The latest medical research on Bariatric Surgery

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about bariatric surgery gathered by our medical AI research bot.

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Impact of bariatric surgery on anthropometric, metabolic, and reproductive outcomes in polycystic ovary syndrome: a systematic review and meta-analysis.

Obesity Reviews

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in females. Modest weight loss improves reproductive and metabolic PCOS features. W...

Collaborative Approach toward Transplant Candidacy for Obese End-Stage Renal Disease Patients.

American College of Surgeons

An elevated Body Mass Index (BMI) is a major cause of transplant preclusion for patients with End Stage Renal Disease (ESRD). This phenomenon exacerbates existing socioeconomic and racial disparities and increases the economic burden of maintaining patients on dialysis. Metabolic Bariatric Surgery (MBS) in such patients is not widely available. Our center created a collaborative program to undergo weight loss surgery before obtaining a kidney transplant.

We studied the outcomes of these patients post MBS and transplant surgery. One hundred and eighty-three ESRD patients were referred to the bariatric team by the transplant team between Jan 2019 through June 2023. Of these, 36 underwent MBS (20 RYGB, 16 SG), and 10 underwent subsequent transplantation, with another 15 currently waitlisted. Both surgical teams shared resources, including dieticians, social workers, and a common database, for easy transition between teams.

The mean starting BMI for all referrals was 46.4 kg/m2 and was 33.9 kg/m2 at the time of transplant. The average number of hypertension medications decreased from 2.0 (range 2.0 to 4.0) pre-surgery to 1.0 (range 1.0 to 3.0) post-surgery. Similarly, HbA1C levels improved, with pre-operative averages at 6.2 (range 5.4 to 7.6) and postoperative levels at 5.2 (range 4.6 to 5.8) All transplants are currently functioning, with a median creatinine of 1.5 (1.2 - 1.6) mg/dl (GFR 46 (36.3 - 71.0)).

A collaborative approach between bariatric and transplant surgery teams offers a pathway toward transplant for obese ESRD patients, and potentially alleviates existing healthcare disparities. ESRD patients that undergo MBS have unique complications to be aware of. The improvement in comorbidities may lead to superior post-transplant outcomes.

Barriers to Black Medical Students and Residents Pursuing and Completing Surgical Residency in Canada: A Qualitative Analysis.

American College of Surgeons

The limited available data suggest that the Canadian surgical workforce does not reflect the racial diversity of the patient population it serves, despite the well-established benefits of patient-provider race concordance. There have been no studies to date that characterize the systemic and individual challenges faced by Black medical students in matching to and successfully finishing training in a surgical specialty within a Canadian context that can explain this underrepresentation.

Using critical qualitative inquiry and purposive sampling to ensure gender, geographical, and student/trainee year heterogeneity, we recruited self-identifying Black medical students and surgical residents across Canada. Online in-depth semi-structured interviews were conducted and transcribed verbatim. Transcripts were analyzed through an inductive reflexive narrative thematic process by four analysts.

27 participants including 18 medical students and 9 residents, were interviewed. The results showed three major themes that characterized their experiences: journey to and through medicine, perceptions of the surgical culture, and recommendations to improve the student experience. Medical students identified lack of mentorship and representation, as well as experiences with racism as the main barriers to pursuing surgical training. Surgical trainees cited systemic racism, lack of representation and insufficient safe spaces as the key deterrents to program completion. The intersection with gender exponentially increased these identified barriers.

Except for a few surgical programs, medical schools across Canada do not offer a safe space for Black students and trainees to access and complete surgical training. An urgent change is needed to provide diverse mentorship that is transparent, acknowledges the real challenges related to systemic racism and biases, and is inclusive of different racial and ethnic backgrounds.

Potent incretin-based therapy for obesity: A systematic review and meta-analysis of the efficacy of semaglutide and tirzepatide on body weight and waist circumference, and safety.

Obesity Reviews

Potent incretin-based therapy shows promise for the treatment of obesity along with reduced incidence of cardiovascular events in patients with pre...

Fatty acid esters of hydroxy fatty acids: A potential treatment for obesity-related diseases.

Obesity Reviews

Obesity, a burgeoning worldwide health system challenge, is associated with multiple chronic diseases, including diabetes and chronic inflammation....

Influence of mental and behavioral factors on weight loss after bariatric surgery: A systematic review and meta-analysis.

Obesity Reviews

Multiple factors are related to lower weight loss after bariatric surgery. This review and meta-analysis evaluates the influence of several mental and behavioral factors on weight loss.

Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non-moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow-up moments were analyzed separately.

In total, 75 articles were included in the review; 12 meta-analyses were conducted. Higher postoperative compliance to follow-up was associated with 6.86%-13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24- and 36-month follow-up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms.

Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric-metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss.

The range of outcomes and outcome measurement instruments collected in multisectoral community-based obesity prevention interventions in children: A systematic review.

Obesity Reviews

Multicomponent and multisectoral community-based interventions (CBIs) have proven potential in preventing overweight and obesity in children. Synth...

Why we struggle to make progress in obesity prevention and how we might overcome policy inertia: Lessons from the complexity and political sciences.

Obesity Reviews

Despite evidence for the effectiveness of policies that target obesogenic environments, their adoption remains deficient. Using methods and concept...

Research trends between diabetes mellitus and bariatric surgery researches: Bibliometric analysis and visualization from 1998 to 2023.

Obesity Reviews

This study conducted a bibliometric analysis using the Web of Science Core Collection (WOSCC) to explore the relationship between diabetes mellitus...

Effect of Behavioral Health Disorders on Surgical Outcomes in Cancer Patients.

American College of Surgeons

Behavioral health disorders (BHD) can often be exacerbated in the setting of cancer. We sought to define the prevalence of BHD among cancer patients and characterize the association of BHD with surgical outcomes.

Patients diagnosed with lung, esophageal, gastric, liver, pancreatic, and colorectal cancer between 2018-2021 were identified within Medicare Standard Analytic Files. Data on BHD defined as substance abuse, eating disorder, or sleep disorder were obtained. Post-operative textbook outcome (TO)(i.e., no complications, prolonged length of stay, 90-day readmission, or 90-day mortality), as well as in-hospital expenditures and overall survival were assessed.

Among 694,836 cancer patients, 46,719 (6.7%) patients had at least one BHD. Patients with BHD were less likely to undergo resection (no BHD: 23.4% vs. BHD: 20.3%; p<0.001). Among surgical patients, individuals with BHD had higher odds of a complication (OR 1.32 [1.26-1.39]), prolonged length of stay (OR 1.36 [1.29-1.43]), and 90-day readmission (OR 1.57 [1.50-1.65]) independent of social vulnerability or hospital volume status, resulting in lower odds to achieve a TO (OR 0.66 [0.63-0.69]). Surgical patients with BHD also had higher in-hospital expenditures (no BHD: $16,159 vs. BHD: $17,432; p<0.001). Of note, patients with BHD had worse long-term post-operative survival (median, no BHD: 46.6 [45.9-46.7] vs. BHD: 37.1 [35.6-38.7] months) even after controlling for other clinical factors (HR 1.26 [1.22-1.31], p<0.001).

BHD was associated with lower likelihood to achieve a postoperative TO, higher expenditures, as well as worse prognosis. Initiatives to target BHD are needed to improve outcomes of cancer patients undergoing surgery.

Outcomes and Management of Re-Establishing Bariatric Patients.

American College of Surgeons

Lifelong follow-up after metabolic/bariatric surgery (MBS) is necessary to monitor for patient outcomes and nutritional status. However, many patients do not routinely follow up with their MBS team. We studied what prompted MBS patients to seek bariatric care after being lost to follow-up and the subsequent treatments they received.

A retrospective cohort study of patients after MBS who had discontinued regular MBS follow-up but represented to the MBS clinic between July 2018 and December 2022 to re-establish care. Patients with a history of a Sleeve Gastrectomy (SG), Roux-En-Y Gastric Bypass (RYGB), and Adjustable Gastric Banding (AGB) were included.

We identified 400 patients (83.5% female, mean age 50.3 ± 12.2 years at the time of RBC), of whom 177 (44.3%) had RYGB, 154 (38.5%) had SG, and 69 (17.2%) had AGB. Overall, recurrent weight gain (RWG) was the most common reason for presentation for all three procedures (81.2% in SG, 62.7% in RYGB, and 65.2% in AGB; p<.001). SG patients were more likely to undergo a revision MBS compared to RYGB patients (16.9% vs. 5.8%, p<.001), while RYGB patients were more likely to undergo an endoscopic intervention than SG patients (17.5% vs. 7.8%, p<.001). The response to AOM agents, specifically GLP-1 drugs, was better in RYGB patients, than SG patients.

This study highlights RWG as the most common reason for patients after MBS seeking to re-establish care with the MBS team. SG had a higher rate of revision MBS than RYGB, whereas endoscopic interventions were performed more frequently in the RYGB group. AOM, especially GLP-1 drugs, were more effective in RYGB patients.

Ultrasound-based measurement of central adiposity: Key considerations and guidelines.

Obesity Reviews

Central adiposity, which is visceral and subcutaneous adiposity in the abdominal region, is a known risk factor for developing chronic cardiometabo...