Substantial Decrease in Comorbidity 5 Years After Gastric Bypass

Sundbom, Magnus; Hedberg, Jakob; Marsk, Richard; Boman, Lars; Bylund, Ami; Hedenbro, Jan; Laurenius, Anna; Lundegårdh, Göran; Möller, Peter; Olbers, Torsten; Ottosson, Johan; Näslund, Ingmar; Näslund, Erik

doi:10.1097/sla.0000000000001920

Cited by 84 publications

(31 citation statements)

References 19 publications

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“…Gastric bypass surgery is a safe and effective treatment for morbid obesity [ 1 , 2 ]. Mean weight loss remains high even after long-term follow-up [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The association between socioeconomic factors and weight loss 5 years after gastric bypass surgery

et al. 2020

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Introduction Patients with low socioeconomic status have been reported to have poorer outcome than those with a high socioeconomic status after several types of surgery. The influence of socioeconomic factors on weight loss after bariatric surgery remains unclear. The aim of the present study was to evaluate the association between socioeconomic factors and postoperative weight loss. Materials and methods This was a retrospective, nationwide cohort study with 5-year follow-up data for 13,275 patients operated with primary gastric bypass in Sweden between January 2007 and December 2012 (n = 13,275), linking data from the Scandinavian Obesity Surgery Registry, Statistics Sweden, the Swedish National Patient Register, and the Swedish Prescribed Drugs Register. The assessed socioeconomic variables were education, profession, disposable income, place of residence, marital status, financial aid and heritage. The main outcome was weight loss 5 years after surgery, measured as total weight loss (TWL). Linear regression models, adjusted for age, preoperative body mass index (BMI), sex and comorbid diseases were constructed. Results The mean TWL 5 years after surgery was 28.3 ± 9.86%. In the adjusted model, first-generation immigrants (%TWL, B −2.4 [95% CI −2.9 to −1.9], p < 0.0001) lost significantly less weight than the mean, while residents in medium-sized (B 0.8 [95% CI 0.4–1.2], p = 0.0001) or small towns (B 0.8 [95% CI 0.4–1.2], p < 0.0001) lost significantly more weight. Conclusions All socioeconomic groups experienced improvements in weight after bariatric surgery. However, as first-generation immigrants and patients residing in larger towns (>200,000 inhabitants) tend to have inferior weight loss compared to other groups, increased support in the pre- and postoperative setting for these two groups could be of value. The remaining socioeconomic factors appear to have a weaker association with postoperative weight loss.

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“…Gastric bypass surgery is a safe and effective treatment for morbid obesity [ 1 , 2 ]. Mean weight loss remains high even after long-term follow-up [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The association between socioeconomic factors and weight loss 5 years after gastric bypass surgery

et al. 2020

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“…1,23 In the present cohort, BMI and HbA 1c concentration were reduced in the GBP group 1 year postoperatively compared with the controls, in accordance with published 5-year results on approximately 25 000 patients from the SOReg who underwent GBP. 8 The rapid improvement in metabolic control after bariatric surgery may entail a risk for paradoxical deterioration in preexisting DR. 24,25 In the Diabetes Control and Complications Trial, 13.1% of 711 patients with type 1 diabetes in the intensive treatment group had early worsening of DR compared with 7.6% of 728 patients in the conventional treatment group. 26 More re-cently, in the clinical trial evaluating semaglutide (SUSTAIN [Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes]), a glucagon-like peptide-1 receptor agonist for the treatment of diabetes, a significant increase in the risk for DR complications was observed compared with placebo.…”

Section: Discussionmentioning

confidence: 99%

Association of Gastric Bypass Surgery With Risk of Developing Diabetic Retinopathy Among Patients With Obesity and Type 2 Diabetes in Sweden

Åkerblom¹,

Franzén

Zhou

et al. 2021

JAMA Ophthalmol

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incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients.OBJECTIVE To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP.DESIGN, SETTING, AND PARTICIPANTS Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007)(2008)(2009)(2010)(2011)(2012)(2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019.EXPOSURE Gastric bypass surgery. MAIN OUTCOMES AND MEASURESIncidence of new DR and other diabetic ocular complications. RESULTSThe study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A 1c concentration at baseline were 42.0 (5.7) and 7.6% (1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5% (1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P < .001). The dominant risk factors for development of DR at baseline were diabetes duration, hemoglobin A 1c concentration, use of insulin, glomerular filtration rate, and BMI.CONCLUSIONS AND RELEVANCE This nationwide matched cohort study suggests that there is a reduced risk of developing new DR associated with GBP, and no evidence of an increased risk of developing DR that threatened sight or required treatment.

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“…If symptoms remain -or new ones emerge -several years postoperatively, this may lead to disappointment and a feeling of hopelessness. Rumination, a type of emotion-focused coping with a repetitive focus on possible causes and consequences of ambiguous symptoms, has been found to predict the severity of depressive symptoms (28) .…”

Section: Discussionmentioning

confidence: 99%

Associations between perceived somatic symptoms and mental health after Roux-en-Y gastric bypass: a 3-year prospective cohort study

Kvalem

Bårdstu

Bergh³

et al. 2020

Surgery for Obesity and Related Diseases

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BackgroundPreoperative anxiety, and to some extent depression, predict the perceived impact of somatic symptoms (such as dumping, pain, and fatigue) one year after Roux-en-Y gastric bypass (RYGB). Negative attention to and interpretation of somatic symptoms may thus be associated with post-operative changes in affect. ObjectivesThe aim of this study was to explore whether preoperative anxiety and depressive symptoms predicted the perceived impact of somatic symptoms three years after RYGB.Secondly, we aimed to examine the three-year trajectory of depressive and anxiety symptoms, and their interaction with perceived somatic symptoms postoperatively. SettingUniversity hospital. MethodsPre-surgery, 1-, and 3-years post-surgery data were collected from 169 participants (62.4% follow-up). A cross-lagged, autoregressive regression analysis was employed to examine the mutual interaction of trajectories over the follow-up period. ResultsFatigue (30.8%) and dumping (23.7%) were common high-impact symptoms three years postoperatively. Pre-surgery anxiety was associated with higher impact of fatigue (p<.001), pain (p<.001), and diarrhea (p<.001), while pre-surgery depressive mood was related to reporting higher impact of diarrhea (p<.01) at 3-year follow-up. Higher anxiety/depression symptoms were related to higher perceived total symptom impact at one and three years postoperatively, controlling for percent total weight loss. Higher impact of somatic symptoms at one-year post-surgery predicted a significant increase in depressive symptoms 3-years postsurgery. ConclusionHigher perceived total symptom burden (pain, fatigue, dumping, diarrhea, and vomiting) at one-year post-surgery predicted increase in depression over the next two years. The results underscore the importance of managing somatic symptoms after surgery to prevent patients' distress..

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Substantial Decrease in Comorbidity 5 Years After Gastric Bypass

Cited by 84 publications

References 19 publications

The association between socioeconomic factors and weight loss 5 years after gastric bypass surgery

The association between socioeconomic factors and weight loss 5 years after gastric bypass surgery

Association of Gastric Bypass Surgery With Risk of Developing Diabetic Retinopathy Among Patients With Obesity and Type 2 Diabetes in Sweden

Associations between perceived somatic symptoms and mental health after Roux-en-Y gastric bypass: a 3-year prospective cohort study

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