Surgical Prevention of Weight Regain and Type 2 Diabetes Recurrence in 3 Different Bariatric Operations and Their Differential Long-Term Outcome: An 8-Year Prospective Observational Study.

Introduction: Comparative data on long-term outcomes of mechanistically different bariatric operations are scarce.

Methods: In this prospective, observational study, consecutive patients with severe obesity were studied using a predefined reoperation algorithm to determine long-term health outcomes after bariatric surgery (BS): adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD). All patients were assessed for mortality, postoperative weight loss, rate of reoperation, comorbidities, and quality of life (QoL) 8 years after surgery.

Reversal of Long-Term Weight Regain After Roux-en-Y Gastric Bypass Using Liraglutide or Surgical Revision. A Prospective Study.

Purpose: This study investigates whether pharmacotherapy with liraglutide is similarly effective in reversing weight regain more than 6 years after Roux-en-Y gastric bypass (RYGB) as revisional surgery aimed at restoring restriction.

Methods: Ninety-five consecutive patients (11 male, 84 female; mean BMI 45 ± 6 kg/m) undergoing RYGB 9 ± 4 years ago were treated for 24 months as follows: Patients, who gained less than 10% from weight NADIR, served as controls and were provided lifestyle counseling (DC, n = 30). The others were allowed to choose between three different treatment groups: daily s.

Eating Behavior, Low-Frequency Functional Mutations in the Melanocortin-4 Receptor (MC4R) Gene, and Outcomes of Bariatric Operations: A 6-Year Prospective Study.

Objective: Data on the effects of eating behavior and genetics on outcomes of gastrointestinal surgery for diabesity have been sparse, often flawed, and controversial. We aimed to assess long-term outcomes of bariatric operations in patients characterized for eating behavior and rare mutations in the melanocortin-4 receptor (MC4R) gene, which is strongly implicated in energy balance.

Research Design And Methods: Between 1996 and 2005, 1,264 severely obese Swiss patients underwent current laparoscopic adjustable gastric banding, gastroduodenal bypass, or a hybrid operation.

Successful multi-intervention treatment of severe obesity: a 7-year prospective study with 96% follow-up.

Background: No long-term, high participation study of the outcome of bariatric surgery has examined how a multi-intervention approach to the treatment of severe obesity can achieve and sustain weight loss after an initial bariatric procedure.

Methods: We employed a multi-intervention treatment that combines adjustable gastric banding with intensive follow-up to support patient life-style change and use of an algorithm allowing reoperation-to bypass, if necessary-in the event of complications. Four hundred four severely obese patients with an average BMI = 42.

Endocannabinoid receptor 1 gene variations increase risk for obesity and modulate body mass index in European populations.

The therapeutic effects of cannabinoid receptor blockade on obesity-associated phenotypes underline the importance of the endocannabinoid pathway on the energy balance. Using a staged-approach, we examined the contribution of the endocannabinoid receptor 1 gene (CNR1) on obesity and body mass index (BMI) in the European population. With the input of CNR1 exons and 3' and 5' regions sequencing and HapMap database, we selected and genotyped 26 tagging single-nucleotide polymorphisms (SNPs) in 1932 obese cases and 1173 non-obese controls of French European origin.

Bowel habits after bariatric surgery.

Background: Disordered bowel habits might influence quality of life after bariatric surgery. Different types of bariatric operations-gastric banding (AGB), Roux-en-Y gastric bypass (RYGB), or biliopancreatic diversion (BPD)-might alter bowel habits as a consequence of the surgical procedure used. Whether change in bowel habits affects quality of life after AGB, RYGB, or BPD differently is unknown.

Health-related quality of life in patients with class II and class III obesity.

Background: Severe obesity may substantially impact quality of life. We estimated the health-related quality of life (HRQoL) in patients with class II and class III obesity, and explored the impact of patient characteristics and co-morbidities on quality of life.

Methods: 110 patients with BMI > or = 35 kg/m2 presenting for evaluation for bariatric surgery were asked to complete the EuroQoL questionnaire.

Impact of age, sex and body mass index on outcomes at four years after gastric banding.

Background: Adjustable gastric banding for weight reduction in severely obese persons allows reversible individualized restriction during postoperative follow-up. It is unknown whether preoperative age, sex and BMI might modulate treatment outcome.

Methods: 404 severely obese patients (79% women; age 42 +/- 0.

Analysis of sequence variability in the CART gene in relation to obesity in a Caucasian population.

Background: Cocaine and amphetamine regulated transcript (CART) is an anorectic neuropeptide located principally in hypothalamus. CART has been shown to be involved in control of feeding behavior, but a direct relationship with obesity has not been established. The aim of this study was to evaluate the effect of polymorphisms within the CART gene with regards to a possible association with obesity in a Caucasian population.

Salvage of gastric restriction following staple-line dehiscence after vertical banded gastroplasty by insertion of an adjustable gastric band.

Background: Vertical banded gastroplasty (VBG) has been a common and safe surgical treatment for morbid obesity. However, the complication of staple-line dehiscence (SLD) results in VBG failure. We present a minimally invasive revision procedure when SLD occurs: gastric restriction is salvaged by adjustable gastric banding (AGB), usually laparoscopically, providing that the previous restriction had achieved sufficient weight loss initially and was well-tolerated.

Management of failed adjustable gastric banding.

Background: About 100,000 adjustable gastric band placements have been performed worldwide, but more than 10% of patients have needed reoperation for insufficient weight loss or device-related complications. This study investigates the complications following gastric banding, and the outcome using a structured management strategy.

Methods: In the period April 1996 to January 2002, 824 severely obese patients (body mass index 43 +/- 1 kg/m 2 [mean +/- standard error under the mean], age 43 +/- 1 years; 77% women) underwent gastric banding in a single institution and were followed prospectively.

Gene variants and binge eating as predictors of comorbidity and outcome of treatment in severe obesity.

Melanocortin-4 receptor gene (MC4R) variants are associated with obesity and binge eating disorder (BED), whereas the more prevalent proopiomelanocortin (POMC) and leptin receptor gene (LEPR) mutations are rarely associated with obesity or BED. The complete coding regions of MC4R, POMC, and leptin-binding domain of LEPR were comparatively sequenced in 300 patients (233 women and 67 men; mean +/- SEM age, 42 +/- 1 years; mean +/- SEM body mass index, 43.5 +/- 0.

G protein polymorphisms do not predict weight loss and improvement of hypertension in severely obese patients.

Both the gene encoding the alpha subunit of G stimulatory proteins (GNAS1) and the beta3 subunit gene (GNB3) of G proteins are associated with obesity and/or hypertension. Moreover, the TT/TC825 polymorphism of GNB3 predicts greater weight loss than the CC825 polymorphism in obese patients (mean body mass index, 35 kg/m2) undergoing a structured nonpharmacologic weight loss program. Gastric banding enforces a low-calorie diet by diminishing the need for volitional adherence.

Effect of significant intermediate-term weight loss on serum leptin levels and body composition in severely obese subjects.

Background: Leptin, produced by adipose tissue, signals body fat content to the hypothalamus. Serum leptin levels (SLL), elevated in obese humans, decrease with weight loss. This study investigated the reduction of SLL and fat mass following restrictive bariatric surgery.

Laparoscopic gastric bypass versus laparoscopic adjustable gastric banding: a comparative study of 1,200 cases.

Background: Indications for and results of laparoscopic adjustable gastric banding (LAGB) and laparoscopic gastric bypass (LGB) are still controversial, especially between Europe and the United States. The recent availability of gastric bandings in the United States made it necessary to compare the two techniques.

Study Design: We compared a series of 456 LGB to a series of 805 LAGB performed in two different institutions.

Laparoscopic Swedish adjustable gastric banding: a five-year prospective study.

Background: Laparoscopic adjustable gastric banding is a popular bariatric operation in Europe. However, the long-term complication rate and weight loss are still unclear.

Methods: 824 patients underwent a laparoscopic Swedish Adjustable Gastric Banding (SAGB) in a 5-year period.

Binge eating as a major phenotype of melanocortin 4 receptor gene mutations.

Background: Obesity, a multifactorial disease caused by the interaction of genetic factors with the environment, is largely polygenic. A few mutations in these genes, such as in the leptin receptor (LEPR) gene and melanocortin 4 receptor (MC4R) gene, have been identified as causes of monogenic obesity.

Methods: We sequenced the complete MC4R coding region, the region of the proopiomelanocortin gene (POMC) encoding the alpha melanocyte-stimulating hormone, and the leptin-binding domain of LEPR in 469 severely obese white subjects (370 women and 99 men; mean [+/-SE] age, 41.

Anti-Xa activity in obese patients after double standard dose of nadroparin for prophylaxis.

We measured anti-Xa activity before and at 2, 4, 9 and 12 h after subcutaneous injection of 0.3 ml nadroparin (2850 IU anti-Xa) in normal-weight volunteers (median bodyweight 71 kg, n=5) and compared them to the anti-Xa activity after subcutaneous injection of 0.6 ml nadroparin (5700 IU anti-Xa) in obese patients (median bodyweight 134 kg, n=8).

Changes in bone mineral density over 18 months following kidney transplantation: the respective roles of prednisone and parathyroid hormone.

Background: Prednisone is a major factor of bone loss after kidney transplantation. The role of hyperparathyroidism and immunosuppressors is less clear.

Methods: Thirty-three patients (14 men, 19 women) with ESRD were followed prospectively for 18 months after kidney transplantation.

Modeling the impact of adjustable gastric banding on survival in patients with morbid obesity.

Objective: Morbid obesity is associated with premature death. Adjustable gastric banding may lead to substantial weight loss in patients with morbid obesity. Little is known about the impact of weight loss on survival after adjustable gastric banding.

Impact of orlistat therapy on weight reduction in morbidly obese patients after implantation of the Swedish adjustable gastric band.

Background: Adjustable gastric banding (AGB) is frequently performed to treat morbid obesity. One problem which can occasionally develop after a restrictive procedure is consumption of a high calorie liquid diet, which may prohibit further weight loss. Orlistat, a newly developed intestinal lipase inhibitor, prevents absorption of about one-third of ingested fat.