Are there really any predictive factors for a successful weight loss after bariatric surgery?
Are there really any predictive factors for a successful weight loss after bariatric surgery?
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DOI：
10.1186/s12902-020-0499-4
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发表时间：
2020-02-05
影响因子：
2.7
通讯作者：
Espinosa-Cardenas, Etual
中科院分区：
文献类型：
--
作者：
Cadena-Obando, Diego;Ramirez-Renteria, Claudia;Espinosa-Cardenas, Etual
背景目前，减肥手术是治疗严重肥胖及其代谢并发症的最有效方法;然而，15-35%接受减肥手术的患者没有达到减肥目标。这项研究的目的是确定在前12个月内没有达到50%或更多的过度减肥目标的患者比例，并确定与这种失败相关的因素。方法我们从2012年至2017年在我们机构接受减肥手术的130例重度肥胖患者中获得人口统计学，人体测量和生化信息。我们使用了身体活动，热量摄入和饮食组成的自我报告。当患者在手术后12个月减掉多余体重的50%或更多时，认为体重减轻不成功。我们比较了成功组和不成功组的特征，以找到与成功相关的因素。结果我们纳入了130例患者（平均年龄48 ± 9岁，81.5%为女性）。术后1年，26例（20%）EBW损失< 50%。手术不成功与年龄较大、既往高血压史、腹部手术或抑郁/焦虑相关，合并症和失业的数量也影响结果。这些患者减轻了足够的体重以改善他们的一些合并症，但他们更容易在手术后2年恢复体重。结论：五分之一接受减肥手术的患者可能没有减掉足够的体重，按照目前的标准被认为是成功的。一些患者可能会在短期内受益于手术，但他们更有可能在2年后恢复体重。影响这一结果的因素仍有争议，但可能是特定人群。尽早发现更有可能失败的患者对于制定额外的治疗策略至关重要，而不是剥夺他们手术的机会或等待体重重新增加。
Background Currently, bariatric surgery is the most effective treatment for severe obesity and its metabolic complications; however, 15-35% of the patients that undergo bariatric surgery do not reach their goal for weight loss. The aim of this study was to determine the proportion of patients that didn't reach the goal of an excess weight loss of 50% or more during the first 12 months and determine the factors associated to this failure. Methods We obtained the demographic, anthropometric and biochemical information from 130 patients with severe obesity who underwent bariatric surgery in our institution between 2012 and 2017. We used self-reports of physical activity, caloric intake and diet composition. An unsuccessful weight loss was considered when the patient lost < 50% or more of the excess weight 12 months after surgery. We compared the characteristics between the successful and unsuccessful groups in order to find the factors associated with success. Results We included 130 patients (mean age 48 +/- 9 years, 81.5% were women). One year after surgery, 26 (20%) had loss < 50% EBW. Unsuccessful surgery was associated with an older age, previous history of hypertension, abdominal surgery or depression/anxiety, also the number of comorbidities and unemployment affected the results. These patients loss enough weight to improve some of their comorbidities, but they are more prone to regain weight 2 years after surgery. Conclusions A fifth of the patients undergoing bariatric surgery may not lose enough weight to be considered successful by current standards. Some patients may benefit from the surgery in the short term, but they are more likely to regain weight after 2 years. The factors influencing this result are still controversial but may be population-specific. Early detection of the patients that are more likely to fail is imperative to establish additional therapeutic strategies, without denying them the opportunity of surgery or waiting for weight re-gain to occur.