Pre-surgical factors related to latent trajectories of 5-year weight loss for a diverse bariatric surgery population.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
01 Feb 2024
Historique:
received: 31 08 2023
revised: 10 01 2024
accepted: 21 01 2024
medline: 6 3 2024
pubmed: 6 3 2024
entrez: 5 3 2024
Statut: aheadofprint

Résumé

Analyzing trajectories of weight loss may address how particular groups of patients respond to metabolic and bariatric surgery. The Bariatric Experience Long Term (BELONG) study was designed to use a theoretical model to examine determinants of weight loss and recurrence. Large integrated health system in Southern California with 11 surgical practices and 23 surgeons. A total of n = 1338 patients who had metabolic and bariatric surgery were surveyed before surgery to measure factors related to median percent total weight loss (%TWL) over 5 years. Longitudinal weight data were available for n = 1024 (76.5% of the sample). Data were analyzed using latent growth mixture models (GMM) to estimate trajectories of weight change separately for gastric sleeve and bypass operations. These trajectories were then described using relevant variables from the baseline survey. For both gastric sleeve (n = 733) and bypass (n = 291) operations, 3 latent trajectories of median %TWL were found corresponding to most, moderate, and least %TWL. Sleeve trajectories were distinguished by body mass index at surgery and geocoded environmental factors. Bypass trajectories varied by self-reported and geocoded environmental factors, comorbidity burden, race, experiential avoidance, and weight control strategies. Future research should examine the role of the built and perceived environment in surgical weight loss. Bariatric practices should focus less on the presurgical period for predictors of long-term weight loss and begin efforts to monitor real-time patient-reported outcomes to help tailor intervention strategies for patients who either do not lose an expected amount of weight or who begin to experience weight recurrence.

Sections du résumé

BACKGROUND BACKGROUND
Analyzing trajectories of weight loss may address how particular groups of patients respond to metabolic and bariatric surgery.
OBJECTIVES OBJECTIVE
The Bariatric Experience Long Term (BELONG) study was designed to use a theoretical model to examine determinants of weight loss and recurrence.
SETTING METHODS
Large integrated health system in Southern California with 11 surgical practices and 23 surgeons.
METHODS METHODS
A total of n = 1338 patients who had metabolic and bariatric surgery were surveyed before surgery to measure factors related to median percent total weight loss (%TWL) over 5 years. Longitudinal weight data were available for n = 1024 (76.5% of the sample). Data were analyzed using latent growth mixture models (GMM) to estimate trajectories of weight change separately for gastric sleeve and bypass operations. These trajectories were then described using relevant variables from the baseline survey.
RESULTS RESULTS
For both gastric sleeve (n = 733) and bypass (n = 291) operations, 3 latent trajectories of median %TWL were found corresponding to most, moderate, and least %TWL. Sleeve trajectories were distinguished by body mass index at surgery and geocoded environmental factors. Bypass trajectories varied by self-reported and geocoded environmental factors, comorbidity burden, race, experiential avoidance, and weight control strategies.
CONCLUSIONS CONCLUSIONS
Future research should examine the role of the built and perceived environment in surgical weight loss. Bariatric practices should focus less on the presurgical period for predictors of long-term weight loss and begin efforts to monitor real-time patient-reported outcomes to help tailor intervention strategies for patients who either do not lose an expected amount of weight or who begin to experience weight recurrence.

Identifiants

pubmed: 38443200
pii: S1550-7289(24)00041-8
doi: 10.1016/j.soard.2024.01.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Ernest Shen (E)

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.

Aileen Baecker (A)

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.

Ming Ji (M)

College of Population Health, University of New Mexico, Albuquerque, New Mexico.

Sonya Negriff (S)

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.

Silvia R Paz (SR)

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.

Bhumi B Bhakta (BB)

Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.

Cecelia L Crawford (CL)

Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, California.

Adam Drewnowski (A)

Center for Public Health Nutrition, University of Washington, Seattle, Washington.

Kristina H Lewis (KH)

Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina.

Darren D Moore (DD)

Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, Illinois.

Sameer B Murali (SB)

Department of Surgery, Center for Obesity Medicine & Metabolic Performance, University of Texas McGovern Medical School, Houston, Texas.

Deborah R Young (DR)

College of Population Health, University of New Mexico, Albuquerque, New Mexico.

Karen J Coleman (KJ)

College of Population Health, University of New Mexico, Albuquerque, New Mexico; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California. Electronic address: Karen.J.Coleman@kp.org.

Classifications MeSH