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Obesity Surgery
Published in: Obesity Surgery 4/2019

01-04-2019 | Obesity | Review Article

Ongoing Inconsistencies in Weight Loss Reporting Following Bariatric Surgery: a Systematic Review

Authors: Valentin Mocanu, Awrad Nasralla, Jerry Dang, Mack Jacobson, Noah Switzer, Karen Madsen, Daniel W. Birch, Shahzeer Karmali

Published in: Obesity Surgery | Issue 4/2019

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Abstract

Weight loss is the primary outcome following bariatric surgery; however, its documentation within current literature is heterogeneous and poorly defined, limiting meaningful comparison between studies. Randomized controlled trials from 2012 to 2016 were identified using the Medline database through “Gastric bypass OR sleeve gastrectomy AND weight” search terms. A total of 73 studies with 5948 patients were included. Reporting of preoperative weight was done primarily using mean body mass index (BMI) (87.7%) and mean weight (65.8%). Postoperative weight reporting was more variable, with the most frequently reported measure being mean postoperative BMI (71.2%). Overall, nearly one third of all bariatric literature contained discrepancies that precluded meaningful meta-analysis. Reporting of weight loss following bariatric surgery is becoming increasingly diverse for both pre- and post-operative outcomes. Ongoing heterogeneity will continue to act as a barrier to meaningful comparison of bariatric outcomes until standardized reporting practices become adopted.
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Literature
1.
Kalarchian MA et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am. J. Psychiatry. 2007;164:328–34; quiz 374.CrossRefPubMed
2.
Heymsfield SB, Wadden TA. Mechanisms, pathophysiology, and management of obesity. N Engl J Med. 2017;376:254–66.CrossRefPubMed
3.
WHO. WHO | Obesity and overweight. World Health Organisation Media Centre Fact Sheet No. 311 1–2 (2012).
4.
Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity. Jama. 2018;319:255–65.CrossRefPubMedPubMedCentral
5.
Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity. Jama. 2018;319:241–54.CrossRefPubMedPubMedCentral
6.
7.
Smith BR, Schauer P, Nguyen NT. Surgical approaches to the treatment of obesity: bariatric surgery. Endocrinol Metab Clin N Am. 2008;37:943–64.CrossRef
8.
Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMed
9.
Dixon JB, McPhail T, O’Brien PE. Minimal reporting requirements for weight loss: current methods not ideal. Obes Surg. 2005;15:1034–9.CrossRefPubMed
10.
Coulman KD, Abdelrahman T, Owen-Smith A, et al. Patient-reported outcomes in bariatric surgery: a systematic review of standards of reporting. Obes Rev. 2013;14:707–20.CrossRefPubMed
11.
Hopkins JC, Howes N, Chalmers K, et al. Outcome reporting in bariatric surgery: an in-depth analysis to inform the development of a core outcome set, the BARIACT study. Obes Rev. 2015;16:88–106.CrossRefPubMed
12.
13.
Serrano OK, Zhang Y, Cumella L, et al. Excess weight loss and cardiometabolic parameter reduction diminished among Hispanics undergoing bariatric surgery: outcomes in more than 2,000 consecutive Hispanic patients at a single institution. J Am Coll Surg. 2016;222:166–73.CrossRefPubMed
14.
15.
Abdallah E, el Nakeeb A, Yousef T, et al. Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24:1587–94.CrossRefPubMed
16.
Angrisani L, Cutolo PP, Formisano G, et al. Laparoscopic adjustable gastric banding versus Roux-en-Y gastric bypass: 10-year results of a prospective, randomized trial. Surg Obes Relat Dis. 2013;9:405–13.CrossRefPubMed
17.
de Barros F, Setúbal S, Martinho JM, et al. Early endocrine and metabolic changes after bariatric surgery in grade III morbidly obese patients: a randomized clinical trial comparing sleeve gastrectomy and gastric bypass. Metab Syndr Relat Disord. 2015;13:264–71.CrossRefPubMed
18.
Fernandes R, Beserra BT, Mocellin MC, et al. Effects of prebiotic and synbiotic supplementation on inflammatory markers and anthropometric indices after Roux-en-Y gastric bypass: a randomized, triple-blind, placebo-controlled pilot study. J Clin Gastroenterol. 2016;50:208–17.CrossRefPubMed
19.
Zhang Y, Zhao H, Cao Z, et al. A randomized clinical trial of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy for the treatment of morbid obesity in China: a 5-year outcome. Obes Surg. 2014;24:1617–24.CrossRefPubMed
20.
O’Neill S, O’Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes Rev. 2015;16:1–12.CrossRefPubMed
21.
22.
Abellán I, López V, Lujan J, et al. Stapling versus hand suture for gastroenteric anastomosis in Roux-en-Y gastric bypass: a randomized clinical trial. Obes Surg. 2015;25:1796–801.CrossRefPubMed
23.
Azagury DE, Ris F, Pichard C, et al. Does perioperative nutrition and oral carbohydrate load sustainably preserve muscle mass after bariatric surgery? A randomized control trial. Surg Obes Relat Dis. 2015;11:920–6.CrossRefPubMed
24.
Biörserud C, Olbers T, Søvik TT, et al. Comment on: Experience of excess skin after gastric bypass or duodenal switch in patients with super obesity. Surg Obes Relat Dis. 2014;10:891–6.CrossRefPubMed
25.
Cal P, Deluca L, Jakob T, et al. Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial. Surg Endosc. 2016;30:1812–5.CrossRefPubMed
26.
Chronaiou A, Tsoli M, Kehagias I, et al. Lower ghrelin levels and exaggerated postprandial peptide-YY, glucagon-like peptide-1, and insulin responses, after gastric fundus resection, in patients undergoing Roux-en-Y gastric bypass: a randomized clinical trial. Obes Surg. 2012;22:1761–70.CrossRefPubMed
27.
Coen PM, Menshikova EV, Distefano G, et al. Exercise and weight loss improve muscle mitochondrial respiration, lipid partitioning, and insulin sensitivity after gastric bypass surgery. Diabetes. 2015;64:3737–50.CrossRefPubMedPubMedCentral
28.
Coen PM, Tanner CJ, Helbling NL, et al. Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity. J Clin Invest. 2015;125:248–57.CrossRefPubMed
29.
Courcoulas AP, Belle SH, Neiberg RH, et al. Three-year outcomes of bariatric surgery vs lifestyle intervention for type 2 diabetes mellitus treatment. JAMA Surg. 2015;150:931–40.CrossRefPubMedPubMedCentral
30.
31.
Cummings DE, Arterburn DE, Westbrook EO, et al. Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia. 2016;59:945–53.CrossRefPubMedPubMedCentral
32.
Darabi S, Talebpour M, Zeinoddini A, et al. Laparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial. Surg Obes Relat Dis. 2013;9:914–9.CrossRefPubMed
33.
Dillard TH, Purnell JQ, Smith MD, et al. Omentectomy added to Roux-en-Y gastric bypass surgery: a randomized, controlled trial. Surg Obes Relat Dis. 2013;9:269–75.CrossRefPubMed
34.
Dodet P, Perrot S, Auvergne L, et al. Sensory impairment in obese patients? Sensitivity and pain detection thresholds for electrical stimulation after surgery-induced weight loss, and comparison with a nonobese population. Clin J Pain. 2013;29:43–9.CrossRefPubMed
35.
Dunn JP, Abumrad NN, Breitman I, et al. Hepatic and peripheral insulin sensitivity and diabetes remission at 1 month after Roux-en-Y gastric bypass surgery in patients randomized to omentectomy. Diabetes Care. 2012;35:137–42.CrossRefPubMed
36.
Eid GM, McCloskey CA, Eagleton JK, et al. StomaphyX vs a sham procedure for revisional surgery to reduce regained weight in Roux-en-Y gastric bypass patients. JAMA Surg. 2014;149:372–9.CrossRefPubMed
37.
ElGeidie A, ElHemaly M, Hamdy E, et al. The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. Surg Obes Relat Dis. 2015;11:997–1003.CrossRefPubMed
38.
Gras-Miralles B, Haya JR, Moros JMR, et al. Caloric intake capacity as measured by a standard nutrient drink test helps to predict weight loss after bariatric surgery. Obes Surg. 2014;24:2138–44.CrossRefPubMed
39.
Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes. JAMA Surg. 2014;149:716–26.CrossRefPubMedPubMedCentral
40.
Hedberg J, Sundbom M. Superior weight loss and lower HbA1c 3 years after duodenal switch compared with Roux-en-Y gastric bypass—a randomized controlled trial. Surg Obes Relat Dis. 2012;8:338–43.CrossRefPubMed
41.
Heneghan HM, Annaberdyev S, Eldar S, et al. Banded Roux-en-Y gastric bypass for the treatment of morbid obesity. Surg Obes Relat Dis. 2014;10:210–6.CrossRefPubMed
42.
Huang C-K, Lo C-H, Houng J-Y, et al. Surgical results of single-incision transumbilical laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2012;8:201–7.CrossRefPubMed
43.
Ikramuddin S, Korner J, Lee WJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia. JAMA. 2013;309:2240–9.CrossRefPubMedPubMedCentral
44.
Immonen H, Hannukainen JC, Iozzo P, et al. Effect of bariatric surgery on liver glucose metabolism in morbidly obese diabetic and non-diabetic patients. J Hepatol. 2014;60:377–83.CrossRefPubMed
45.
Keidar A, Hershkop KJ, Marko L, et al. Roux-en-Y gastric bypass vs sleeve gastrectomy for obese patients with type 2 diabetes: a randomised trial. Diabetologia. 2013;56:1914–8.CrossRefPubMed
46.
Khoo CM, Chen J, Pamuklar Z, et al. Effects of Roux-en-Y gastric bypass or diabetes support and education on insulin sensitivity and insulin secretion in morbidly obese patients with type 2 diabetes. Ann Surg. 2014;259:494–501.CrossRefPubMed
47.
Korner J, Conroy R, Febres G, et al. Randomized double-blind placebo-controlled study of leptin administration after gastric bypass. Obesity. 2013;21:951–6.CrossRefPubMed
48.
Kratz M, Hagman DK, Kuzma JN, et al. Improvements in glycemic control after gastric bypass occur despite persistent adipose tissue inflammation. Obesity. 2016;24:1438–45.CrossRefPubMed
49.
Lee W-J, Chong K, Lin Y-H, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24:1552–62.CrossRefPubMed
50.
Liang Z, Wu Q, Chen B, et al. Effect of laparoscopic Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus with hypertension: a randomized controlled trial. Diabetes Res Clin Pract. 2013;101:50–6.CrossRefPubMed
51.
Lima MMO, Pareja JC, Alegre SM, et al. Visceral fat resection in humans: effect on insulin sensitivity, beta-cell function, adipokines, and inflammatory markers. Obesity. 2013;21:E182–9.CrossRefPubMed
52.
MacLaughlin HL, Hall WL, Patel AG, et al. Weight loss, adipokines, and quality of life after sleeve gastrectomy in obese patients with stages 3-4 CKD: a randomized controlled pilot study. Am J Kidney Dis. 2014;64:660–3.CrossRefPubMed
53.
Maghrabi AH, Wolski K, Abood B, et al. Two-year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy. Obesity. 2015;23:2344–8.CrossRefPubMed
54.
Malin SK, Bena J, Abood B, et al. Attenuated improvements in adiponectin and fat loss characterize type 2 diabetes non-remission status after bariatric surgery. Diabetes, Obes. Metab. 2014;16:1230–8.CrossRef
55.
Malin SK, Samat A, Wolski K, et al. Improved acylated ghrelin suppression at 2 years in obese patients with type 2 diabetes: effects of bariatric surgery vs standard medical therapy. Int J Obes. 2014;38:364–70.CrossRef
56.
Michalsky D, Dvorak P, Belacek J, et al. Radical resection of the pyloric antrum and its effect on gastric emptying after sleeve gastrectomy. Obes Surg. 2013;23:567–73.CrossRefPubMed
57.
Mingrone G, Panunzi S, de Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366:1577–85.CrossRefPubMed
58.
Mingrone G, Panunzi S, de Gaetano A, et al. Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386:964–73.CrossRefPubMed
59.
Morseth MS, Hanvold SE, Rø Ø, et al. Self-reported eating disorder symptoms before and after gastric bypass and duodenal switch for super obesity—a 5-year follow-up study. Obes Surg. 2016;26:588–94.CrossRefPubMed
60.
Nergaard BJ, Leifsson BG, Hedenbro J, et al. Gastric bypass with long alimentary limb or long pancreato-biliary limb—long-term results on weight loss, resolution of co-morbidities and metabolic parameters. Obes Surg. 2014;24:1595–602.CrossRefPubMedPubMedCentral
61.
Nguyen KT, Billington CJ, Vella A, et al. Preserved insulin secretory capacity and weight loss are the predominant predictors of glycemic control in patients with type 2 diabetes randomized to Roux-en-Y gastric bypass. Diabetes. 2015;64:3104–10.CrossRefPubMedPubMedCentral
62.
Nijamkin MP, Campa A, Sosa J, et al. Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial. J Acad Nutr Diet. 2012;112:382–90.CrossRefPubMed
63.
Ogden J, Hollywood A, Pring C. The impact of psychological support on weight loss post weight loss surgery: a randomised control trial. Obes Surg. 2015;25:500–5.CrossRefPubMed
64.
Peterli R, Borbély Y, Kern B, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS). Ann Surg. 2013;258:690–5.CrossRefPubMed
65.
Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22:740–8.CrossRefPubMedPubMedCentral
66.
Petry TZ, Fabbrini E, Otoch JP, et al. Effect of duodenal-jejunal bypass surgery on glycemic control in type 2 diabetes: a randomized controlled trial. Obesity. 2015;23:1973–9.CrossRefPubMed
67.
Praveen Raj P, Kumaravel R, Chandramaliteeswaran C, et al. Is laparoscopic duodenojejunal bypass with sleeve an effective alternative to Roux En Y gastric bypass in morbidly obese patients: preliminary results of a randomized trial. Obes Surg. 2012;22:422–6.CrossRefPubMed
68.
Rasera I, Coelho TH, Ravelli MN, et al. A comparative, prospective and randomized evaluation of Roux-en-Y gastric bypass with and without the silastic ring: a 2-year follow up preliminary report on weight loss and quality of life. Obes Surg. 2016;26:762–8.CrossRefPubMed
69.
Reis LO, Zani EL, Saad RD, et al. Bariatric surgery does not interfere with sperm quality—a preliminary long-term study. Reprod Sci. 2012;19:1057–62.CrossRefPubMed
70.
Ren Y, Yang W, Yang J, et al. Effect of Roux-en-Y gastric bypass with different pouch size in Chinese T2DM patients with BMI 30–35 kg/m2. Obes Surg. 2015;25:457–63.CrossRefPubMed
71.
Risstad H, Søvik TT, Engström M, et al. Five-year outcomes after laparoscopic gastric bypass and laparoscopic duodenal switch in patients with body mass index of 50 to 60. JAMA Surg. 2015;150:352–61.CrossRefPubMed
72.
Rosas U, Ahmed S, Leva N, et al. Mesenteric defect closure in laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. Surg Endosc. 2015;29:2486–90.CrossRefPubMed
73.
Sarwer DB, Moore RH, Spitzer JC, et al. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Surg Obes Relat Dis. 2012;8:561–8.CrossRefPubMed
74.
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370:2002–13.CrossRefPubMedPubMedCentral
75.
Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567–76.CrossRefPubMedPubMedCentral
76.
Schmidt JB, Pedersen SD, Gregersen NT, et al. Effects of RYGB on energy expenditure, appetite and glycaemic control: a randomized controlled clinical trial. Int J Obes. 2016;40:281–90.CrossRef
77.
Sdralis E, Argentou M, Mead N, et al. A prospective randomized study comparing patients with morbid obesity submitted to sleeve gastrectomy with or without omentectomy. Obes Surg. 2013;23:965–71.CrossRefPubMed
78.
Sharma S, Narwaria M, Cottam DR, et al. Randomized double-blinded trial of laparoscopic gastric imbrication v laparoscopic sleeve gastrectomy at a single Indian institution. Obes Surg. 2015;25:800–4.CrossRefPubMed
79.
Skroubis G, Kouri N, Mead N, et al. Long-term results of a prospective comparison of Roux-en-Y gastric bypass versus a variant of biliopancreatic diversion in a non-superobese population (BMI 35–50 kg/m2). Obes Surg. 2014;24:197–204.CrossRefPubMed
80.
Søvik TT, Karlsson J, Aasheim ET, et al. Gastrointestinal function and eating behavior after gastric bypass and duodenal switch. Surg Obes Relat Dis. 2013;9:641–7.CrossRefPubMed
81.
Thompson CC, Chand B, Chen YK, et al. Endoscopic suturing for transoral outlet reduction increases weight loss after Roux-en-Y gastric bypass surgery. Gastroenterology. 2013;145:129–137.e3.CrossRefPubMed
82.
Vix M, Diana M, Liu KH, et al. Evolution of glycolipid profile after sleeve gastrectomy vs. Roux-en-Y gastric bypass: results of a prospective randomized clinical trial. Obes Surg. 2013;23:613–21.CrossRefPubMed
83.
Vix M, Liu KH, Diana M, et al. Impact of Roux-en-Y gastric bypass versus sleeve gastrectomy on vitamin D metabolism: short-term results from a prospective randomized clinical trial. Surg Endosc. 2014;28:821–6.CrossRefPubMed
84.
Werling M, Fändriks L, Björklund P, et al. Long-term results of a randomized clinical trial comparing Roux-en-Y gastric bypass with vertical banded gastroplasty. Br J Surg. 2013;100:222–30.CrossRefPubMed
85.
Woodlief TL, Carnero EA, Standley RA, et al. Dose response of exercise training following roux-en-Y gastric bypass surgery: a randomized trial. Obesity. 2015;23:2454–61.CrossRefPubMed
86.
Yang J, Wang C, Cao G, et al. Long-term effects of laparoscopic sleeve gastrectomy versus roux-en-Y gastric bypass for the treatment of Chinese type 2 diabetes mellitus patients with body mass index 28-35 kg/m(2). BMC Surg. 2015;15:88.CrossRefPubMedPubMedCentral
87.
Youssef T, Abdalla E, el-Alfy K, et al. Impact of botulinum neurotoxin pyloric injection during laparoscopic sleeve gastrectomy on postoperative gastric leak: a clinical randomized study. Obes Surg. 2016;26:494–504.CrossRefPubMed
88.
Yi B, Jiang J, Zhu L, et al. Comparison of the effects of Roux-en-Y gastrojejunostomy and LRYGB with small stomach pouch on type 2 diabetes mellitus in patients with BMI < 35 kg/m2. Surg Obes Relat Dis. 2015;11:1061–8.CrossRefPubMed
89.
Zarate X, Arceo-Olaiz R, Montalvo Hernandez J, et al. Long-term results of a randomized trial comparing banded versus standard laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2013;9:395–7.CrossRefPubMed
90.
Brethauer SA et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg. Obes. Relat. Dis. 2015;11:489–506.CrossRefPubMed
Metadata
Title
Ongoing Inconsistencies in Weight Loss Reporting Following Bariatric Surgery: a Systematic Review
Authors
Valentin Mocanu
Awrad Nasralla
Jerry Dang
Mack Jacobson
Noah Switzer
Karen Madsen
Daniel W. Birch
Shahzeer Karmali
Publication date
01-04-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-03702-6

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