Knee Pain Improved After Bariatric Surgery For Obesity

MedicalResearch.com Interview with:

Jonathan Samuels, MD Associate Professor of Medicine Division of Rheumatology NYU Langone Health

Dr. Jonathan Samuels

Jonathan Samuels, MD
Associate Professor of Medicine
Division of Rheumatology
NYU Langone Health

MedicalResearch.com: What is the background for this study?

 Response: A high percentage of obese patients have painful knee osteoarthritis, and have difficulty losing weight as well as treating the knee pain with a self-perpetuating cycle.

 MedicalResearch.com: What are the main findings?

Response:  Patients who lost weight with their laparoscopic banding surgeries also experienced marked improvement of their knee pain. We found a significant correlation between the degree of improvement in the body mass index and reduction of knee pain in our cohort.

In addition, the patients who experienced the most relief from weight loss surgeries had their procedures at earlier ages, as well as those who never had a traumatic knee injury nor developed osteoarthritis in other joints.

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Bariatric Surgery Associated With Reduced Need For Diabetes Medications at Six Years

MedicalResearch.com Interview with:
Dr Jérémie Thereauz
Praticien Hospitalier
Chirurgie viscérale et digestive 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Bariatric surgery has been proved to reduce type 2 diabetes in morbid obese patients. However, results of bariatric surgery at a nationwide level are lacking.

The aim of our study was to assess the 6-year antidiabetic treatment continuation, discontinuation or initiation rates after BS compared with matched control obese patients.

This large-scale nationwide study confirms that bariatric surgery is responsible for a significant 6-year postoperative antidiabetic treatment discontinuation rate compared to baseline and compared to an obese control group without surgery, and a low treatment initiation rate, with gastric bypass being the most effective procedure. 

MedicalResearch.com: What should readers take away from your report?

Response: This long term study confirms at a nationwide level, previous mid term randomized studies finding effiicency of bariatric surgery in type 2 diabetes for patients with morbid obesity associated.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Patients and physicians must be aware that morbid obesity still remains a chronic disease even after bariatric surgery, as 50% of patients with pre-existing antidiabetic treatment remained on treatment 6 years after surgery. Our study highlights the message that these patients require careful lifelong follow-up to monitor obesity complications. Complementary medico-economic study would be helpful to determine the relevance of such treatment in a national health care system.

No disclosures

Citations:

Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, Millat B, Fagot-Campagna A. Association Between Bariatric Surgery and Rates of Continuation, Discontinuation, or Initiation of Antidiabetes Treatment 6 Years Later. JAMA Surg. Published online February 14, 2018. doi:10.1001/jamasurg.2017.6163

https://jamanetwork.com/journals/jamasurgery/fullarticle/2672216?resultClick=1

 

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Bariatric Surgery Linked To Long Term Mortality Reduction

MedicalResearch.com Interview with:
Oma Reges, PhD
Clalit Research Institute, Clalit Health Services, Tel Aviv, Israel
Department of Health Systems Management, Ariel University, Ariel, Israel

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Israel, based on the most recently published data (2015), performs more per-capita bariatric surgery than the U.S.A (about 9,000 to 9,500 procedures annually, which is 1.8 times higher rate per capita than the U.S.A, where there are about 200,000 procedures a year).

It is important to evaluate the impact of these procedures on health status, as there is a lack of data of the effectiveness of these procedures over time. We were able to document lower mortality rates, of up to 50%, in the obese patient undergoing surgery as opposed to matched obese patients who continue with usual care.  Continue reading

Long-term Medical Complications with Bariatric Surgery vs Medical Obesity Treatment

MedicalResearch.com Interview with:

Jøran Hjelmesæth MD, PhD Professor, Head Morbid Obesity Centre and Section of Endocrinology Department of Medicine Vestfold Hospital Trust Tønsberg, Norway Department of Endocrinology, Morbid Obesity and Preventive Medicine Institute of Clinical Medicine University of Oslo, Norway

Prof. Hjelmesæth

Jøran Hjelmesæth MD, PhD
Professor, Head
Morbid Obesity Centre and Section of Endocrinology
Department of Medicine
Vestfold Hospital Trust
Tønsberg, Norway
Department of Endocrinology, Morbid Obesity and Preventive Medicine
Institute of Clinical Medicine
University of Oslo, Norway

MedicalResearch.com: What is the background for this study? What is known?  Some previous studies have shown beneficial long-term effects of bariatric surgery on the remission and incidence of diabetes, hypertension and dyslipidemia, whilst high quality data on the long-term incidence of adverse effects, mental health conditions and complications after bariatric surgery are sparse or lacking. In addition, the control groups in previous studies of the effect of bariatric surgery seldom or never received any specific specialist based non-surgical treatment alternative.

The present pragmatic real world study was performed at a publicly funded single tertiary care obesity center in Norway where patients could choose between bariatric surgery and specialized medical treatment (voluntarily and free of charge). Nearly complete short- and long-term (≤ 10 years) data on beneficial and detrimental outcomes were retrieved from national registries (Norwegian Prescription Database and Norwegian Patient Registry).  The results confirm the beneficial long-term effects of bariatric surgery (gastric bypass) on the remission and incidence of diabetes, hypertension and dyslipidemia, as demonstrated in some previous studies.

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Weight Loss After Bariatric Procedures Mostly Sustained Over Time

MedicalResearch.com Interview with:

Anita P. Courcoulas MD, MPH Professor of Surgery, Chief MIS Bariatric & General Surgery University of Pittsburgh Medical Center

Dr. Courcoulas

Anita P. Courcoulas MD, MPH
Professor of Surgery, Chief MIS Bariatric & General Surgery
University of Pittsburgh Medical Center

MedicalResearch.com: What is the background for this study?

Response: This study is the main long term outcomes report from The Longitudinal Assessment of Bariatric Surgery (LABS) Study, an NIH-NIDDK ( National Institute of Diabetes and Digestive and Kidney Diseases) funded study at 10 hospitals in 6 clinical centers and a data coordinating center.  It was a multicenter, prospective three phase longitudinal cohort study that began recruitment of participants in 2006 when gastric bypass and laparoscopic adjustable banding were the two most common bariatric procedures performed in the U.S.

The goal of this particular study from LABS was to address the longer-term durability and variability of weight loss and the assess the longer-term impact of bariatric surgery on major health conditions including diabetes, dyslipidemia, and hypertension. Continue reading

Bariatric Surgery Can Reduce Number Of Medications Needed To Control Blood Pressure

MedicalResearch.com Interview with:
“Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0Dr.
Carlos Aurelio Schiavon
Research Institute, Heart Hospital
São Paulo, Brazil 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity and hypertension are highly prevalent diseases and when they are associated,  cardiovascular risk is almost double over patients with obesity alone. 60-70% of hypertension in adults may be attributable to adiposity.

To address both problems, we designed the GATEWAY TRIAL to evaluate the efficacy of Gastric Bypass in the reduction of antihypertensive medications in obese patients using at least 2 medications at maximum doses.

After 1 year, results were very consistent. 83.7 % of the patients submitted to Gastric Bypass reduced at least 30% of the total number of medications maintaining a controlled blood pressure (<140/90 mm Hg) and 51% remitted from hypertension, defined by controlled blood pressure without medications. When we evaluated the reduction of the medication maintaining the Systolic blood pressure below 120 mmHg (SPRINT TARGET), 22.4% of the patients showed remission of hypertension.

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Bariatric Surgery Associated With Reduced Risk of Obesity-Related Cancers

MedicalResearch.com Interview with:

Daniel P. Schauer, MD, MSc Associate Professor, Internal Medicine University of Cincinnati College of Medicine Division of General Internal Medicine Cincinnati OH 45267-0535

Dr. Schauer

Daniel P. Schauer, MD, MSc
Associate Professor, Internal Medicine
University of Cincinnati College of Medicine
Division of General Internal Medicine
Cincinnati OH 45267-0535

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity is associated with many types of cancer and bariatric surgery is the most effective treatment for severe obesity.  We conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from Kaiser Permanente using 5 study sites. The study included 22,198 patients who had bariatric surgery matched to 66,427 nonsurgical patients with severe obesity.

We found that bariatric surgery was associated with a reduced risk of cancer.  The risk reduction was greatest for the cancers that are associated with obesity including postmenopausal breast, endometrial, colon, and pancreatic cancers, as well as esophageal adenocarcinoma.

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Gastric Bypass Surgery Improves Quality of Life For Obese Teenagers, But Complications Not Rare

MedicalResearch.com Interview with:
Dr Thomas H. Inge MD

University of Colorado Denver School of Medicine
Aurora, CO 80045

MedicalResearch.com: What is the background for this study?

Response: Gastric bypass surgery helps severely obese teenagers lose weight and keep it off, according to the first long term follow up studies of teenagers who had undergone the procedure 5-12 years earlier. However, the studies show some patients will need further surgery to deal with complications or may develop vitamin deficiencies later in life, according to two studies published in The Lancet Diabetes & Endocrinology.
Severe obesity is classified as having a BMI of 40 or over (around 100 pounds overweight) and affects around 4.6 million children and teenagers in the USA. It causes ill health, poor quality of life and cuts life expectancy.

The studies are the first to look at long-term effects of gastric bypass surgery in teenagers. Until now, it has been unclear how successful the surgery is in the long-term and whether it can lead to complications. Thousands of teenagers are offered surgical treatment each year.

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Bariatric Surgery in Women of Childbearing Age and Perinatal Complications

MedicalResearch.com Interview with:
Brodie Parent, MD MS

General Surgery R4
University of Washington

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We already knew that women with a history of bariatric surgery are a high risk group when it comes to childbirth. Our study has confirmed prior data which show that infants from these women are at a higher risk for being premature, low birth-weight, or requiring ICU admission. However, this is some of the first data which looks at their risk over time after recovery from the operation. Data from this study show that risks to the infant are highest in the first 3 years after an operation, and diminish over time. This suggests that women should wait a minimum of three years after an operation before attempting conception.

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DiaRem Score Predicts Long-Term Diabetes Remission After Bariatric Surgery

MedicalResearch.com Interview with:

Annemarie G. Hirsch, PhD, MPH Center for Health Research Geisinger Health System Danville, Pennsylvania

Dr. Annemarie Hirsch

Annemarie G. Hirsch, PhD, MPH
Center for Health Research
Geisinger Health System
Danville, Pennsylvania

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Bariatric surgery is currently the most effective treatment in reversing insulin resistance in patients with type 2 diabetes. However, the likelihood of remission or cure after surgery varies tremendously based on certain patient characteristics. The DiaRem score provides patients with a personalized prediction of whether or not they can expect long-term remission of their disease if they choose to have surgery.

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Eating and Weight Control Practices Help Determine Weight Loss After Bariatric Surgery

MedicalResearch.com Interview with:

James E. Mitchell, MD President and Scientific Director Neuropsychiatric Research Institute, Fargo Professor and Chairman Department of Neuroscience University of North Dakota School of Medicine and Health Sciences

Dr. Mitchell

James E. Mitchell, MD
President and Scientific Director
Neuropsychiatric Research Institute, Fargo
Professor and Chairman
Department of Neuroscience
University of North Dakota School of Medicine and Health Sciences

MedicalResearch.com: What is the background for this study? What are the main findings

Dr. Mitchell: The amount of weight loss following bariatric surgery is widely variable. Eating behaviors and weight control practices after surgery are important in determining weight loss outcomes.

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ED Visits and Hospitalizations for Heart Failure After Bariatric Surgery Drop

MedicalResearch.com Interview with:
Yuichi Shimada, MD, MPH
Cardiology Division, Massachusetts General Hospital
A Teaching Affiliate for Harvard Medical School
Boston, MA 02115

 Medical Research: What is the background for this study?

Dr. Shimada: Heart failure (HF) is an important public health issue. The United States also has experienced an obesity epidemic. Studies have shown an association between obesity and heart failure-related morbidity. However, little is known about whether substantial weight loss, enabled by bariatric surgery, results in a decreased rate of HF-related adverse events. In this context, we investigated whether bariatric surgery is associated with significantly reduced rates of ED visits and hospitalizations for heart failure exacerbation among obese patients with heart failure.

Medical Research: What are the main findings?

Dr. Shimada: Among 524 patients with heart failure who underwent bariatric surgery, 16.2% had an ED visit or hospitalization for heart failure exacerbation before surgery. We observed a non-significant but a slight decline in the exacerbation rate (12.0%, p = 0.052) within 12 months after surgery. Then, the rate of heart failure exacerbation went down dramatically, to about half, in the subsequent 13 to 24 months after surgery (9.9%; adjusted odds ratio: 0.57; p = 0.003).

Medical Research: What should clinicians and patients take away from your report?

Dr. Shimada: The rate of ED visits or hospitalizations for heart failure exacerbation was reduced by about 40% after bariatric surgery. For patients with HF and morbid obesity, clinicians should discuss the option of bariatric surgery as a method to achieve substantial and sustained weight reduction, as it may prevent future ED visits and hospitalizations for heart failure exacerbation.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Shimada: Further research is needed to understand the mechanism by which bariatric surgery is associated with reduced risk of heart failure exacerbations.

Medical Research: Is there anything else you would like to add?

Response: Because a large proportion of obese patients with heart failure would not undergo bariatric surgery for various reasons, including initial high cost and risk of peri-surgical complications, we would also like to stress the importance of developing effective non-surgical interventions that achieve a substantial and sustained weight reduction.

Citation:

Yuichi Shimada (2016). ED Visits and Hospitalizations for Heart Failure After Bariatric Surgery Drop 

ER Visits Rise in Three Years Following Bariatric Surgery

MedicalResearch.com Interview with:

Junaid A. Bhatti, MBBS, MSc, PhD Sunnybrook Health Sciences Centre Research Institute Toronto, Canada

Dr. Junaid Bhatti

Junaid A. Bhatti, MBBS, MSc, PhD
Sunnybrook Health Sciences Centre Research Institute
Toronto, Canada 

Medical Research: What is the background for this study? What are the main findings?

Dr. Bhatti: Weight loss surgeries are consistently increasing in the US. While the positive impact of surgery on patient’s health are undebatable, limited information is available about long-term healthcare utilization, especially, emergency care utilization in bariatric surgery patients. This study compared emergency care utilization in bariatric patients three years following surgery to that of three years prior to surgery. Overall, we found that emergency care utilization increased by about 17% following surgery compared to the before surgery period. While complaints related to cardiovascular, ear, respiratory, and dermatology decreased, the complaints related to gastrointestinal, genitourinary, mental health, and substance misuse increased following surgery.  Continue reading

Mental Health May Improve For Some Patients After Bariatric Surgery

Aaron J. Dawes, MD Fellow, VA/RWJF Clinical Scholars Program Division of Health Services Research, University of California Los Angeles Los Angeles, CA 90024

Dr. Aaron Dawes

MedicalResearch.com Interview with:
Aaron J. Dawes, MD
Fellow, VA/RWJF Clinical Scholars Program
Division of Health Services Research
University of California Los Angeles
Los Angeles, CA 90024

Medical Research: What is the background for this study? What are the main findings?

Dr. Dawes: We reviewed the published literature to answer three basic questions about bariatric surgery and mental health conditions.

First, how common are mental health conditions among patients being referred for or undergoing bariatric surgery?

  • Second, do patients who carry a diagnosis of one of these conditions lose less weight after surgery than patients without these conditions?
  • And, third, what happens to the clinical course of mental health conditions after patients undergo surgery? Do they get better, worse, or stay the same?

We found that mental health conditions are surprisingly common among bariatric patients, especially depression and binge eating disorder, which occur at almost twice the rate among bariatric patients than in the general U.S. population. We also found no strong evidence to suggest that patients with depression lose less weight after surgery and some evidence that the condition may actually improve after surgery. Eleven of the twelve studies on the topic found either lower rates or fewer symptoms of depression, at least during the first 3 years post-operatively.

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Vitamin D Status May Influence Bariatric Surgery Outcomes

Leigh A. Peterson, PhD, MHS Post-doctoral fellow Department of Surgery - Bayview Johns Hopkins School of Medicine

Dr. Leigh Peterson

MedicalResearch.com Interview with:
Leigh A. Peterson, PhD, MHS

Post-doctoral fellow
Department of Surgery – Bayview
Johns Hopkins School of Medicine

Medical Research: What is the background for this study? What are the main findings?
Dr. Peterson: From our previous study published in Obesity Surgery earlier this year, we knew that vitamin D deficiency and insufficiency was very common in our bariatric surgery candidates (71.4% < 20 ng/ml and 92.9% < 30 ng/ml). We wanted to explore the effect of this deficiency on adverse outcomes after bariatric surgery such as wound healing, infection, and extended hospital stay.

We turned to the Nationwide Inpatient Sample to answer this question, as it would contain enough surgeries to detect changes in even less frequent outcomes such as wound infection. But blood concentration of vitamin D is not available, so we used a traditional method to estimate group vitamin D status with season and geography. Vitamin D comes from the sun, so people have the most vitamin D in summer and in sunnier places.

In 932,091 records of bariatric surgeries from 2001 to 2010, we saw that more adverse outcomes occurred during winter—January to March, the time of lowest vitamin D status—compared to summer or even spring or fall. Additionally, most adverse outcomes occurred in northern latitudes (≥ 37°N) compared to sunnier southern latitudes.

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Study Confirms Bariatric Surgery Success In Treating Type2 Diabetes

MedicalResearch.com Interview with:
Jan Peter Yska, PharmD
Medical Centre Leeuwarden
Department of Clinical Pharmacy & Clinical Pharmacology
Leeuwarden The Netherlands

Medical Research: What is the background for this study?

Dr. Yska: Many patients with morbid obesity have known type 2 diabetes mellitus. Bariatric surgery effectively prevents and treats type 2 diabetes. A growing number of studies suggests that surgical treatment for obese patients may be considered an additional treatment option for the management of type 2 diabetes. However, an observational study on the remission of type 2 diabetes, using strict criteria for remisson of diabetes, after different types of bariatric surgery, based on data from general practice has not been carried out yet.

Medical Research: What are the main findings?

Dr. Yska: Our study included 569 obese patients with type 2 diabetes who had different types of weight-loss surgery and 1,881 similar diabetic patients who didn’t have surgery. This study confirms that bariatric surgery is successful in treating diabetes mellitus type 2. Per 1,000 person years 94.5 diabetes remissions were found in patients who underwent bariatric surgery, compared to 4.9 diabetes remissions in matched controls. A strict definition of remission of diabetes was used, much stricter than in other studies: patients should have stopped all diabetic medications with an HbA1c < 6.0% after at least 6 months of follow-up. Diabetic patients who underwent bariatric surgery had an 18-fold increased chance of diabetes remission, compared to diabetic patients who did not undergo surgery, with the greatest effect size observed for gastric bypass (adj. RR 43.1), followed by sleeve gastrectomy (adj. RR 16.6), and gastric banding (adj. 6.9). The largest decrease in  HbA1c and blood glucose levels was observed in the first two years after bariatric surgery.

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Suicide Risk Increases After Bariatric Surgery

Dr. Junaid A. Bhatti MBBS PhD Sunnybrook Health Sciences Centre Toronto, ONMedicalResearch.com Interview with:
Dr. Junaid A. Bhatti MBBS PhD
Sunnybrook Health Sciences Centre
Toronto, ON

Medical Research: What is the background for this study? What are the main findings?

Dr. Bhatti:  Bariatric surgery remains an important option for morbidly obese patients where other obesity management options fail. It is a safe procedure with mortality risk not higher than any other major procedure of this type. Some studies report that some patients may experience psychological stress following surgery. Studies on the long-term outcomes noted that there was a higher suicide risk in bariatric patients as compared to the general population. It was not clear whether these risks increased following surgery.
In this study, we used the data of bariatric patients from Ontario who underwent surgery between 2006 and 2011. We assessed their emergency room visits three years before and three years following surgery. We looked into whether these patients had significantly more visits related to suicide attempts before compared to post surgery period. Overall, about 111 patients (1%) of the cohort had suicide attempts during follow-up. What we saw is that suicide risk increased by 50% following surgery than before surgery period. The risks were higher, but not significantly higher than others, if they were 35 years or older or from low-income or rural settings. The emergency services utilization of suicide attempts following surgery was more intense for the visits before surgery.

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Bariatric Surgery: Better Outcomes, Lower Costs For Patients With Diabetes

Martin Neovius PhD Department of Medicine, SolnaMedicalResearch.com Interview with:
Martin Neovius PhD

Department of Medicine, Solna

Medical Research: What is the background for this study? What are the main findings?

Dr. Neovius: Long-term real world data on economic effects of bariatric surgery versus nonsurgical treatment are scarce. We have previously looked at long-term drug costs, inpatient and outpatient care in the overall bariatric surgery population (Neovius, Narbro et al, JAMA 2012). However, overall findings may mask important subgroup variations.

Based on data from the Swedish Obese Subjects (SOS) study, we documented large drug cost savings over 15 years after bariatric surgery versus non-surgically treated controls in patients who had diabetes and prediabetes before intervention. No savings were seen in patients who were euglycemic at baseline.

In terms of overall healthcare costs, we saw cost-neutrality versus non-surgically treated patients for the diabetes group, while costs were higher for both patients with normal blood glucose and those with prediabetes (due to the initial high cost of surgery and inpatient care).

For the subgroup of patients with diabetes, we also found that patients with recent diabetes onset had more favorable economic outcomes than patients with established diabetes. 

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Bariatric Surgery Bests Lifestyle Interventions For Diabetes Remission In Obesity

Anita P. Courcoulas M.D., M.P.H., F.A.C.S Professor of Surgery Director, Minimally Invasive Bariatric & General Surgery University of Pittsburgh Medical CenterMedicalResearch.com Interview with:
Anita P. Courcoulas M.D., M.P.H., F.A.C.S

Professor of Surgery
Director, Minimally Invasive Bariatric & General Surgery
University of Pittsburgh Medical Center

Medical Research: What is the background for this study?

Dr. Courcoulas: This study is a randomized clinical trial that was originally funded through the American Recovery and Reinvestment Act of 2009 (ARRA) as a high priority comparative effectiveness topic; the goal of which was to better understand the role of surgical versus non-surgical treatments for Type 2 diabetes mellitus (T2DM) in people with lower Body Mass Index (BMI) between 30 and 40 kg/m2. This report highlights longer-term outcomes at 3 years following random assignment to either an intensive lifestyle weight loss intervention for 1 year followed by a low-level lifestyle intervention for 2 years or surgical treatments (Roux-en-Y gastric bypass [RYGB] or laparoscopic adjustable gastric banding [LAGB]) followed by low-level lifestyle intervention in years 2 and 3.

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Bariatric Surgery Reduces Urinary Incontinence As Well As Obesity

MedicalResearch.com Interview with:
Leslee L. Subak, MD

University of California, San Francisco
Professor, Departments of Obstetrics, Gynecology & Reproductive Sciences, Urology and Epidemiology & Biostatistics
Chief of Gynecology, SF Veterans Affairs Medical Center
UCSF Women’s Health Clinical Research Center

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Subak: Urinary incontinence is very common, affecting an estimated 30 million adults in the U.S., and may account for as much as $60 billion in annual medical costs. Incontinence can cause significant distress, limitations in daily functioning, and reduced quality of life. Obesity is an important risk factor, with each 5-unit increase in body mass index – a ratio of someone’s weight divided by the square of their height – above normal weight associated with far higher rates of incontinence.   The prevalence of incontinence has been reported to be as high as 70 percent among severely obese women, and 24 percent among severely obese men (BMI greater than 40, or more than about 100 pounds greater than ideal body weight).

Since obesity is a risk factor for incontinence, several studies have examined whether weight loss is a treatment for incontinence among obese people with the condition.  Clinical trials have shown the low calorie diets, behavioral weight reduction, and bariatric surgery are associated with improvement in incontinence in obese women and men through one year, but evidence on the durability of this effect is lacking.

We performed this study to examine changes in urinary incontinence and identify factors associated with improvement among women and men in the first 3 years following bariatric surgery.

This study included 1987women and men in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study performed at 10 hospitals at 6 clinical centers in the U.S. who underwent bariatric surgery between 2005 and 2009.  The study participants ranged in age from 18 to 78 years old – the median age was 47. The analysis controlled for factors such as age, race, smoking status and recent pregnancy.  Nearly 79 percent of the participants in the study were women with 49% reporting at least weekly incontinence, compared with 2% of men reporting incontinence.

Following surgery and large weight loss of 29% for women and 26% for men, substantial improvements in incontinence were observed, with a majority of women and men achieving remission at 3 years post-surgery. The more weight lost, the higher the chances of improvement. While the risk of relapse rose with each gain of about 10 pounds, overall there was substantial improvement for both women and men. People who were older, had severe walking limitations or were recently pregnant showed less improvement.

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