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The Metabolic Medicine Postoperative Bariatric Surgery Consultation
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Not surprisingly, insulin resistance improves steadily as a patient loses body fat. For the bariatric patient, this will be most dramatic within the first 3 months after surgery and continue for the first 12–24 months. However, it is important to note that the rate of improvement may vary depending on the loss of fat from different depot regions in the body (i.e., liver, muscle, visceral, SC).
Surgical Treatments of Obesity
Published in Ruth Chambers, Paula Stather, Tackling Obesity and Overweight Matters in Health and Social Care, 2022
Surgery is a treatment option in severely obese individuals who have failed non-surgical treatment and who have consented to surgery following thorough assessment, screening and counselling. Bariatric surgery is an extremely effective method for long-term weight management if noninvasive approaches have failed. ‘Bariatrics’ is the term given to the branch of medicine involving the management of obesity. Bariatric surgery for obesity is more effective than other modalities at maintaining weight loss. Over the last decade, surgical treatment of obesity is also termed ‘metabolic’ surgery, as the surgery deals with several metabolic conditions, such as diabetes, non-alcoholic fatty liver disease (NAFLD) and others.
Polycystic ovarian syndrome, metabolic syndrome, and obesity in pregnancy
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Bariatric surgeries can be classified into either restrictive (e.g., adjustable laparoscopic band (lap band), sleeve gastrectomy) or malabsorptive (e.g., Roux-en-Y gastric bypass, biliopancreatic diversion with duodenal switch). More nutrient deficiencies are seen after malabsorptive surgeries and medication absorption may also be impaired.
Low dose of liraglutide combined with metformin leads to a significant weight loss in Chinese Han women with polycystic ovary syndrome: a retrospective study
Published in Gynecological Endocrinology, 2023
Xuefeng Long, Hengwei Liu, Wenqian Xiong, Wenjin Li, Haitang He, Tian Fu, Xiaoou Li, Chunyan Chen, Ling Zhang, Yi Liu
Even a modest weight loss of 5–10% may improve reproductive and metabolic profile [5]. Nowadays, ways to lose weight include lifestyle interventions, medication, and bariatric surgery. Lifestyle interventions is the first line of treatments but is not sustainable in daily life as many women usually regain lost weight because of poor compliance [11,12]. Bariatric surgery is an effective way and usually reserved for patients with a body mass index (BMI) >40 kg/m2 or with BMI >35 kg/m2 and one or more significant comorbid conditions, when nonsurgical methods of weight loss have failed. But bariatric surgery may cause nutritional deficiencies and other postoperative complications [13]. As for pharmacological interventions, metformin is an established treatment for PCOS with good safety and toleration. As an insulin sensitizer, it can not only improve insulin resistance significantly, but also has effects on menstrual disorders, anovulation, metabolic, and cardiovascular abnormalities [14,15]. However, some meta-analysises show its effect on weight loss with lifestyle changes always unsatisfactory [16].
Translation and validation of a Swedish version of the BODY-Q: a patient-reported outcome instrument for weight loss and body contouring surgery
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Monika Fagevik Olsén, Christina Biörserud, Micheline Al Nouh, Trude Staalesen, Anna Elander
To evaluate the criterion validity, questionnaires from 30 subjects were required for applicable analyses. Subjects with known excess skin after massive weight loss were, therefore, identified from the waiting list after referral to the department of Plastic Surgery for abdominoplasty because of excess skin. A convenience sample of forty-nine were invited by mail and sent the two questionnaires, BODY-Q and SESQ. If there was no response, one reminder was posted. Thirty patients (61%) of them returned the questionnaires. They were an average age of 48.6 years (min 26 and max 67 years), had a current body mass index (BMI) of 33.6 kg/m2 (min 22.9 and max 44.3) and maximal BMI of 49.6 kg/m2 (min 38.2 and max 81.5). All but one had undergone bariatric surgery, the last one had lost weight through diet. The average time since bariatric surgery was 6.9 years (1–17 years).
Announcement of an updated Belgian consensus on the assessment and management of obesity
Published in Acta Clinica Belgica, 2020
Bart Van Der Schueren, Inge Gies, Marie Barea, Matthias Lannoo, Veronique Beauloye, Roland Devlieger, Eveline Dirinck, Barbara Lembo, Dirk Vissers, An Verrijken, Jean-Paul Thissen
Firstly, the surge in number of bariatric surgery patients over the last years, together with a better understanding on the physiological effects of these surgical procedures, has urged a need to clearly define pre- and post-operative procedures that require a multidisciplinary team. The consensus now presents recommendations on what specialists are needed in these bariatric surgery teams, along with their specific roles before, during and after surgery. The optimal follow-up for bariatric surgery patients is also suggested, together with details on expected surgery outcomes (in terms of co-morbidities, weight loss, and gastrointestinal, survival, psychosocial and well-being aspects). Nutritional management, psychological care and physical activity interventions after bariatric surgery are also detailed.