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Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass

BACKGROUND: Previous studies show that ‘poor responders’ to Roux-en-Y gastric bypass (RYGBP) may be identified on the basis of early postoperative weight loss. Early identification of poor responders could allow earlier provision of postoperative behavioural and/or intensive lifestyle interventions...

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Autores principales: Manning, Sean, Pucci, Andrea, Carter, Nicholas C., Elkalaawy, Mohamed, Querci, Giorgia, Magno, Silvia, Tamberi, Anna, Finer, Nicholas, Fiennes, Alberic G., Hashemi, Majid, Jenkinson, Andrew D., Anselmino, Marco, Santini, Ferruccio, Adamo, Marco, Batterham, Rachel L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422859/
https://www.ncbi.nlm.nih.gov/pubmed/25239175
http://dx.doi.org/10.1007/s00464-014-3829-7
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author Manning, Sean
Pucci, Andrea
Carter, Nicholas C.
Elkalaawy, Mohamed
Querci, Giorgia
Magno, Silvia
Tamberi, Anna
Finer, Nicholas
Fiennes, Alberic G.
Hashemi, Majid
Jenkinson, Andrew D.
Anselmino, Marco
Santini, Ferruccio
Adamo, Marco
Batterham, Rachel L.
author_facet Manning, Sean
Pucci, Andrea
Carter, Nicholas C.
Elkalaawy, Mohamed
Querci, Giorgia
Magno, Silvia
Tamberi, Anna
Finer, Nicholas
Fiennes, Alberic G.
Hashemi, Majid
Jenkinson, Andrew D.
Anselmino, Marco
Santini, Ferruccio
Adamo, Marco
Batterham, Rachel L.
author_sort Manning, Sean
collection PubMed
description BACKGROUND: Previous studies show that ‘poor responders’ to Roux-en-Y gastric bypass (RYGBP) may be identified on the basis of early postoperative weight loss. Early identification of poor responders could allow earlier provision of postoperative behavioural and/or intensive lifestyle interventions and enhance their maximal weight loss. Our aim was to investigate whether early postoperative weight loss predicts the maximal weight loss response after RYGBP and sleeve gastrectomy (SG). METHODS: We undertook a retrospective cross-sectional study of 1,456 adults who underwent either RYGBP (n = 918) or SG (n = 538) as a primary procedure in one of two European centres. Postoperative weight loss was expressed as weight loss velocity (WLV) and percentage weight loss. Linear regression analyses were performed to determine the association of early postoperative weight loss with maximal %WL, including adjustment for baseline variables. RESULTS: There was marked variability in maximal %WL following both RYGBP (mean 32.9 %, range 4.1–60.9 %) and SG (mean 26.2 %, range 1.1–58.3 %). WLV 3–6 months postoperatively was more strongly associated with maximal %WL (r (2) = 0.32 for RYGBP and r (2) = 0.26 for SG, P < 0.001 for both) than either WLV 0–6 weeks or 6 weeks to 3 months postoperatively (r (2) = 0.14 and 0.10 for RYGBP, respectively; r (2) = 0.18 and 0.21 for SG, respectively; P < 0.001 for all). Multiple linear regression analysis, including baseline variables of age, sex, preoperative BMI, type 2 diabetes, ethnicity, and bariatric centre, revealed that 3–6 month WLV was an independent predictor of maximal %WL in both SG and RYGBP groups (standardised β-coefficients 0.51 and 0.52, respectively; P < 0.001 for both). CONCLUSIONS: There is a marked variability in weight loss response following RYGBP and SG. Early postoperative weight loss can be used to identify patients whose predicted weight loss trajectories are suboptimal. Early targeting of poor responders with more intensive postoperative lifestyle and behavioural support could potentially enhance their weight loss response.
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spelling pubmed-44228592015-05-13 Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass Manning, Sean Pucci, Andrea Carter, Nicholas C. Elkalaawy, Mohamed Querci, Giorgia Magno, Silvia Tamberi, Anna Finer, Nicholas Fiennes, Alberic G. Hashemi, Majid Jenkinson, Andrew D. Anselmino, Marco Santini, Ferruccio Adamo, Marco Batterham, Rachel L. Surg Endosc Article BACKGROUND: Previous studies show that ‘poor responders’ to Roux-en-Y gastric bypass (RYGBP) may be identified on the basis of early postoperative weight loss. Early identification of poor responders could allow earlier provision of postoperative behavioural and/or intensive lifestyle interventions and enhance their maximal weight loss. Our aim was to investigate whether early postoperative weight loss predicts the maximal weight loss response after RYGBP and sleeve gastrectomy (SG). METHODS: We undertook a retrospective cross-sectional study of 1,456 adults who underwent either RYGBP (n = 918) or SG (n = 538) as a primary procedure in one of two European centres. Postoperative weight loss was expressed as weight loss velocity (WLV) and percentage weight loss. Linear regression analyses were performed to determine the association of early postoperative weight loss with maximal %WL, including adjustment for baseline variables. RESULTS: There was marked variability in maximal %WL following both RYGBP (mean 32.9 %, range 4.1–60.9 %) and SG (mean 26.2 %, range 1.1–58.3 %). WLV 3–6 months postoperatively was more strongly associated with maximal %WL (r (2) = 0.32 for RYGBP and r (2) = 0.26 for SG, P < 0.001 for both) than either WLV 0–6 weeks or 6 weeks to 3 months postoperatively (r (2) = 0.14 and 0.10 for RYGBP, respectively; r (2) = 0.18 and 0.21 for SG, respectively; P < 0.001 for all). Multiple linear regression analysis, including baseline variables of age, sex, preoperative BMI, type 2 diabetes, ethnicity, and bariatric centre, revealed that 3–6 month WLV was an independent predictor of maximal %WL in both SG and RYGBP groups (standardised β-coefficients 0.51 and 0.52, respectively; P < 0.001 for both). CONCLUSIONS: There is a marked variability in weight loss response following RYGBP and SG. Early postoperative weight loss can be used to identify patients whose predicted weight loss trajectories are suboptimal. Early targeting of poor responders with more intensive postoperative lifestyle and behavioural support could potentially enhance their weight loss response. Springer US 2014-09-20 2015 /pmc/articles/PMC4422859/ /pubmed/25239175 http://dx.doi.org/10.1007/s00464-014-3829-7 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Article
Manning, Sean
Pucci, Andrea
Carter, Nicholas C.
Elkalaawy, Mohamed
Querci, Giorgia
Magno, Silvia
Tamberi, Anna
Finer, Nicholas
Fiennes, Alberic G.
Hashemi, Majid
Jenkinson, Andrew D.
Anselmino, Marco
Santini, Ferruccio
Adamo, Marco
Batterham, Rachel L.
Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title_full Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title_fullStr Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title_full_unstemmed Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title_short Early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and Roux-en-Y gastric bypass
title_sort early postoperative weight loss predicts maximal weight loss after sleeve gastrectomy and roux-en-y gastric bypass
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4422859/
https://www.ncbi.nlm.nih.gov/pubmed/25239175
http://dx.doi.org/10.1007/s00464-014-3829-7
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