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Weight loss before bariatric surgery linked to shorter hospital stay, faster weight loss
October 16, 2007High-risk morbidly obese patients who lose 5 to 10 percent of their excess body weight before undergoing gastric bypass surgery appear to have shorter hospital stays and more rapid postoperative weight loss, according to a report in the October issue of Archives of Surgery, a theme issue on bariatric surgery.
Bariatric surgery is an effective long-term treatment for morbidly obese patients with co-occurring medical problems, according to background information in the article. "To that end, older and higher-risk patients with multiple uncontrolled medical problems (such as diabetes mellitus, obstructive sleep apnea, steatohepatitis [liver inflammation], degenerate joint disease, venous stasis disease [loss of vein function in the legs] and cardiopulmonary vascular disease) are opting for bariatric surgery," the authors write. "Moreover, patients are seeking referral for bariatric surgery when the disease burden from their comorbidities eliminates meaningful quality of life." These patients may face more complications following surgery.
Christopher D. Still, D.O., and colleagues at Geisinger Health System, Danville, Penn., assessed patients who underwent open or laparoscopic gastric bypass surgery between 2002 and 2006. "Patients were required to participate in a standardized multidisciplinary preoperative program that encompasses medical, psychological, nutritional and surgical interventions and education," the authors write. "In addition, patients were encouraged to achieve a 10 percent loss of excess body weight prior to surgical intervention."
Of the 884 patients (average age 45), 169 (19 percent) lost 5 to 10 percent of their excess body weight prior to the operation and 425 (48 percent) lost 10 percent or more of excess weight prior to the operation. Those who lost more than 5 percent were less likely to stay in the hospital longer than four days, whereas those who lost more than 10 percent of their excess weight before surgery were more than twice as likely to have lost 70 percent of excess weight one year afterward, compared with those who lost between none and 5 percent of their excess pounds before surgery.
The authors speculate that physiologic improvements associated with weight loss decreased surgical complications, reducing the length of hospital stay. "Numerous reports have confirmed the beneficial effects of even limited weight loss on co-morbid medical conditions, such as hypertension [high blood pressure], diabetes mellitus, degree of visceral [among internal organs] fat, liver size, thromboembolism [blood clot] predisposition and severity of sleep apnea," the authors write. "Additional studies will be required to pinpoint which comorbidity (or comorbidities) is responsible for reduced lengths of stay."
In addition, further research is needed to determine how preoperative weight loss could help with long-term weight loss following surgery, they note.
JAMA and Archives Journals
Of the 884 patients (average age 45), 169 (19 percent) lost 5 to 10 percent of their excess body weight prior to the operation and 425 (48 percent) lost 10 percent or more of excess weight prior to the operation. Those who lost more than 5 percent were less likely to stay in the hospital longer than four days, whereas those who lost more than 10 percent of their excess weight before surgery were more than twice as likely to have lost 70 percent of excess weight one year afterward, compared with those who lost between none and 5 percent of their excess pounds before surgery.
The authors speculate that physiologic improvements associated with weight loss decreased surgical complications, reducing the length of hospital stay. "Numerous reports have confirmed the beneficial effects of even limited weight loss on co-morbid medical conditions, such as hypertension [high blood pressure], diabetes mellitus, degree of visceral [among internal organs] fat, liver size, thromboembolism [blood clot] predisposition and severity of sleep apnea," the authors write. "Additional studies will be required to pinpoint which comorbidity (or comorbidities) is responsible for reduced lengths of stay."
In addition, further research is needed to determine how preoperative weight loss could help with long-term weight loss following surgery, they note.
JAMA and Archives Journals
Bariatric Surgery Current Events and Bariatric Surgery News RSSDiabetes surgery summit consensus lays foundation for new field of medicine
A first-of-its-kind consensus statement on diabetes surgery is published online today in the Annals of Surgery.
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Americans continue to get heavier. Most weight control methods short of bariatric surgery are generally considered ineffective in preventing obesity or reducing weight.
Addressing obesity via the 'energy gap'
The November issue of the Journal of the American Dietetic Association features a commentary by James O. Hill, an honorary ADA member, professor of pediatrics and medicine and director of the Center for Human Nutrition at the University of Colorado-Denver.
'Superobesity,' chronic disease burden associated with risk of death following bariatric surgery
Veterans classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.
NIH study finds low short-term risks after bariatric surgery for extreme obesity
Short-term complications and death rates were low following bariatric surgery to limit the amount of food that can enter the stomach, decrease absorption of food or both, according to the Longitudinal Assessment of Bariatric Surgery (LABS-1).
Study: Bariatric surgery patients have 67 percent lower chance of complications at top hospitals
The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals.
A simpler definition for major depressive disorder
Researchers from Rhode Island Hospital's department of psychiatry propose that the definition for major depressive disorder (MDD) should be shortened to include only the mood and cognitive symptoms that have been part of the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for the past 35 years.
Roux-en-Y weight loss surgery raises kidney stone risk
The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study.
Physiological response may explain why some severely obese patients overeat
Don't feel like you are getting full when eating a large meal? New research from The Miriam Hospital suggests that a physiological response may partially explain why severely obese individuals may not feel satisfied after eating and often have difficulty controlling the amount of food they consume during a meal.
Waiting times too long for bariatric surgery
Obesity is now acknowledged as a chronic disease with a number of related complications, and its prevalence has reached alarming epidemic proportions.
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