Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample and Data Collection
2.2. Demographic and Clinical Factors
2.3. Weight Loss Medications
2.4. Primary Endpoints
2.5. Statistical Analysis
3. Results
3.1. Participants
3.2. Weight Loss Medications and Response
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variable | Surgery Type | ||
---|---|---|---|
All Patients | Sleeve Gastrectomy | Roux-En-Y Gastric Bypass | |
n = 37 | n = 9 (25.7%) | n = 28 (75.7%) | |
Gender | |||
Female | 34 (91.9%) | 8 (88.9%) | 26 (92.9%) |
Male | 3 (8.1%) | 1 (11.1%) | 2 (7.1%) |
Age at Surgery (Years) | |||
≤20 | 0 | ||
21–25 | 15 (40.5%) | 3 (33.3%) | 12 (42.9%) |
26+ | 22 (59.5%) | 6 (66.7%) | 16 (57.1%) |
Race/Ethnicity | |||
White | 24 (64.9%) | 6 (66.7%) | 18 (64.3%) |
Hispanic | 7 (18.9%) | 0 | 7 (25%) |
African-American | 5 (13.5%) | 3 (33.3%) | 2 (7.1%) |
Asian | 0 | 0 | 0 |
Other/Declined to state | 1 (2.7%) | 0 | 1 (3.6%) |
Preoperative Characteristics | |||
Mean BMI (kg/m2) | 50.6 (SD = 10.2) | 47.1 (SD = 5.8) | 51.7 (SD = 11.1) |
Obesity Class | |||
Class I (BMI 30–34.9) | 0 | 0 | 0 |
Class II (BMI 35–39.9) | 5 (13.5%) | 1 (11.1%) | 4 (14.3%) |
Class III (BMI ≥ 40) | 32 (86.5%) | 8 (88.9%) | 24 (85.7%) |
Comorbid Conditions (Individual) | |||
Hypertension | 10 (27%) | 2 (22.2%) | 8 (28.6%) |
Type II Diabetes | 2 (5.4%) | 0 | 2 (7.1%) |
OSA | 10 (27%) | 2 (22.2%) | 8 (28.6%) |
Dyslipidemia | 10 (27%) | 3 (33.3%) | 7 (25%) |
NAFLD | 28 (74.3%) | 4 (44.4%) | 24 (85.7%) |
Number of Comorbid Conditions | |||
None | 4 | 2 | 2 |
1 | 16 | 4 | 12 |
2 | 10 | 2 | 8 |
3 | 4 | 1 | 3 |
4 | 3 | 0 | 3 |
All Patients | Sleeve Gastrectomy | Roux-En-Y Gastric Bypass | |
---|---|---|---|
Post-Op Nadir Before Medication | n = 37 | n = 9 (24.3%) | n = 28 (75.7%) |
Mean BMI (kg/m2) | 33.9 (SD = 7.8) | 34.6 (SD = 4.9) | 33.7 (SD = 8.6) |
Mean Time to Achieve Nadir (months) | 17.3 (SD = 11.2) | 15.9 (SD = 10.8) | 17.7 (SD = 11.4) |
At Start of Medication | |||
Mean BMI (kg/m2) | 38.5 (SD = 8.3) | 37.3 (SD = 5.7) | 38.9 (SD = 9.1) |
Time elapsed between surgery and start of medication (months) | |||
Mean (SD) | 52.2 (SD = 38.7) | 20.1 (SD = 5.2) | 62.6 (SD = 39.1) |
Min | 6.6 | 9.8 | 6.6 |
Max | 164.8 | 28.1 | 164.8 |
Post-Medication Treatment—At Nadir Weight | |||
Mean BMI (kg/m2) | 34.0 (SD = 6.4) | 35.9 (SD = 5.6) | 33.4 (SD = 6.6) |
Subgroup | Weight Change | p Value | |
---|---|---|---|
(kg) | (%) ^ | ||
All patients (n = 37) | −5.8 | −5.1 | |
(IQR: −2.5, −16.1) | (IQR: −2.6, −14.6) | ||
Patients prescribed medication at weight plateau (n = 8) ~ | −5.7 | −6.0 | 0.5304 a |
(IQR: −3.2, −14.2) | (IQR: −3.1, −20.1)) | ||
Patients prescribed medication at weight regain (n = 29) ~ | −5.8 | −5.4 | |
(IQR: −2.3, −16.7) | (IQR: −2.4, −13.3) | ||
Surgery Type | |||
Sleeve Gastrectomy (n = 9) | −3.9 | −3.3 | 0.0515 a |
(IQR: −1.5, −6.1) | (IQR: −1.5, −5.3) | ||
Roux-En-Y Gastric Bypass (n = 26) | −7.6 | −8.1 | |
(IQR: −2.4, −17.9) | (IQR: −2.6, −17.5) | ||
Patients who lost ≥5% total body weight with treatment (n = 20, 54.1%) | −15.6 | −13.3 | |
(IQR: −7.3, −24.3) | (IQR: −7.7, −20.9) | ||
Patients who lost ≥10% total body weight with treatment (n = 12, 34.3%) | −18.1 | −18.2 | |
(IQR: −15.6, −29.5) | (IQR: −13.3, −27.1) | ||
Patients who lost ≥15% total body weight with treatment (n = 8, 22.9%) | −26.0 | −24.3 | |
(IQR: −16.1, −34.4) | (IQR: −18.3, −29.4) |
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Toth, A.T.; Gomez, G.; Shukla, A.P.; Pratt, J.S.; Cena, H.; Biino, G.; Aronne, L.J.; Stanford, F.C. Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study. Children 2018, 5, 116. https://doi.org/10.3390/children5090116
Toth AT, Gomez G, Shukla AP, Pratt JS, Cena H, Biino G, Aronne LJ, Stanford FC. Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study. Children. 2018; 5(9):116. https://doi.org/10.3390/children5090116
Chicago/Turabian StyleToth, Alexander T., Gricelda Gomez, Alpana P. Shukla, Janey S. Pratt, Hellas Cena, Ginevra Biino, Louis J. Aronne, and Fatima Cody Stanford. 2018. "Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study" Children 5, no. 9: 116. https://doi.org/10.3390/children5090116