Our Summary

This research looks at the need for additional surgery after two types of weight loss surgery: sleeve gastrectomy (SG) and gastric bypass (GBP). Data was collected from a Scandinavian registry and four benchmarks were used to analyze the need for additional surgery: less than 50% excess weight loss, regaining more than 10 kg, meeting certain obesity surgery guidelines, or meeting criteria for metabolic surgery 2 years after the original surgery.

The study found that patients who had sleeve gastrectomy were more likely to not lose enough weight, regain more than 10 kg, and meet the criteria for needing additional surgery than those who had gastric bypass. This suggests that sleeve gastrectomy is associated with a higher risk of not achieving the desired weight loss results compared to gastric bypass.

However, the researchers point out that providing additional surgery to all patients who do not achieve the desired results is not feasible or practical. Therefore, they suggest that doctors need to evaluate each case individually and consider other treatment options.

FAQs

  1. What were the two types of weight loss surgeries evaluated in this study?
  2. What criteria were used to determine if additional surgery was needed after the initial weight loss surgery?
  3. Are patients who had sleeve gastrectomy more likely to need additional surgery than those who had a gastric bypass?

Doctor’s Tip

One helpful tip a doctor might tell a patient about obesity surgery is to carefully consider the type of surgery (such as sleeve gastrectomy or gastric bypass) based on individual factors and potential risks. Patients should also be aware that additional surgery may be needed in some cases, and regular follow-up with healthcare providers is crucial for monitoring progress and addressing any concerns. It is important for patients to have realistic expectations and be committed to making lifestyle changes to support long-term weight loss success.

Suitable For

Patients who are typically recommended for obesity surgery include those who have a body mass index (BMI) of 40 or higher, or a BMI of 35-39.9 with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. Additionally, patients who have tried and failed to lose weight through diet and exercise may also be recommended for obesity surgery. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are a suitable candidate for obesity surgery.

Timeline

Before obesity surgery:

  1. Patient consults with a medical professional to discuss weight loss options.
  2. Patient undergoes a thorough evaluation to determine if they are a candidate for surgery.
  3. Patient undergoes pre-operative testing and preparation.
  4. Patient receives counseling on diet and lifestyle changes to make before and after surgery.

After obesity surgery:

  1. Patient undergoes the surgery, either sleeve gastrectomy or gastric bypass.
  2. Patient is closely monitored post-operatively for any complications.
  3. Patient begins a strict diet and exercise regimen to aid in weight loss.
  4. Patient attends regular follow-up appointments with their medical team.
  5. Patient may experience significant weight loss in the first few months after surgery.
  6. Patient may plateau in weight loss or experience weight regain over time.
  7. If necessary, patient may require additional surgery to address inadequate weight loss or weight regain.
  8. Patient continues to receive ongoing support and monitoring from their medical team to maintain weight loss and overall health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about obesity surgery include:

  1. What are the potential risks and complications associated with the specific type of weight loss surgery being recommended?
  2. How much weight loss can I expect to achieve with this surgery and what are the long-term outcomes?
  3. What lifestyle changes will I need to make before and after surgery to ensure success?
  4. What is the likelihood that I may need additional surgery or interventions in the future?
  5. How will my diet and exercise routine need to change after surgery?
  6. What type of follow-up care and support will be provided after the surgery?
  7. Are there any specific criteria or benchmarks I should be aiming for in terms of weight loss and overall health improvement?
  8. What are the potential impacts of the surgery on my overall health and well-being in the long term?
  9. How will the surgery affect any existing medical conditions I may have?
  10. Are there any alternative treatment options or lifestyle changes that I should consider before proceeding with surgery?

Reference

Authors: Axer S, Szabo E, Näslund I. Journal: Obes Surg. 2023 Oct;33(10):2973-2980. doi: 10.1007/s11695-023-06783-0. Epub 2023 Aug 16. PMID: 37587379