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 paper reporting that satisfaction with RYGB surgery significantly decreased over time, revisional surgery after OAGB for GERD is rare, redo bariatric surgeries are an effective method of treatment for obesity-related morbidity, ASMBS research grants are successful at producing peer reviewed publications, and beliefs about the consequences of maintaining a healthy body weight are associated with individuals’ weight (please note, log-in maybe required to access the full paper).
Long-term Satisfaction with Roux-en-Y Gastric Bypass Surgery - Results From a Multicenter Prospective Cohort Study
Researchers from the University of Pittsburgh School of Medicine, Pittsburgh, PA, have reported that the level of satisfaction with Roux-en-Y gastric bypass (RYGB) surgery significantly decreased three to seven years following surgery.
Writing in the Annals of Surgery, the researchers examined the change in overall satisfaction with RYGB surgery and identify pre-surgery predictors and post-surgery factors associated with not being satisfied. In total, 1,423 participants of the 1,770 who underwent RYGB had data on satisfaction with surgery (81% female; median age 47 years; median body mass index 46 kg/m2).
The percentage of participants who were not satisfied with RYGB surgery significantly increased from 15.4% 3 years post-surgery to 23.0% 7 years post-surgery (p=0.01). Pre-surgery younger age, lower BMI, higher percent weight loss needed to reach dream weight, poorer physical and mental health, and less social support independently predicted higher risk of not being satisfied with surgery. When examining pre- to post-surgery changes, less post-surgery weight loss, worsening physical and mental health status, less social support, and greater depressive symptomology were associated with higher risk of not being satisfied with surgery.
The authors concluded that several pre- and post-surgery characteristics were associated with not being satisfied with surgery and provide potentially useful insight into individual patient experiences following RYGB. They added that knowledge of these characteristics may be useful in communication between surgeons and patients regarding post-surgical expectations and the impact of surgery on patients’ lives.
Surgical Management of Gastro-oesophageal Reflux Disease After One Anastomosis Gastric Bypass - a Systematic Review
An international team of researchers have reported that Revisional surgery after One Anastomosis Gastric Bypass (OAGB) for gastro-oesophageal reflux disease (GERD) appears to be rare, and when required, conversion to Roux-en-Y configuration is the commonest choice.
Reporting in Obesity Surgery, the study authors carried out a literature review on revisional surgery after OAGB for GORD. They identified 21 studies (13,658 OAGB patients).
There was a total of 230 (1.6%) patients who underwent revisional surgery for GERD. Revision to Roux-en-Y configuration was performed in 211 (91.7%) patients. Six (2.6%) patients had a Braun entero-enterostomy added to the OAGB, 13 (5.6%) patients underwent excluded stomach fundoplication (ESF). Reflux symptoms resolved in 112 (48.6%) patients, persisted in 13 (5.6%) patients, and were not reported in 105 (45.6%) patients.
They concluded that revisional surgery after OAGB for GORD appears to be rare, and when required, conversion to RYGB is the commonest choice.
Analysis of the Factors Contributing to Bariatric Success After Laparoscopic Redo Bariatric Procedures: Results from Multicenter Polish Revision Obesity Surgery Study (PROSS)
Investigators for Polish Revision Obesity Surgery Study (PROSS)–Collaborative Study Group has reported that redo bariatric surgeries (RBS) are an effective method of treatment for obesity-related morbidity.
The study, published in Obesity Surgery, looked at the factors that determine the success of redo-surgeries. They retrospectively analysed 529 consecutive patients who underwent RBS in 12 referral bariatric centers in Poland from 2010 to 2020. The efficacy endpoints were percentage of excessive weight loss (%EWL) and remission of hypertension (HT) and/or type 2 diabetes (T2D).
Two hundred thirty-eight of 352 patients (67.6%) exceeded 50% EWL after RBS. The difference in body mass index (BMI) pre-RBS and lowest after primary procedure < 10.6 kg/m2 (OR 2.33, 95% CI: 1.43–3.80, p=0.001) was independent factor contributing to bariatric success after RBS, i.e., > 50% EWL.
One hundred thirty of 177 patients (73.4%) exceeded 50% EWL after RBS. The difference in BMI pre-RBS and lowest after primary procedure (OR 0.76, 95% CI: 0.64–0.89, p=0.001) was independent factors lowering odds for bariatric success.
Forty-three of 87 patients (49.4%) achieved remission of hypertension and/or type 2 diabetes. One Anastomosis Gastric Bypass (OAGB) as RBS was independent factor contributing to bariatric success (OR 7.23, 95% CI: 1.67–31.33, p=0.008), i.e., complete remission of HT and/or T2D.
OAGB was associated with greater chance of complete remission of hypertension and/or diabetes, the authors concluded.
Evaluating the success of ASMBS research grants
US researchers, writing in SOARD, have reported that research grants awarded by the American Society of Metabolic and Bariatric Surgery (ASMBS) Foundation are successful at producing peer reviewed publications at a high rate and often lead to further funding suggesting that they boost the career of their recipients.
Since 2004 the ASMBS Foundation has funded competitive proposals by ASMBS members that are administered through the ASMBS Research Committee. These grants are intended to further the knowledge in the field of metabolic and bariatric surgery and support the scholarly growth of its members. In total, the ASMBS Foundation and Research Committee have awarded over 1 million dollars in 28 grants. The aim of this project was to evaluate the factors associated with grant completion success and barriers encountered by investigators.
Members of the ASMBS Research Committee retrospectively reviewed all awarded research grants since 2004. Information captured included research topic, status of awarded grants and related publications. Further, a web-based survey of grant recipients was administered exploring the perceived factors of successful completion and barriers encountered.
Fifty-seven percent of awardees responded to the survey. Seventeen projects had been completed at the time of the survey leading to 13 publications, while eleven remain in progress. Seventy percent of non-completed grant recipients indicated that a publication was forthcoming in the next 12 months. Overall, 64% received additional funding. Factors reported to influence successful completion of grants included the effectiveness of the research team, PI (principal investigator) perseverance, PI protected time, institutional support and available resources, and mentorship. Over the last decade, the average time from the award to publication was two years.
They concluded that by identifying factors of success can help guide future applicants and the ASMBS Research Committee during its grant selection process.
Public beliefs about the consequences of living with obesity in the Republic of Ireland and Northern Ireland
Researchers from the Republic of Ireland and the UK, reporting in BMC Public Health, have found that beliefs about the consequences of maintaining a healthy body weight are associated with individuals’ weight, self-rated health, diet and perceived ease of adoption of dietary and exercise-related improvements.
The study aimed to capture public beliefs about living with obesity, examine how these beliefs have changed over time and to explore whether certain characteristics were associated with them in a nationally representative sample of adults from the Republic of Ireland and Northern Ireland.
In total, 1,046 adults across Republic of Ireland and Northern Ireland were included in the study. They report that higher endorsement of the negative outcomes of obesity was significantly associated with living with a healthy weight, higher self-rated health, dietary quality and perceived ability to improve diet and physical activity. Those who lived with overweight, with obesity and non-responders were less likely to endorse the negative consequences of obesity.
Those living with obesity and non-responders were also more likely to support there is an increased cost and effort in maintaining a healthy weight. Comparison with survey data from 2013 showed that currently, there is a greater endorsement of the health benefits of maintaining a healthy weight (p<0001), but also of the increased costs associated with it (p<0001).
Beliefs about the consequences of maintaining a healthy body weight are associated with individuals’ weight, self-rated health, diet and perceived ease of adoption of dietary and exercise-related improvements, they concluded, adding that beliefs about the health risks of obesity and perceived greater costs associated with maintaining a healthy weight appear to have strengthened over time. interventions to address obesity.