The Changing Bariatric Surgery Landscape in the USA

Spaniolas, Konstantinos; Kasten, Kevin R.; Brinkley, Jason; Sippey, Megan; Mozer, Anthony B.; Chapman, William H.; Pories, Walter J.

doi:10.1007/s11695-015-1764-x

Cited by 94 publications

(50 citation statements)

References 8 publications

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“…There is a similar trend across all weight loss surgery centers in the USA [33]. However, our results, and those of other similar studies [4–13, 15–19, 21–24, 27], suggest a greater weight loss and/or improvement in obesity-related comorbidities including diabetes and hyperlipidemia, as well as similar rates of serious (grades II–III) complications with GB [14].…”

Section: Discussionsupporting

confidence: 85%

Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss

et al. 2016

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BackgroundThe purpose of the study was to compare weight loss, metabolic parameters, and postoperative complications in patients undergoing Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG).MethodsWe retrospectively studied 30-day postoperative complications as well as change in weight, blood pressure, cholesterol, hemoglobin, hemoglobin A1C, and creatinine from baseline to 2, 6, 12, and 24 months postoperatively in 383 patients undergoing GB and 336 patients undergoing SG at the University of Michigan from January 2008 to November 2013. For a study population which typically has high attrition rates, there were excellent follow-up rates (706/719 at 2 months, 566/719 at 6 months, 519/719 at 12 months, and 382/719 at 24 months).ResultsBaseline characteristics were similar in both groups except for higher weight and BMI in the SG group. The GB group experienced greater total body weight loss at 6, 12, and 24 months (41.9 vs. 34.6 kg at 24 months, p < 0.0001). Excess weight loss was 69.7 and 51.7 % following GB and SG respectively at 24 months (p < 0.0001). BP improved significantly in both groups. Surgical complication rates were greater after GB (10.1 vs. 3.5 %, p = 0.0007) with no significant difference in life-threatening or potentially life-threatening complications.ConclusionsWeight loss was greater following GB compared to SG at 2 years. The risk for surgical complications was greater following GB. Surgical intervention should be tailored to surgical risk, comorbidities, and desired weight loss.Electronic supplementary materialThe online version of this article (doi:10.1007/s11695-016-2265-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 85%

Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss

et al. 2016

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“…These changing trends in bariatric surgery are consistent with the changes observed worldwide such as in England, [2] the USA and Canada, [7,8] or the Asia-Pacific regions. [9] Data from Europe indicate that France is now the country with the highest bariatric surgery rate alongside with Belgium and Sweden.…”

Section: Discussionsupporting

confidence: 83%

Current challenges in providing bariatric surgery in France

et al. 2016

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Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d’Information Inter-régimes de l’Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure. All types of primary bariatric procedures (Roux-en-Y gastric bypass [RYGB] or omega loop, adjustable gastric banding [AGB], or longitudinal sleeve gastrectomy [LSG]) performed during 2011 to 2013 were systematically recorded. Surgical techniques performed by region of residence and age-range relative risks with 95% confidence intervals of undergoing LSG or RYGB versus AGB were computed.In 2013, LSG was performed more frequently than RYGB and AGB (57% vs 31% and 13%, respectively). A total of 41,648 patients underwent a bariatric procedure; they were predominantly female (82%) with a mean (±standard deviation) age of 40 (±12) years and a body mass index ≥40 kg/m2 for 68% of them. A total of 114 procedures were performed in patients younger than 18 years and 2381 procedures were performed in patients aged 60 years and older. Beneficiaries of the French universal health insurance coverage for low-income patients were more likely to undergo surgery than the general population. Large nationwide variations were observed in the type choice of bariatric surgical procedures. Significant positive predictors for undergoing RYGB compared to those for undergoing AGB were as follows: referral to a center performing a large number of surgeries or to a public hospital, older age, female gender, body mass index ≥50 kg/m2, and treatment for obstructive sleep apnea syndrome, diabetes, or depression. Universal health insurance coverage for low-income patients was inversely correlated with the probability of RYGB.Differences in access to surgery have been observed in terms of the patient's profile, geographical variations, and predictors of types of procedures. Several challenges must be met when organizing the medical care of this growing number of patients, when delivering surgery through qualified centers while assuring the quality of long-term follow-up for all patients.

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“…Additionally, many of the post‐operative studies ( n = 4) included primarily Roux‐en‐Y gastric bypass surgeries. Sleeve gastrectomy surgery, however, is now the most commonly performed bariatric surgery in the USA . Only four studies included more than one bariatric surgery ; two of which had particularly small sample sizes ( n = 44 and n = 50), making surgical comparisons difficult.…”

Section: Discussionmentioning

confidence: 99%

Food addiction and bariatric surgery: a systematic review of the literature

2017

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Emerging research suggests that rates of food addiction are high among individuals seeking bariatric surgery, but little is known about associated features and the prognostic significance of pre-operative food addiction. Thus, this article provides a systematic review and synthesis of the literature on food addiction and bariatric surgery. Articles were identified through PubMed and SCOPUS databases, resulting in a total of 19 studies which assessed food addiction among pre- and/or post-bariatric surgery patients using the Yale Food Addiction Scale. Most studies were cross-sectional and only two studies prospectively measured food addiction both pre-and post-operatively. The presence of pre-surgical food addiction was not associated with pre-surgical weight or post-surgical weight outcomes, yet pre-surgical food addiction was related to broad levels of psychopathology. The relationship between food addiction and substance misuse among individuals undergoing bariatric surgery is mixed. In addition, very few studies have attempted to validate the construct of food addiction among bariatric surgery patients. Results should be interpreted with caution due to the methodological limitations and small sample sizes reported in most studies. Future rigorous research with larger and more diverse samples should prospectively examine the clinical utility and validity of the food addiction construct following bariatric surgery.

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The Changing Bariatric Surgery Landscape in the USA

Cited by 94 publications

References 8 publications

Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss

Roux-En-Y Gastric Bypass Vs. Sleeve Gastrectomy: Balancing the Risks of Surgery with the Benefits of Weight Loss

Current challenges in providing bariatric surgery in France

Food addiction and bariatric surgery: a systematic review of the literature

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