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Reviews in Endocrine and Metabolic Disorders

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Open Access 02-05-2023 | Obesity

Towards precision medicine in bariatric surgery prescription

Authors: Sofia S. Pereira, Marta Guimarães, Mariana P. Monteiro

Published in: Reviews in Endocrine and Metabolic Disorders | Issue 5/2023

Abstract

Obesity is a complex, multifactorial and chronic disease. Bariatric surgery is a safe and effective treatment intervention for obesity and obesity-related diseases. However, weight loss after surgery can be highly heterogeneous and is not entirely predictable, particularly in the long-term after intervention. In this review, we present and discuss the available data on patient-related and procedure-related factors that were previously appointed as putative predictors of bariatric surgery outcomes. In addition, we present a critical appraisal of the available evidence on which factors could be taken into account when recommending and deciding which bariatric procedure to perform. Several patient-related features were identified as having a potential impact on weight loss after bariatric surgery, including age, gender, anthropometrics, obesity co-morbidities, eating behavior, genetic background, circulating biomarkers (microRNAs, metabolites and hormones), psychological and socioeconomic factors. However, none of these factors are sufficiently robust to be used as predictive factors. Overall, there is no doubt that before we long for precision medicine, there is the unmet need for a better understanding of the socio-biological drivers of weight gain, weight loss failure and weight-regain after bariatric interventions. Machine learning models targeting preoperative factors and effectiveness measurements of specific bariatric surgery interventions, would enable a more precise identification of the causal links between determinants of weight gain and weight loss. Artificial intelligence algorithms to be used in clinical practice to predict the response to bariatric surgery interventions could then be created, which would ultimately allow to move forward into precision medicine in bariatric surgery prescription.

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Title: Towards precision medicine in bariatric surgery prescription
Authors: Sofia S. Pereira
Marta Guimarães
Mariana P. Monteiro
Publication date: 02-05-2023
Publisher: Springer US
Keywords: Obesity
Obesity
Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Type 2 Diabetes
Published in: Reviews in Endocrine and Metabolic Disorders / Issue 5/2023
Print ISSN: 1389-9155
Electronic ISSN: 1573-2606
DOI: https://doi.org/10.1007/s11154-023-09801-9

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