Journal Watch 09/02/2022

Welcome to our weekly round-up of the latest bariatric and obesity-related papers published in the medical literature. 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 a meta-analysis of RYGB, SG and OAGB, outcomes from a meta-analysis that evaluated the event rate of bile reflux after SADI-S, an Australian comparison of ESG vs LSG, the prevalence of obesity and overweight in the Middle East Countries from 2000 to 2020 and the outcomes from an RCT on the effects of a group-based weight management programme on anxiety and depression (please note, log-in maybe required to access the full paper).


Roux-en-Y gastric bypass, sleeve gastrectomy, or one-anastomosis gastric bypass? A systematic review and meta-analysis of randomized-controlled trials

Investigators from the University Hospitals of Geneva, Genève, Switzerland have reported the outcomes from a meta-analysis of the three most common bariatric procedures: Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) – in terms of obtaining the best weight-loss outcomes and a remission of type 2 diabetes.


Writing in the Obesity journal, the paper included data from 25 RCTs and they reported that excess weight loss (EWL, percentage) was greater for RYGB patients at three years (p<0.00001) and five years (p=0.0004). Higher excess BMI loss (percentage) was found in RYGB at one-year (p=0.01). Total weight loss (percentage) was greater for RYGB patients after three months (p=0.02), six months (p<0.00001), one year (p<0.00001) and five years (p=0.005). No difference in terms of remission of type 2 diabetes was seen between RYGB and SG. EWL was significantly more important after OAGB than after RYGB after one year (p=0.003).


The researchers concluded that RYGB was more efficient than SG in the midterm, whilst OAGB offers greater EWL than RYGB after one year, but further investigation is needed to confirm these results.


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Bile Reflux After Single Anastomosis Duodenal-Ileal Bypass with Sleeve (SADI-S): a Meta-analysis of 2,029 Patients

Writing in Obesity Surgery, investigators from the Mayo Clinic, Rochester, MN, have reported the outcomes from a meta-analysis that evaluated the event rate of bile reflux after Single anastomosis duodenal-ileal bypass with sleeve (SADI-S).


Out of 3,027 studies analysed, seven were included and the mean follow-up was 10.3 months. The total number of patients was 2,029, with 25 reports of bile reflux, resulting in an incidence of 1.23%, with an event rate of 0.016.


The authors concluded that bile reflux has not been demonstrated to be problematic after SADI-S, although further long-term studies are needed.


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Efficacy and safety of endoscopic sleeve gastroplasty and laparoscopic sleeve gastrectomy with 12+ months of adjuvant multidisciplinary support

Researchers from Australia, who examined the six- and 12-month weight loss efficacy, safety and weight-related quality of life (QoL) of adults with obesity who received the endoscopic sleeve gastroplasty (ESG) or laparoscopic sleeve gastrectomy (LSG) bariatric procedure with 12+ months of adjuvant multidisciplinary pre- and postprocedural support.


In total, there were 16 ESG and 45 LSG patients recruited. At 12-months post-procedure, ESG %EWL was 57% and LSG %EWL was 79%. Both ESG and LSG cohorts improved QoL, liver function, HbA1c and triglycerides. ESG reported 25% mild-moderate adverse events possibly related to the procedure, and the LSG reported 27% mild-severe adverse events possibly related to the procedure.


The authors concluded ESG and LSG were safe and effective weight loss treatments for obesity adults alongside multidisciplinary support. Patients who elected the ESG maintained fat-free mass at six-months but both cohorts lost fat-free mass at 12-months post-procedure.


Patients who elected the LSG had large and significant improvements to weight-related quality of life. Further well-powered studies are required to confirm these findings.


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Prevalence of Obesity and Overweight among Adults in the Middle East Countries from 2000 to 2020: A Systematic Review and Meta-Analysis

Iranian investigators have reported that current interventions to combat the overweight epidemic need to be maintained and strengthened because the prevalence of overweight and obesity in the Middle East region is still very high.


In their systematic review, they sought to identify the prevalence of obesity and overweight in the Middle East region and different countries in this region. From 101 studies (698,905 participants), the pooled estimates of the prevalence of obesity and overweight in the Middle East area were 21.17 and 33.14, respectively. Obesity prevalence in the Middle East area remained steady between 2000–2006 and 2014–2020 (23%). During these time intervals, the prevalence of overweight decreased from 34.83 to 32.85.


Despite the relative stabilization of the overweight and obesity trend in the Middle East, implementing intervention programs to prevent and control obesity and overweight in the Middle East is essential, the authors concluded.


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Effects of a group-based weight management programme on anxiety and depression: A randomised controlled trial (RCT)

UK researchers investigating the impact of a group-based weight management programme on symptoms of depression and anxiety vs. self-help in a randomised controlled trial (RCT), have reported that there was no evidence of harm to depression or anxiety symptoms as a result of attending a group-based weight loss programme.


People with BMI≥28kg/m2 were randomly allocated self-help (n=211) or a group-based weight management programme for 12 weeks (n=528) or 52 weeks (n=528) from October 2012 to February 2014. Symptoms were assessed using the Hospital Anxiety and Depression Scale, at baseline, three, 12 and 24 months.


They found that at three months, there was a -0.6 point difference in depression score and -0.1 difference in anxiety score between group-based weight management programme and self-help. At subsequent time points there was no consistent evidence of a difference in depression or anxiety scores between trial arms. There was no evidence that depression or anxiety worsened at any time point.


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