

Although the number of FA symptoms was not associated in the multivariable model, impairment attributable to FA remained a significant predictor of surgical attrition. This trend suggests that an evaluation of FA may reflect a complex network of factors. Further, FA may not be a predictor of surgical attrition in the absence of perceived clinically significant impairment. Additional research should explore the relationship between impairment attributable to FA and surgical attrition to test the generalizability of these findings.

Obstructive Sleep Apnea: The Effect of Bariatric Surgery After Five Years-A Prospective Multicenter Trial

BACKGROUND

The prevalence of obstructive sleep apnea (OSA) is high among the bariatric surgery candidates. Obesity is the most important individual risk factor for OSA. The aim of this study was to investigate the effect of a laparoscopic Roux-en-Y gastric bypass (LRYGB) on OSA 5 years after the surgery.

PATIENTS AND METHODS

In this prospective multicenter study, standard overnight cardiorespiratory recording was conducted to 150 patients at baseline prior to bariatric surgery. A total of 111 (73.3%) patients of those had OSA. Cardiorespiratory recordings at 5 years after surgery were available for 70 OSA patients. The changes in anthropometric and demographic measurements including age, weight, body mass index (BMI), and waist and neck circumference were evaluated. Also, a quality of life (QoL) questionnaire 15D administered in a baseline was controlled at 5-year follow-up visit.

RESULTS

At 5-year OSA was cured in 55% of patients, but moderate or severe OSA still persisted in 20% of patients after operation. Mean total AHI decreased from 27.8 events/h to 8.8 events/h (p < 0.001) at 5-year follow-up. A clinically significant difference in QoL was seen in mobility, breathing, sleeping, usual activities, discomfort and symptoms, vitality and sexual activity. The QoL total score improved more in OSA patient at 5-year follow-up.

CONCLUSIONS

LRYGB is an effective treatment of OSA in obese patients and the achieved beneficial outcomes are maintained at 5-year follow-up.