MedicalResearch.com Interview with:
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.
MedicalResearch.com: What are the main findings?
Response: This report on 7-year outcomes shows that most participants maintained much of their weight loss with variable fluctuations over the 7-year period. 7-year mean weight loss for gastric bypass participants was 28.4% with 3.9% weight regain between years 3 and 7. For band participants, 7-year mean weight loss was 14.9% with 1.4% regain between years 3 and 7.
For gastric bypass, the prevalence of all the health conditions studied for this report was reduced at 7 years compared to before surgery. Also, for gastric bypass, the remission of diabetes was sustained in the majority over time with 60.2% in remission at year-7. In addition, the incidence of new cases of diabetes was low, less than 1.5%, for those people who had a gastric bypass.
MedicalResearch.com: What should readers take away from your report?
Response: Weight loss following these 2 bariatric procedures is mostly sustained over time. Comorbid health improvements are sustained over time following gastric bypass. There is variability in both the patterns of weight loss and weight fluctuations over time. This variability is a potential target for future research to better understand which specific people may respond better or worse to specific surgical treatments.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research can help to identify specific obesity subtypes that may help predict who may respond better to surgical treatments. These efforts would likely include genomic and metabolomic data, as well. Future studies will also need to address longer-term weight and health outcomes following the sleeve gastrectomy procedure, now a common bariatric operation that was not studied in large numbers in LABS.
Disclosures: No commercial disclosures, prior research grant from Ethicon and Covidien, outside this work
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Anita P. Courcoulas, Wendy C. King, Steven H. Belle, Paul Berk, David R. Flum, Luis Garcia, William Gourash, Mary Horlick, James E. Mitchell, Alfons Pomp, Walter J. Pories, Jonathan Q. Purnell, Ashima Singh, Konstantinos Spaniolas, Richard Thirlby, Bruce M. Wolfe, Susan Z. Yanovski. Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surg. Published online December 06, 2017. doi:10.1001/jamasurg.2017.5025
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