Profil des patients en surpoids ou obèses avant une première consultation pour prise en charge nutritionnelle

PARIS7-Xavier Bichat (751182101) / SudocSudocFranceF

Spin occurs in bariatric surgery randomized controlled trials with a statistically nonsignificant primary outcome: A systematic review

Objectives: To systematically identify the strategy and frequency of spin in reports of bariatric surgery randomized controlled trials (RCTs) with statistically nonsignificant primary endpoint. Study design and Setting: The use of specific reporting strategies to highlight the beneficial effect of an experimental treatment can affect the reader interpretation of trial results, particularly when the primary endpoint is not statistically significant. A literature search was performed to identify RCTs publications assessing the impact of bariatric surgery on obesity-related comorbidities published over the past 10 years (from January 2020 till December 2020) in MEDLINE and EMBASE. RCTs publications with statistically non-significant primary outcomes were included. Results: Of 46 576 reports screened for title and abstract inclusion, 29 RCT reports met the inclusion criteria for spin analysis. In total, 16 abstracts (55%) and 18 main texts (62%) were classified as having a spin. In abstract results and conclusion sections, the spin was identified in 69% of reports. In main text results, discussion, and conclusion sections, the spin was recognized in 37%, 72%, and 76% of reports respectively. The spin consisted mainly of focusing on within-group improvements and the interpretation of statistically nonsignificant results as showing treatment equivalence. Conclusion: Spin occurred in a high proportion of bariatric surgery RCTs with a statistically nonsignificant primary endpoint

Associations of lifetime traumatic experience with dysfunctional eating patterns and post-surgery weight-loss in adults with obesity: a retrospective study

This study aimed to examine the associations of lifetime traumatic experience with pre- and post-surgery eating pathology and postoperative weight-loss in a sample of bariatric surgery patients using electronic medical record (EMR) data. Pre-surgery lifetime exposure to traumatic event, pre- and post-surgery dysfunctional eating patterns, and post-operative total and excess weight losses were extracted from EMR of 200 bariatric surgery patients in 2013 and 2014. Logistic regression analyses were conducted. 60.5% of the patients (81.5% women; age=44.4±11.5 years; BMIpre=44.9±5.5 kg/m2) reported that they were exposed to a traumatic event during their lifetime. Before surgery, trauma exposure was associated with impulsive, compulsive or restrictive eating patterns (OR=2.40), overeating or disturbed eating (OR=1.55), and grazing or night eating behaviors (OR=1.72). After surgery, trauma exposure was associated with lower total weight loss at 6 months (OR=2.06) and 24 months (OR=2.06), and to overeating or disturbed eating (OR=1.53) 12 months after surgery. Bariatric surgery candidates with a history of trauma exposure could benefit from closer medical, dietetic, and/or psychological follow-up care to avoid insufficient postoperative weight loss as well as reappearance of dysfunctional eating patterns after surgery

Changes in total sperm count after gastric bypass and sleeve gastrectomy: the BARIASPERM prospective study

International audienceBackground: The massive weight loss induced by bariatric surgery is associated with major benefits, but the effect on semen variables is still uncertain.Objectives: To explore semen modifications with gastric bypass and sleeve gastrectomy.Setting: Five French University Hospitals.Methods: Male candidates for bariatric surgery with no history of infertility were recruited in this controlled prospective study. Sperm characteristics were collected before surgery and then 6 months and up to 12 months after surgery.Results: Forty-six adult men who underwent gastric bypass (n = 20) or sleeve gastrectomy (n = 26) were included. Total sperm count tended to be lower at 6 months and showed a significant decrease at 12 months in both surgery groups, at -69.5 million (-96.8 to -42.2 million; P = 0.0021). Total sperm count at 12 months relative to baseline was -41.4 million (P = .0391) after gastric bypass and -91.1 million (P = .0080) after sleeve gastrectomy. This was counterbalanced by an associated resolution of hypogonadism and decrease of DNA fragmentation in most patients with time after surgery.Conclusion: Improvement in some semen variables after bariatric surgery observed in 3 previous studies is in contrast to the lower mean total sperm count found in this study at 1 year. The possible reversibility of this effect in the long term and the impact of surgery on fertility both remain unknown