Journal Watch 08/12/2021

Updated: Dec 15, 2021

Welcome to our weekly round-up of the latest bariatric and obesity-related papers published in the medical literature. As ever, we have looked far and wide to give you an overview of papers including β-cell function after RYGB, post-LSG gastropexy vs non- gastropexy, predictors of 30-day follow-up visits, outcomes from the BARI-LIFESTYLE RCT and the latest paper from the Swedish Obese Subjects study (please note, log-in maybe required to access the full paper).


Role of the Gut in the Temporal Changes of β-Cell Function After Gastric Bypass in Individuals With and Without Diabetes Remission

Writing in Diabetes Care, US researchers have assessed the temporal change in insulin secretory capacity after RYGB, using oral and intravenous (IV) glucose, in individuals with type 2 diabetes.

Measures of β-cell function were assessed after oral glucose intake and graded glucose infusion in individuals with severe obesity and diabetes studied at 0, 3, 12 and 24 months after RYGB.


They found that decreases in body weight, fat mass, waist circumference, and insulin resistance after surgery (all P < 0.001 at 12 and 24 months) did not differ according to diabetes remission status. Conversely, both the magnitude and temporal changes in β-cell glucose sensitivity after oral glucose intake differed by remission status (p=0.04): greater (6.5-fold; p<0.01) and sustained in those in full remission, moderate and not sustained past 12 months in those with partial remission (3.3-fold; p<0.001) and minimal in those not experiencing remission (2.7-fold; p=ns).


They concluded that data show the time course of changes in β-cell function after RYGB and the improvement in β-cell function after RYGB, but not changes in weight loss or insulin sensitivity, drives diabetes remission.


To access this paper, please click here


Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy

Researchers from Menoufia University Hospital, Shebeen El-Kom, Egypt, have reported the outcomes from randomised study on positive and negative effect of gastropexy on reducing distressing postoperative LSG-related gastrointestinal symptoms.


In total, 200 participants were divided into two groups, with 100 patients in each group. Patients in group A underwent gastropexy and patients in group B underwent LSG without gastropexy.

They found that was no significant difference between the groups in age, sex or length of hospital stay (p > 0.05). However, there were significant differences between the two groups regarding nausea, vomiting, reflux symptoms and the amount and frequency of antiemetics used (p < 0.001). hospital readmissions (p < 0.05) and in clinic visits during the postoperative period.


The concluded that patients who underwent gastropexy showed a significant reduction in antiemetic consumption and a significantly lower incidence of postoperative nausea, vomiting, GERD symptoms and gastric torsion vs non-gastropexy patient.


To access this paper, please click here


Predictors of 30-day Follow-up Visit Completion after Primary Bariatric Surgery: An Analysis of MBSAQIP Data Registry

US researchers from the University of Rochester Medical Center, Rochester, NY, who sought to identify predictors, including surgery type and preoperative demographics, body mass index (BMI), medical conditions and smoking status, of 30-day follow-up visit completion - have identified subgroups at a higher risk of being lost to follow-up after bariatric surgery. The findings were published in SOARD.


Using data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, patients (n=56,6774) who underwent primary Roux-en-Y gastric bypass or sleeve gastrectomy (SG) were included in this analysis. Over 95% of patients completed the 30-day visits. In the whole-sample analysis, they reported that older age (OR: 1.02) and the presence of non-insulin-dependent diabetes (OR: 1.04), hypertension (OR: 1.03), hyperlipidaemia (OR: 1.10), obstructive sleep apnoea (OR: 1.15), gastroesophageal reflux disease (OR: 1.16) were positive predictors of the 30-day visit completion (ps<0.01).


However, SG procedure (OR: 0.86), black race (OR: 0.87), Hispanic ethnicity (OR: 0.94), presence of insulin-dependent diabetes (OR: 0.96) and smoking (OR: 0.83) were negative predictors (ps<0.01).


To access this paper, please click here


Patients' views and experiences of live supervised tele-exercise classes following bariatric surgery during the COVID-19 pandemic: The BARI-LIFESTYLE qualitative study

Tele-exercise, when implemented specifically in patients who have undergone bariatric surgery, is feasible and well-accepted, and potentially as effective and useful as in-person exercise classes, according to the outcomes from a randomized controlled trial by UK researchers.


The findings were reported in the paper, ‘Patients' views and experiences of live supervised tele-exercise classes following bariatric surgery during the COVID-19 pandemic: The BARI-LIFESTYLE qualitative study’, published in Clinical Obesity, by investigators from the Centre for Obesity Research UCL, UCLH, Whittington and Homerton Hospitals.


The interview questions explored the participants' overall experiences and views of the tele-exercise classes, including the use of technology, the content of the classes, the exercise therapist and supervision; identifying barriers and facilitators of participation, benefits and/or limitations of the classes; and identifying elements for future improvements of the classes.


Four overarching themes were identified, namely:

  • Coping with the impact of COVID-19 lockdown

  • Tele-exercise programme was perceived as acceptable

  • Professional supervision and guidance affecting adherence to tele-exercise

  • Tele-exercise provided physical, emotional and social benefits

To access this paper, please click here


To read a summary of this paper, please click here


Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-Term Results From the Swedish Obese Subjects Study

The risk of getting cancer was 37 percent lower in the group that underwent bariatric surgery, compared to a control group, however, good glucose control was shown to be more important for the reduction of cancer risk in patients with obesity and type 2 diabetes, according to a study from the University of Gothenburg. The study, ‘Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-Term Results From the Swedish Obese Subjects Study’, published in the journal Diabetes Care, used data from the "SOS" (Swedish Obese Subjects) intervention trial, which is led and coordinated from the University of Gothenburg, as well as data from other sources, such as the Swedish Cancer Registry.


In the surgery group, 68 individuals (approximately 17 percent) developed cancer in parallel with a significant weight loss. The corresponding emerging cancer cases in the control group amounted to 74 (24 percent), while these individuals retained their condition of severe obesity. The median follow-up period was 21 years. Overall, the risk of getting cancer was 37 percent lower in the group that underwent bariatric surgery.


However, the largest difference was observed when cancer risk was analysed in the patients who achieved normal glucose control and had no relapse of diabetes over a ten-year period. Among these patients, the incidence of cancer was only 12 out of 102 (12 percent), against 75 out of 335 (22 percent) in the group whose diabetes had recurred in the same period. Thus, the results show a 60% reduction in cancer risk in the group where normal glucose control was maintained over ten years.


To access this paper, please click here


To read a summary of this paper, please click here