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https://www.readbyqxmd.com/read/29156188/addressing-obesity-in-aging-patients
#1
REVIEW
John A Batsis, Alexandra B Zagaria
Obesity in older adults affects not only morbidity and mortality but, importantly, quality of life and the risk of institutionalization. Weight loss interventions can effectively lead to improved physical function. Diet-alone interventions can detrimentally affect muscle and bone physiology and, without interventions to affect these elements, can lead to adverse outcomes. Understanding social and nutritional issues facing older adults is of utmost importance to primary care providers. This article will also discuss the insufficient evidence related to pharmacotherapy as well as providing an overview of using physiologic rather than chronologic age for identifying suitable candidates for bariatric surgery...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156184/bariatric-surgery-for-obesity
#2
REVIEW
Carel W le Roux, Helen M Heneghan
In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156183/medical-devices-for-obesity-treatment-endoscopic-bariatric-therapies
#3
REVIEW
Eric J Vargas, Monika Rizk, Fateh Bazerbachi, Barham K Abu Dayyeh
Endoscopic bariatric therapies (EBTs) are effective tools for the management of obesity. By mimicking restrictive and bypass surgery physiology, they provide a safe and effective treatment option with the added capabilities of reaching a broader population. Multiple efficacious medical devices, such as intragastric balloons, endoscopic suturing/plication devices, and bypass liners, at various stages of development are available in the United States. EBTs represent the newest addition to a multidisciplinary approach in obesity management...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29153379/bariatric-patients-reported-motivations-for-surgery-and-their-relationship-to-weight-status-and-health
#4
Jessica C Peacock, Levi Perry, Kyle Morien
BACKGROUND: Literature on patient motivation for bariatric surgery remains limited. A few studies have examined relation to outcomes and found no established connection between motivation and weight loss. SETTING: A retrospective convenience sample of 345 participants was recruited from an obesity support website to complete an online survey. METHODS: Content analysis was used to describe motivations for surgery, and analysis of variance and covariance were completed to compare groups of participants created from the qualitative analysis on pre- and postsurgical factors like body mass index, number of co-morbidities, and percentage of excess weight loss...
October 12, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29153006/effect-of-bariatric-surgery-on-diabetic-nephropathy-in-obese-type-2-diabetes-patients-in-a-retrospective-2-year-study-a-local-pilot
#5
Anthony Tl Chao, Sum Chee Fang, Benjamin Cc Lam, Anton Ks Cheng, Serena Km Low, Lim Su Chi
PURPOSE: To determine the effects of bariatric surgery on albuminuria in obese patients with type 2 diabetes mellitus. METHODS: Retrospective analyses of clinical records of obese patients with type 2 diabetes mellitus who had either micro- or macroalbuminuria and had undergone various bariatric surgery were retrieved from a local hospital database. Their clinical data from follow-up appointments including albuminuria were analysed. RESULTS: Of the 46 subjects with type 2 diabetes mellitus, 15 subjects had diabetic nephropathy and had pre- and post-bariatric surgery urine albumin-to-creatinine ratio or urine protein-to-creatinine ratio data available for analysis; 13 out of the 15 subjects (86...
November 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/29152299/gastrointestinal-stromal-tumor-an-incidental-finding-during-laparoscopic-bariatric-surgery
#6
Shireesh Saurabh
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Lack of clinical symptoms and findings on preoperative upper endoscopy makes its diagnosis difficult in bariatric patients. A laparoscopic resection of the gastric GIST during bariatric surgery is associated with good long-term prognosis.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29152218/recent-advances-in-understanding-managing-type-2-diabetes-mellitus
#7
REVIEW
Pablo Aschner
The treatment of type 2 diabetes mellitus has evolved in the present century toward safer and maybe more effective drugs, which in some cases can also reduce the risk of cardiovascular and renal outcomes. Nevertheless, we still need better strategies to reduce excess body weight in order to achieve diabetes remission, which is now a feasible target, as has been demonstrated with bariatric surgery. This review focuses on the significant advances in the management of blood glucose in type 2 diabetes mellitus, including the current understanding of the mechanisms of drug action but keeping in mind that the treatment of the disease is multifactorial...
2017: F1000Research
https://www.readbyqxmd.com/read/29151717/bariatric-surgery-a-perspective-for-primary-care
#8
Scott Kizy, Cyrus Jahansouz, Keith Wirth, Sayeed Ikramuddin, Daniel Leslie
IN BRIEF Bariatric surgery is the most efficacious treatment for obesity, type 2 diabetes, and other obesity-related comorbidities. In this article, the authors review the current indications for bariatric surgery and discuss the most commonly performed procedures. They analyze medical outcomes of bariatric procedures by reviewing key prospective trials and discuss changes in physiology after these procedures. They conclude by discussing long-term management of bariatric patients by reviewing current guidelines for nutritional support and listing common complications related to these procedures...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151716/endoscopic-medical-devices-for-primary-obesity-treatment-in-patients-with-diabetes
#9
Shelby Sullivan
IN BRIEF Several new endoscopic bariatric therapies have been approved by the U.S. Food and Drug Administration for the treatment of obesity, with many more devices and procedures undergoing investigational studies. This article describes these devices and procedures and special considerations for their use in patients with diabetes.
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151591/us-health-policy-and-prescription-drug-coverage-of-fda-approved-medications-for-the-treatment-of-obesity
#10
G Gomez, F C Stanford
OBJECTIVE: Obesity is now the most prevalent chronic disease in the United States, which amounts to an estimated $147 billion in health care spending annually. The Affordable Care Act (ACA) enacted in 2010, included provisions for private and public health insurance plans that expanded coverage for lifestyle/behavior modification and bariatric surgery for the treatment of obesity. Pharmacotherapy, however, has not been included despite their evidence-based efficacy. We set out to investigate the coverage of FDA-approved medications for obesity within Medicare, Medicaid, and ACA-established marketplace health insurance plans...
November 20, 2017: International Journal of Obesity: Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/29151242/a-qualitative-examination-of-increased-alcohol-use-after-bariatric-surgery-among-racially-ethnically-diverse-young-adults
#11
Christine E Spadola, Eric F Wagner, Leah M Varga, Jennifer L Syvertsen, Nestor F De La Cruz Munoz, Sarah E Messiah
INTRODUCTION: Mounting evidence suggests that bariatric surgery, or weight loss surgery (WLS), patients might be vulnerable to developing post-operative alcohol use problems. While the majority of published research offers information concerning the prevalence of problematic alcohol use post-WLS, the literature lacks comprehensive, qualitative explorations examining why alcohol misuse might emerge after WLS. Such data-driven hypotheses are needed to effectively target this emerging concern...
November 19, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29150393/considerations-regarding-sarcoidosis-in-the-bariatric-surgical-patient
#12
Kimberly A Kilby, Colleen M Kilbourne, Marc A Judson, Daniel J Bonville, Scott H Beegle
The sarcoidosis patient who seeks surgical management for obesity presents many challenges. The interaction between sarcoidosis and obesity complicates both disorders and creates special issues to consider when contemplating surgery. This manuscript will review the approach to pre- and postoperative management of the sarcoidosis patient undergoing bariatric surgery.
October 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29150392/improvement-in-quality-of-life-after-bariatric-surgery-sleeve-versus-bypass
#13
Dirk P A Versteegden, Magaly J J Van Himbeeck, Simon W Nienhuijs
BACKGROUND: Obesity is steadily growing to be the largest threat to human health in this century, not only increasing prevalence of obesity-related co-morbidity but also impairing health-related quality of life (QoL). Bariatric surgery has shown to improve co-morbidity as well as QoL. OBJECTIVES: To assess the differences in improvement in QoL for the 2 most performed procedures: laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB)...
October 16, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29150223/do-factors-related-to-participation-in-physical-activity-change-following-restrictive-bariatric-surgery-a-qualitative-study
#14
Juliana Zabatiero, Anne Smith, Kylie Hill, Jeffrey M Hamdorf, Susan F Taylor, Martin S Hagger, Daniel F Gucciardi
AIMS: To explore participants' ability to participate in physical activity (PA), and barriers and facilitators to PA, at 12 months following restrictive bariatric surgery, and how these differed from participants' pre-surgery perceptions. Motivators for PA post-surgery were also explored. METHODS: Qualitative one-on-one in-depth interviews were conducted pre- and 12 months post-surgery. Data were analysed using inductive thematic analysis. RESULTS: Fourteen adults (12 females), with a mean (range) age of 41...
November 14, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/29150037/esophagectomy-after-weight-reduction-surgery
#15
REVIEW
Katy A Marino, Benny Weksler
Obesity is now epidemic worldwide, and an increasing number of patients have undergone a weight-loss procedure. Although obesity is a risk factor for esophageal cancer, there are few reports on esophagectomy after bariatric procedures. Careful understanding of the patient's gastroesophageal anatomy as a result of the bariatric procedure and attention to the creation of the esophageal replacement conduit are fundamental for the success of esophagectomy after bariatric surgery.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29146657/a-randomised-controlled-trial-of-a-duodenal-jejunal-bypass-sleeve-device-endobarrier-compared-with-standard-medical-therapy-for-the-management-of-obese-subjects-with-type-2-diabetes-mellitus
#16
Michael Alan Glaysher, Aruchuna Mohanaruban, Christina Gabriele Prechtl, Anthony P Goldstone, Alexander Dimitri Miras, Joanne Lord, Navpreet Chhina, Emanuela Falaschetti, Nicholas Andrew Johnson, Werd Al-Najim, Claire Smith, Jia V Li, Mayank Patel, Ahmed R Ahmed, Michael Moore, Neil Poulter, Stephen Bloom, Ara Darzi, Carel Le Roux, James P Byrne, Julian P Teare
INTRODUCTION: The prevalence of obesity and obesity-related diseases, including type 2 diabetes mellitus (T2DM), is increasing. Exclusion of the foregut, as occurs in Roux-en-Y gastric bypass, has a key role in the metabolic improvements that occur following bariatric surgery, which are independent of weight loss. Endoscopically placed duodenal-jejunal bypass sleeve devices, such as the EndoBarrier (GI Dynamics, Lexington, Massachusetts, USA), have been designed to create an impermeable barrier between chyme exiting the stomach and the mucosa of the duodenum and proximal jejunum...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146227/bariatric-surgery-improves-lipoprotein-profile-in-morbidly-obese-patients-by-reducing-ldl-cholesterol-apob-and-saa-pon1-ratio-increasing-hdl-cholesterol-but-has-no-effect-on-cholesterol-efflux-capacity
#17
Christian Abendstein Kjellmo, Helen Karlsson, Torunn K Nestvold, Stefan Ljunggren, Karin Cederbrant, Maritha Marcusson-Ståhl, Monica Mathisen, Knut Tore Lappegård, Anders Hovland
BACKGROUND: Bariatric surgery has been shown to reduce cardiovascular events and cause-specific mortality for coronary artery disease in obese patients. Lipoprotein biomarkers relating to low-density lipoprotein (LDL), high-density lipoprotein (HDL), their subfractions, and macrophage cholesterol efflux have all been hypothesized to be of value in cardiovascular risk assessment. OBJECTIVES: The objective of this study was to examine the effect of a lifestyle intervention followed by bariatric surgery on the lipid profile of morbidly obese patients...
November 8, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29145284/effectiveness-of-bariatric-surgical-procedures-a-systematic-review-and-network-meta-analysis-of-randomized-controlled-trials
#18
Jenny H Kang, Quang A Le
BACKGROUND: Bariatric surgery has proved to be an effective strategy in treating obesity. However, randomized controlled trials (RCTs) of 3 most common bariatric surgery procedures, Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric band (LAGB), reported inconsistent results. We performed a systematic review and network meta-analysis to synthesize evidence of effectiveness of the 3 common bariatric procedures from relevant RCTs. METHODS: The present study was a systematic review and network meta-analysis of RCTs...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#19
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144030/the-role-of-glucagon-in-weight-loss-mediated-metabolic-improvement-a-systematic-review-and-meta-analysis
#20
REVIEW
M P Silvestre, J P Goode, P Vlaskovsky, C McMahon, A Tay, S D Poppitt
Aims This meta-analysis aimed to investigate the role of glucagon suppression in regulating glucose homeostasis following diet or bariatric surgery. Methods A comprehensive search of intervention and observational studies was conducted in Medline, Scopus, Web of Science, PubMed and Embase. Random effects model meta-analysis was performed. Primary outcomes were (i) body weight change, (ii) fasting glucagon, (iii) fasting glucose and (iv) fasting insulin concentrations. Results Twenty articles reporting data from 29 interventions were eligible for analysis...
November 16, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
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