Factors Related to Weight Loss Maintenance in the Medium-Long Term after Bariatric Surgery: A Review.
Isabel M Cornejo-ParejaMaría Molina VegaAna María Gómez-PérezMiguel Damas-FuentesFrancisco J TinahonesPublished in: Journal of clinical medicine (2021)
Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015-2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness-complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut-brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.
Keyphrases
- weight loss
- bariatric surgery
- roux en y gastric bypass
- physical activity
- gastric bypass
- obese patients
- glycemic control
- clinical trial
- healthcare
- body mass index
- weight gain
- insulin resistance
- systematic review
- skeletal muscle
- resting state
- sleep quality
- blood brain barrier
- pain management
- health insurance
- subarachnoid hemorrhage
- open label
- affordable care act