Weight loss during medical weight management does not predict weight loss after bariatric surgery: a retrospective cohort study.
Low-energy diet
Medical weight management
Postoperative weight loss
Preoperative weight loss
Weight loss
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
04
02
2020
revised:
01
05
2020
accepted:
29
06
2020
pubmed:
11
8
2020
medline:
28
4
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
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. 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. Multicenter community- and acute-based MWM services referring to one regional bariatric center, United Kingdom. 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. 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. 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.
Sections du résumé
BACKGROUND
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
OBJECTIVE
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
METHODS
Multicenter community- and acute-based MWM services referring to one regional bariatric center, United Kingdom.
METHODS
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
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
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.
Identifiants
pubmed: 32771426
pii: S1550-7289(20)30369-5
doi: 10.1016/j.soard.2020.06.049
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1723-1730Commentaires et corrections
Type : CommentIn
Informations de copyright
Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.