Published in December 2014 Issue             

Outcomes of Laparoscopic Roux-en-Y Gastric Bypass in Super-Super Obese Patients (SOARD)

Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) appears safe for super-super obese (SSO) patients with a Body Mass Index (BMI) >60 kg/m2, and results in significant reductions in excess BMI. Researchers from the Department of Surgery, University of Virginia identified 2,009 patients undergoing LRYGB between 1994 and 2013 from the American College of Surgeons National Surgical Quality Improved Program database. Of the patients undergoing LRYGB over the past 20 years, 328 had BMI>60 kg/ m2. Preoperative comorbidities, conversion to open and length of stay were significantly increased among SSO patients. However, no significant difference in postoperative outcomes or complications was observed.

Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modelling study (The Lancet)

Researchers developed a disease-simulation model to estimate the annual risk of diabetes, cardiovascular disease and mortality for people with obesity, and found it may result in an average loss of eight years of life. The effect was greatest for young individuals and decreased with increasing age. The years of life lost for obese men ranged from 0 - 8 years in those aged 60—79 years to 5 - 9 years in those aged 20 - 39 years, and years lost for very obese men ranged from 0 - 9 years in those aged 60 - 79 years to 8·4 years in those aged
20—39 years, but losses were smaller and sometimes negligible for men who were only overweight. Similar results were noted for women. Healthy life-years lost were two to four times higher than total years of life lost for all age groups and bodyweight categories. The model was developed by McGill University in Canada, using data gathered from 3992 non-Hispanic white participants in the National Nutritional and Examination Survey (2003-10).

Obesity Fuels Silent Heart Damage (Journal of The American College of Cardiology: Heart Failure)

Obesity leads to subclinical heart muscle injury and increases the risk for heart failure even among people without overt heart disease and independently of other cardiovascular risk factors such as diabetes, high blood pressure and high cholesterol, according to a new study from Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. The findings suggest that obesity is an independent driver of heart muscle damage, and that obese individuals, even when free of cardiac symptoms, warrant vigilant monitoring. The silent heart damage was detected by using an ultrasensitive test that measures the levels of a protein released by the cells of the heart muscle during injury.

Time-Restricted Feeding Is a Preventative and Therapeutic Intervention against Diverse Nutritional Challenges (Cell Metabolism)

Researchers found feeding a high-calorie diet to mice, but confining calorie intake to an nine to twelve hour period, also known as time-restricted feeding (TRF), kept mice healthier and slimmer than mice given 24-access to the same diet. The researchers from the Salk Institute for Biological Studies, La Jolla, CA, found the benefits of TRF in mice included a therapeutic intervention against obesity without calorie restriction, protecting against metabolic diseases even when briefly interrupted on weekends, and stabilizing and reversing the progression of metabolic diseases in mice with preexisting obesity and type 2 diabetes. Analyzing the blood metabolites in mice with time-restricted diet showed that many of the molecular pathways that go awry in metabolic disease are repaired by the diet. The study will be developed by creating a more in-depth analysis of these pathways, and then exploring the effects of the diet on humans.

Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI >= 50 kg/m² (SOARD)

Laparoscopic Roux-en-Y gastric bypass (LRYGB) provides better weight loss and resolution in diabetes than laparoscopic sleeve gastrectomy (LSG), with similar postoperative morbidity, found researchers from the Department of General, Digestive and Metabolic Surgery, Ambroise Paré University Hospital, Versailles Saint-Quentin University, Assistance Publique-Hôpitaux in Paris, France. The data studied 359 patients undergoing LSG or LRYGB surgery with a BMI>50kg/m2. At one year, the mean percentage weight loss (22.0 vs 30.3) and percentage of excess weight loss (40.2 vs.55.0) and rates of remission of diabetes (47.5 vs 70.7) were greater in LGBP than in LSG group. Further long-term studies are needed to confirm these results.