TITLE

Does a preoperative medically supervised weight loss program improve bariatric surgery outcomes? A pilot randomized study

AUTHOR(S)
Parikh, Manish; Dasari, Meena; McMacken, Michelle; Ren, Christine; Fielding, George; Ogedegbe, Gbenga
PUB. DATE
March 2012
SOURCE
Surgical Endoscopy;Mar2012, Vol. 26 Issue 3, p853
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Many insurance payors mandate that bariatric surgery candidates undergo a medically supervised weight management (MSWM) program as a prerequisite for surgery. However, there is little evidence to support this requirement. We evaluated in a randomized controlled trial the hypothesis that participation in a MSWM program does not predict outcomes after laparoscopic adjustable gastric banding (LAGB) in a publicly insured population. Methods: This pilot randomized trial was conducted in a large academic urban public hospital. Patients who met NIH consensus criteria for bariatric surgery and whose insurance did not require a mandatory 6-month MSWM program were randomized to a MSWM program with monthly visits over 6 months (individual or group) or usual care for 6 months and then followed for bariatric surgery outcomes postoperatively. Demographics, weight, and patient behavior scores, including patient adherence, eating behavior, patient activation, and physical activity, were collected at baseline and at 6 months (immediately preoperatively and postoperatively). Results: A total of 55 patients were enrolled in the study with complete follow-up on 23 patients. Participants randomized to a MSWM program attended an average of 2 sessions preoperatively. The majority of participants were female and non-Caucasian, mean age was 46 years, average income was less than $20,000/year, and most had Medicaid as their primary insurer, consistent with the demographics of the hospital's bariatric surgery program. Data analysis included both intention-to-treat and completers' analyses. No significant differences in weight loss and most patient behaviors were found between the two groups postoperatively, suggesting that participation in a MSWM program did not improve weight loss outcomes for LAGB. Participation in a MSWM program did appear to have a positive effect on physical activity postoperatively. Conclusion: MSWM does not appear to confer additional benefit as compared to the standard preoperative bariatric surgery protocol in terms of weight loss and most behavioral outcomes after LAGB in our patient population.
ACCESSION #
71107849

 

Related Articles

  • Prospective evaluation and 7-year follow-up of Swedish adjustable gastric banding in adults with extreme obesity. Balsiger, Bruno M.; Ernst, Daniel; Giachino, Daniel; Bachmann, Ruedi; Glaettli, Andreas // Journal of Gastrointestinal Surgery;Nov2007, Vol. 11 Issue 11, p1470 

    Background: Swedish adjustable gastric banding (SAGB) is a widespread laparoscopic procedure in bariatric surgery. Few long-term data is available.Aim: To determine long-term outcome after SAGB in 196 patients studied prospectively.Patients and Methods: 196...

  • Should you go under the knife to slim down? Birnbaum, Cara // All You;12/17/2010, Vol. 7 Issue 12, p63 

    This article focuses on weightloss surgery. The most common weightloss surgeries are gastric bypass, which involves stapling the stomach down to a fraction of its normal size, and gastric banding, which arrived with the Lap-Band. The procedures help people lessen the risk of developing...

  • Changes in Eating Behavior After Laparoscopic Adjustable Gastric Banding: A Systematic Review of the Literature. Dodsworth, Alison; Warren-Forward, Helen; Baines, Surinder // Obesity Surgery;Nov2010, Vol. 20 Issue 11, p1579 

    This systematic review evaluates the current evidence base for eating behavior changes after laparoscopic adjustable gastric banding (LAGB). A literature search from 1990 to February 2010 was conducted to identify original studies that assessed eating behavior in adults who have undergone LAGB....

  • Revision of Laparoscopic Adjustable Gastric Banding: Success or Failure? Vijgen, G.; Schouten, R.; Pelzers, L.; Greve, J.; Helden, S.; Bouvy, N. // Obesity Surgery;Feb2012, Vol. 22 Issue 2, p287 

    Background: Laparoscopic adjustable gastric banding (LAGB) is a safe and frequently performed bariatric procedure. Unfortunately, re-operations are often necessary. Reports on the success of revisional procedures are scarce and show variable results, either supporting or declining the idea of...

  • Bypass better than banding for improving weight loss. Robinson, Stephen // GP: General Practitioner;2/25/2011, p10 

    The article reports that according to a research conducted by University of California researchers, gastric bypass is more effective than gastric banding at helping people lose weight and there is very less risk of complications and improves quality of life of patients. It states that gastric...

  • THIS MONTH'S TECHNIQUE: How to Convert an Adjustable Gastric Band Procedure to a Roux-en-Y Gastric Bypass.  // Bariatric Times;Mar2013, Vol. 10 Issue 3, p16 

    The article offers steps on how to convert a laparoscoping adjustable gastric band (LAGB) procedure to a Roux-en-Y gastric bypass (RYGB). They include taking down of the anterior placation, creating a gastric pouch and creating the gastrojejunostomy. It suggests that weight loss is superior when...

  • Ghrelin and Apolipoprotein AIV Levels Show Opposite Trends to Leptin Levels During Weight Loss in Morbidly Obese Patients. Pardina, E.; López-Tejero, M. D.; Llamas, R.; Catalán, R.; Galard, R.; Allende, H.; Vargas, V.; Lecube, A.; Fort, J. M.; Baena-Fustegueras, J. A.; Peinado-Onsurbe, J. // Obesity Surgery;Oct2009, Vol. 19 Issue 10, p1414 

    The article describes a study that analyzed the effects of bariatric surgery on plasma satiety factors such as leptin, ghrelin, and apolipoprotein. Results revealed higher values of leptin and lower levels of ghrelin levels in the morbidly obese group than in normal weight person while...

  • Hastings HELP clinic offers lap band surgery. CUSTER, JAMI // Native American Times;12/18/2009, Vol. 15 Issue 50, p7 

    The article focuses on the lap band surgery offering of Cherokee Nation W.W. Hastings as part of their Healthy Eating for Life Program. The two types of weight loss surgery being offered include restrictive procedures that could decrease food intake and the malabsorptive procedures to alter...

  • Axis I Disorders in Adjustable Gastric Band Patients: the Relationship Between Psychopathology and Weight Loss. Hayden, M.; Murphy, K.; Brown, W.; O'Brien, P. // Obesity Surgery;Sep2014, Vol. 24 Issue 9, p1469 

    Background: Bariatric surgery candidates have higher rates of co-morbid psychological illnesses than those in the general population. The effect of weight loss on these illnesses is unclear. Methods: This prospective observational study explored psychiatric co-morbidities and weight loss...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics