Weight loss during medical weight management does not predict weight loss after bariatric surgery: a retrospective cohort study.

Abbott, Sally, Lawson, Jacob, Singhal, Rishi, Parretti, Helen M and Tahrani, Abd A (2020) Weight loss during medical weight management does not predict weight loss after bariatric surgery: a retrospective cohort study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. ISSN 1878-7533. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs.

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Official URL: https://www.soard.org/article/S1550-7289(20)30369-...

Abstract

BACKGROUND

Many bariatric surgical centers mandate achieving weight loss targets through medical weight management (MWM) programs before offering bariatric surgery, but the evidence for this is unclear.

OBJECTIVES

To examine the relationship between weight changes during (1) MWM, and (2) preoperative low-energy-diet (LED), and weight changes at 12 and 24 months after surgery.

SETTING

Multicenter community- and acute-based MWM services referring to one regional bariatric center, United Kingdom.

METHODS

A retrospective cohort study of patients who attended MWM and then underwent a primary laparoscopic bariatric procedure (adjustable gastric banding [LAGB], or Roux-en-Y gastric bypass [RYGB]) in a single bariatric center in the United Kingdom between 2013 and 2015. Data were collected from patient electronic records.

RESULTS

Two hundred eight patients were included (LAGB n = 128, RYGB n = 80). Anthropometric data were available for 94.7% and 88.0% of participants at 12 and 24 months, respectively. There was no relationship between weight loss during MWM and after surgery at either 12 or 24 months. Weight loss during the preoperative LED predicted greater weight loss after LAGB (β = .251, P = .006) and less weight loss after RYGB (β = -.390, P = .003) at 24 months, after adjusting for age, sex, ethnicity, baseline weight, and LED duration.

CONCLUSIONS

Weight loss in MWM does not predict greater weight loss outcomes up to 24 months after LAGB or RYGB. Greater weight loss during the preoperative LED predicted greater weight loss after LAGB and less weight loss after RYGB. Our results suggest that patients should not be denied bariatric surgery because of not achieving weight loss in MWM. Weight loss responses to preoperative LEDs as a predictor of postsurgical weight loss requires further investigation.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs.
Subjects: WD Diseases and disorders of systemic, metabolic or environmental origin
WO Surgery
Divisions: Ambulatory Care > Endocrinology
Planned IP Care
Planned IP Care > General Surgery
Related URLs:
Depositing User: Mrs Noomi Tyholdt-Pidgley
Date Deposited: 23 Oct 2020 15:22
Last Modified: 23 Oct 2020 15:22
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3559

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