Our Summary

The research paper is about a study conducted in Poland on patients who underwent a second (or more) weight loss surgery (also known as redo bariatric surgery, RBS) because the first one didn’t work as expected. The study looked at 529 patients who had this second surgery between 2010 and 2020.

The research divided the patients into three groups. The first group was those who regained weight after the first surgery. In this group, about 68% of the patients lost more than half of their excessive weight after the second surgery. The study found that the smaller the difference between the patient’s body mass index (BMI) before the second surgery and their lowest BMI after the first surgery, the more likely they were to successfully lose weight after the second surgery.

The second group included patients who didn’t lose enough weight after the first surgery. In this group, about 73% of patients lost half or more of their excessive weight after the second surgery. However, a smaller difference in BMI before the second surgery and their lowest after the first surgery was associated with lower chances of success.

The third group consisted of patients who didn’t see an improvement in their obesity-related diseases, like hypertension (high blood pressure) and type 2 diabetes, after the first surgery. In this group, about 49% of patients saw their hypertension or diabetes go away (remission) after the second surgery. A specific type of surgery called One Anastomosis Gastric Bypass (OAGB) was found to increase the chances of these diseases going into remission.

In conclusion, the study found that a second weight loss surgery can be an effective treatment for obesity-related diseases. However, if a patient regained a lot of weight before the second surgery, it could reduce the chances of the surgery being successful. Also, the OAGB procedure seemed to be particularly effective in helping patients to completely get rid of their hypertension or diabetes.

FAQs

  1. What is Redo Bariatric Surgery (RBS) and why is it necessary?
  2. What factors contribute to the success of redo bariatric surgeries?
  3. How effective is RBS in the treatment of obesity-related diseases like hypertension and type 2 diabetes?

Doctor’s Tip

A helpful tip a doctor might tell a patient about obesity surgery is to focus on making long-term lifestyle changes, such as adopting a healthy diet and increasing physical activity, in order to maintain weight loss after the surgery. Additionally, choosing the right type of bariatric procedure, such as One Anastomosis Gastric Bypass (OAGB) as a redo surgery, may increase the chances of successful weight loss and remission of obesity-related diseases like hypertension and type 2 diabetes. It’s important to follow the recommendations of your healthcare team and attend regular follow-up appointments to monitor your progress and make adjustments as needed.

Suitable For

Patients who are recommended for obesity surgery typically include those who have experienced weight regain after a previous bariatric procedure, those who have had insufficient weight loss following a primary bariatric procedure, and those who have obesity-related diseases such as hypertension and type 2 diabetes that are not well controlled with other treatments. In this study, factors such as the difference in body mass index before and after the primary procedure, and the type of redo bariatric surgery performed, were found to be important in determining the success of redo surgeries in terms of weight loss and remission of obesity-related diseases.

Timeline

  • Before obesity surgery:
  1. Patient undergoes initial consultation with a bariatric surgeon to discuss options and determine candidacy for surgery.
  2. Patient undergoes pre-operative testing and evaluation to assess health status and readiness for surgery.
  3. Patient may be required to make lifestyle changes, such as dietary modifications and exercise, in preparation for surgery.
  4. Patient undergoes the bariatric surgery procedure, such as gastric bypass or sleeve gastrectomy.
  • After obesity surgery:
  1. Patient is monitored closely in the hospital post-surgery for any complications or concerns.
  2. Patient follows a strict post-operative diet and exercise regimen to aid in weight loss and recovery.
  3. Patient attends follow-up appointments with their bariatric team to track progress and address any issues.
  4. Patient experiences weight loss and improvement in obesity-related health conditions, such as hypertension and type 2 diabetes.
  5. Patient may undergo additional procedures, such as redo bariatric surgery, if weight loss is insufficient or if complications arise.
  6. Patient continues to make lifestyle changes to maintain weight loss and overall health.

What to Ask Your Doctor

  1. What are the different types of redo bariatric surgeries available and which one would be most suitable for me?
  2. What are the potential risks and complications associated with redo bariatric surgery?
  3. What is the expected timeline for recovery and when can I resume normal activities?
  4. How can I best prepare for the surgery in terms of diet and lifestyle changes?
  5. What ongoing follow-up and support will be available to me after the surgery?
  6. What are the expected outcomes in terms of weight loss and improvement in obesity-related diseases such as hypertension and type 2 diabetes?
  7. Are there any specific factors or conditions in my case that may affect the success of the redo bariatric surgery?
  8. How will my previous bariatric surgery (if applicable) impact the outcome of the redo surgery?
  9. What dietary and lifestyle changes will I need to make after the surgery to ensure long-term success?
  10. Are there any restrictions or limitations I should be aware of post-surgery?

Reference

Authors: Łabul M, Wysocki M, Bartosiak K, Orłowski M, Katkowski B, Jaworski P, Małczak P, Major P; PROSS–Collaborative Study Group. Journal: Obes Surg. 2022 Dec;32(12):3879-3890. doi: 10.1007/s11695-022-06306-3. Epub 2022 Oct 15. PMID: 36242680