Background Weight loss causes changes in appetite and energy expenditure that promote weight regain. Ghrelin is a hormone that increases food intake in rodents and humans. If circulating ghrelin participates in the adaptive response to weight loss, its levels should rise with dieting. Because ghrelin is produced primarily by the stomach, weight loss after gastric bypass surgery may be accompanied by impaired ghrelin secretion. Methods We determined the 24-hour plasma ghrelin profiles, body composition, insulin levels, leptin levels, and insulin sensitivity in 13 obese subjects before and after a six-month dietary program for weight loss. The 24-hour ghrelin profiles were also determined in 5 subjects who had lost weight after gastric bypass and 10 normal-weight controls; 5 of the 13 obese subjects who participated in the dietary program were matched to the subjects in the gastric-bypass group and served as obese controls. Results Plasma ghrelin levels rose sharply shortly before and fell shortly after eve...

Plasma Ghrelin Levels after Diet-Induced Weight Loss or Gastric Bypass Surgery

This meta-analysis on surgical treatment of obesity supports the American College of Physicians' clinical guideline in this issue. Surgery is more effective than nonsurgical treatment for weight lo...

http://www.paxysarkia.net/Download/Article_metaanalysis_surgical%20treatment%20of%20obesity.pdf

Meta-analysis: surgical treatment of obesity.

Objective To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months. Background Data The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic approach has significant potential to reduce perioperative complications and recovery time. Methods Consecutive patients (n = 275) who met NIH criteria for bariatric surgery were offered laparoscopic Roux-en-Y gastric bypass between July 1997 and March 2000. A 15-mL gastric pouch and a 75-cm Roux limb (150 cm for superobese) was created using five or six trocar incisions. Results The conversion rate to open gastric bypass was 1%. The start of an oral diet began a mean of 1.58 days after surgery, with a median hospital stay of 2 days and return to work at 21 days. The incidence of early major and minor complications was 3.3% and 27%, respectively. One death occurred related to a pulmonary embolus (0.4%). The hernia rate was 0.7%, and wound infections requiring outpatient drainage only were uncommon (5%). Excess weight loss at 24 and 30 months was 83% and 77%, respectively. In patients with more than 1 year of follow-up, most of the comorbidities were improved or resolved, and 95% reported significant improvement in quality of life. Conclusion Laparoscopic Roux-en-Y gastric bypass is effective in achieving weight loss and in improving comorbidities and quality of life while reducing recovery time and perioperative complications.

Outcomes After Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

Objective To compare outcomes, quality of life (QOL), and costs of laparoscopic and open gastric bypass (GBP). Background Data Laparoscopic GBP has been reported to be a safe and effective approach for the treatment of morbid obesity. The authors performed a prospective randomized trial to compare outcomes, QOL, and costs of laparoscopic GBP with those of open GBP. Methods From May 1999 to March 2001, 155 patients with a body mass index (BMI) of 40 to 60 kg/m 2 were randomly assigned to undergo laparoscopic (n = 79) or open (n = 76) GBP. The two groups were similar in age, sex ratio, mean BMI, and comorbidities. Main outcome measures included operative time, estimated blood loss, length of hospital stay, operative complications, percentage of excess body weight loss, and time to return to activities of daily living and work. Changes in QOL were assessed using the SF-36 Health Survey and the bariatric analysis of reporting outcome system (BAROS). Operative and hospital costs of the two operations were also compared. Results There were no deaths in either group. Mean operative time was longer for laparoscopic GBP than for open GBP, but operative blood loss was less. Two (2.5%) of the 79 patients in the laparoscopic group required conversion to laparotomy. Median length of hospital stay was shorter for laparoscopic GBP patients (3 vs 4 days). The rate of postoperative anastomotic leak was similar between groups. Wound-related complications such as infection (10.5 vs 1.3%) and incisional hernia (7.9 vs 0%) were more common after open GBP; late anastomotic stricture was less frequent after open GBP (2.6 vs 11.4%). Time to return to activities of daily living and work were shorter after laparoscopic GBP than after open GBP. Weight loss at 1 year was similar between groups. Preoperative SF-36 scores were similar between groups; however, at 1 month after surgery, laparoscopic patients had better physical conditioning, social functioning, general health, and less body pain than open GBP patients. At 6 months, the BAROS outcome was classified as good or better in 97% of laparoscopic GBP patients compared with 82% of open GBP patients. Operative costs were higher for laparoscopic GBP patients, but hospital costs were lower. Conclusions Laparoscopic GBP is a safe and cost-effective alternative to open GBP. Despite a longer operative time, patients undergoing laparoscopic GBP benefited from less blood loss, a shorter hospital stay, and faster convalescence. Laparoscopic GBP patients had comparable weight loss at 1 year but a more rapid improvement in QOL than open GBP patients. The higher initial operative costs for laparoscopic GBP were adequately offset by the lower hospital costs.

Laparoscopic Versus Open Gastric Bypass: A Randomized Study of Outcomes, Quality of Life, and Costs

Importance Sleeve gastrectomy is increasingly used in the treatment of morbid obesity, but its long-term outcome vs the standard Roux-en-Y gastric bypass procedure is unknown. Objective To determine whether there are differences between sleeve gastrectomy and Roux-en-Y gastric bypass in terms of weight loss, changes in comorbidities, increase in quality of life, and adverse events. Design, Setting, and Participants The Swiss Multicenter Bypass or Sleeve Study (SM-BOSS), a 2-group randomized trial, was conducted from January 2007 until November 2011 (last follow-up in March 2017). Of 3971 morbidly obese patients evaluated for bariatric surgery at 4 Swiss bariatric centers, 217 patients were enrolled and randomly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass with a 5-year follow-up period. Interventions Patients were randomly assigned to undergo laparoscopic sleeve gastrectomy (n = 107) or laparoscopic Roux-en-Y gastric bypass (n = 110). Main Outcomes and Measures The primary end point was weight loss, expressed as percentage excess body mass index (BMI) loss. Exploratory end points were changes in comorbidities and adverse events. Results Among the 217 patients (mean age, 45.5 years; 72% women; mean BMI, 43.9) 205 (94.5%) completed the trial. Excess BMI loss was not significantly different at 5 years: for sleeve gastrectomy, 61.1%, vs Roux-en-Y gastric bypass, 68.3% (absolute difference, −7.18%; 95% CI, −14.30% to −0.06%;P = .22 after adjustment for multiple comparisons). Gastric reflux remission was observed more frequently after Roux-en-Y gastric bypass (60.4%) than after sleeve gastrectomy (25.0%). Gastric reflux worsened (more symptoms or increase in therapy) more often after sleeve gastrectomy (31.8%) than after Roux-en-Y gastric bypass (6.3%). The number of patients with reoperations or interventions was 16/101 (15.8%) after sleeve gastrectomy and 23/104 (22.1%) after Roux-en-Y gastric bypass. Conclusions and Relevance Among patients with morbid obesity, there was no significant difference in excess BMI loss between laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass at 5 years of follow-up after surgery. Trial Registration clinicaltrials.gov Identifier:NCT00356213

/pdf/effect-of-laparoscopic-sleeve-gastrectomy-vs-laparoscopic-o9e1v8x0hm.pdf

Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial

Updated Bariatric Analysis and Reporting Outcome System (BAROS)

Guidelines for weight calculations and follow-up in bariatric surgery.

The need for a modified BAROS for gastric banding.

Background: The lack of standards for comparison of results was identified by the NIH Consensus Conference panellsts as one of the key problems in evaluating reports in the surgical treatment of severe obesity. The analysis of outcomes after bariatric surgery should include weight loss, improvement in comorbidities related to obesity, and quality-of-life (QOL) assessment. Definitions of success and failure should be established and the presentation of results standardized. Methods: A survey among experienced bariatric surgeons was conducted to study the reporting of results. The concept of evaluating outcomes by using a scoring system was introduced in 1997 and has now been refined further. Psychologists with expertise in bariatrics were asked to recommend a disease-specific instrument to analyze QOL after surgery. Results: The system defines five outcome groups (failure, fair, good, very good, and excellent), based on a scoring table that adds or subtracts points while evaluating three main areas: percentage of excess weight loss, changes in medical conditions, and QOL. To assess changes in QOL after treatment, this method incorporates a specifically designed patient questionnaire that addresses self-esteem and four daily activities. Complications and reoperative surgery deduct points, thus avoiding the controversy of considering reoperations as failures. Conclusions: The Bariatric Analysis and Reporting Outcome System (BAROS) analyzes outcomes in a simple, objective, unbiased, and evidence-based fashion. It can be adapted to evaluate other forms of medical intervention for the control of obesity. This method should be considered by international organizations for the adoption of standards for the outcome assessment of bariatric treatments, and for the comparison of results among surgical series. These standards could also be used to compare the long-term effects of surgery with nonoperative weight loss methods.

Bariatric Analysis and Reporting Outcome System (BAROS)

Background: The Moorehead-Ardelt Quality of Life Questionnaire was originally developed as a disease-specific instrument to measure postoperative outcomes of self-perceived quality of life (QoL) in obese patients. 5 key areas were examined: self-esteem, physical well-being, social relationships, work, and sexuality. Each of these questions offered 5 possible answers, which were given + or - points according to a scoring key. The questionnaire was used independently or incorporated into the Bariatric Analysis and Reporting System (BAROS). The instrument is simple, unbiased, user-friendly and can be completed in <1 minute. It has been found useful, reliable and reproducible in numerous clinical trials in different countries. Further research and feedback from some of its users prompted refinements, now included in the Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQII). This study tested the validity of the improved instrument. Methods: The wording of the questions was changed, to make them less suggestive and allow for the use of the survey before and after medical intervention, and with control groups. A 6th question, analyzing eating behavior, was added. The ±1 point given to the evaluation of self-esteem was split with this new question, thus maintaining the consistency of the scores. The drawings were simplified. Finally, the scoring key was changed to a 10-point Likert scale, to improve response-differentiation. To validate the M-A QoLQII, we examined its concordance with other health and well-being indicators, specifically the MOS 36-Item Short-Form Health Survey (SF-36), the Beck Depression Inventory-II (BDI-II) and the Stunkard and Messick Eating Inventory. The study population included 110 morbidly obese patients (20 males, 90 females, mean BMI=50), participants of gastric bypass support groups. Reliability of the M-A QoLQII was determined using Cronbach's alpha coefficient. Construct validity was measured by conducting a series of Spearman rank correlations. Results: A Cronbach's alpha coefficient of 0.84 indicated satisfactory internal consistency. The M-A QoLQII was found to be significantly correlated (P <0.01) to 7 of the 8 SF-36 scales: Physical Role (r=0.357), Bodily Pain (r=-0.486), General Health (r=0.413), Vitality (r=0.588), Social Functioning (r=0.517), Emotional Role (r=0.480), and Mental Health (r=0.489). The questionnaire also significantly correlated (P <0.01) to the Beck Depression Inventory-II (r=0.317), as well as to the 'Disinhibition' (r=-0.307) and 'Hunger' (r=-0.254) factors of the Stunkard and Messick Eating Inventory. Conclusions: The M-A QoLQII correlates well with other widely used health and well-being indicators such as the SF-36, Beck Depression Inventory II and the Stunkard and Messick Eating Inventory. The study established the validity and reliability of this improved disease-specific instrument for QoL measurement in the obese population.

The validation of the Moorehead-Ardelt Quality of Life Questionnaire II.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Melodie K Moorehead

Author Tools

Chat about Author