Pregnancy and Bariatric Surgery: Significant Variation in Bariatric Surgeons' Practices and Preferences: A National Survey

BACKGROUND: Bariatric complications may occur during pregnancy, potentially causing serious maternal and fetal problems. The aim of this study was to determine the current practice and preferences of bariatric surgeons regarding the pregnancy care of fertile women before and after bariatric surgery. METHODS: A 26-question anonymous online survey was designed and sent to all bariatric surgeons of the Dutch Society of Metabolic and Bariatric Surgery. RESULTS: At least one bariatric surgeon from each bariatric center (n = 18) completed the survey. In case of a future child, wish sleeve gastrectomy became more popular than Roux-en-Y gastric bypass. All surgeons provided preoperative education regarding bariatric complications during pregnancy. Nine centers without neonatal intensive care would not refer pregnant women with acute complications. Half of the centers had a standard operating procedure. Seven per 18 bariatric centers had seen at least one postbariatric pregnant patient with severe maternal morbidity. One case of perinatal mortality was reported. CONCLUSION: There is an inconsistent and often below guideline standard daily practice regarding pregnancy before and after bariatric surgery. There is limited experience with pregnant women with acute bariatric complications. Referral to tertiary centers is inadequate. Better information provision for both professionals and patients regarding possible complications is needed

Emotional eating as predictor of weight loss 2 years after Roux-en-Y gastric bypass

There has been little agreement on the predictive value of emotional eating on weight loss outcomes after bariatric surgery. The aim of this study was to examine the predictive value of preoperative emotional eating, in response to clearly labelled emotions and diffuse emotions, on excess weight loss (EWL) and total weight loss (TWL) 2 years after Roux-en-Y gastric bypass (RYGB). All participants included in this retrospective cohort study were screened for RYGB surgery by a multidisciplinary team. The level of emotional eating was derived from the Dutch Eating Behaviour Questionnaire (DEBQ); the level of psychological variables from the Symptom Checklist-90. Participants were clustered, based on their DEBQ score, in high and low emotional eaters. Multiple linear regression analyses were performed to examine the association between preoperative emotional eating and EWL, and TWL. There were no significant differences in EWL of the 172 included participants, defined as either high or low emotional eaters (EWL 82.7% +/- 18.2 versus 82.4% +/- 21.3, respectively). Based on the regression analysis, emotional eating was not significantly associated with EWL, nor with TWL. When corrected for psychological, demographic and biological variables, preoperative emotional eating in response to diffuse emotions negatively affected EWL (beta = -0.16, P = 0.048), although this was not applicable for TWL. Preoperative emotional eating does not seem to influence EWL, nor TWL 2 years after RYGB. Since this study faced multiple limitations, further investigation is required regarding the predictive value of emotional eating

Emotional eating as predictor of weight loss 2 years after Roux-en-Y gastric bypass

There has been little agreement on the predictive value of emotional eating on weight loss outcomes after bariatric surgery. The aim of this study was to examine the predictive value of preoperative emotional eating, in response to clearly labelled emotions and diffuse emotions, on excess weight loss (EWL) and total weight loss (TWL) 2 years after Roux-en-Y gastric bypass (RYGB). All participants included in this retrospective cohort study were screened for RYGB surgery by a multidisciplinary team. The level of emotional eating was derived from the Dutch Eating Behaviour Questionnaire (DEBQ); the level of psychological variables from the Symptom Checklist-90. Participants were clustered, based on their DEBQ score, in high and low emotional eaters. Multiple linear regression analyses were performed to examine the association between preoperative emotional eating and EWL, and TWL. There were no significant differences in EWL of the 172 included participants, defined as either high or low emotional eaters (EWL 82.7% +/- 18.2 versus 82.4% +/- 21.3, respectively). Based on the regression analysis, emotional eating was not significantly associated with EWL, nor with TWL. When corrected for psychological, demographic and biological variables, preoperative emotional eating in response to diffuse emotions negatively affected EWL (beta = -0.16, P = 0.048), although this was not applicable for TWL. Preoperative emotional eating does not seem to influence EWL, nor TWL 2 years after RYGB. Since this study faced multiple limitations, further investigation is required regarding the predictive value of emotional eating

Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy in Young Adults: a Dutch Registry Study

Background The most commonly performed bariatric procedures worldwide are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), yet outcomes following these procedures in young adults are limited. Therefore, the objective of this study was to compare weight loss outcomes between RYGB and SG in young adults.Methods This is a nationwide retrospective cohort study of young adults, aged 18-25 years, who underwent RYGB or SG between 2015 and 2019, with data from the Dutch Audit Treatment of Obesity (DATO). The primary outcome was weight loss expressed as percentage total weight loss (%TWL) in a period of 3 years after surgery. Secondary outcomes were the incidence of complications (<30 days) and progression of obesity-related comorbidities.Results In total, 2313 patients were included, 1246 in the RYGB group and 1067 in the SG group. Percentage TWL was significantly higher in the RYGB group compared to the SG group at 1, 2, and 3 years after surgery (respectively 2.4%, 2.9%, and 3.3% higher, p < 0.001). RYGB was associated with an on-average 2.75 higher %TWL compared to SG in females (p < 0.001), although this was not seen in males (beta= 0.63, p =0.514). No differences were found in the incidence of complications, nor the progression of obesity-related comorbidities except for gastroesophageal reflux disease (GERD). There was more improvement or resolution of GERD in the RYGB group (95.2% vs. 56.3%, p < 0.001).Conclusion Similar numbers of RYGB and SG were performed in young adults, whereas RYGB was associated with greater weight loss in the short- and midterm, particularly in females

Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy in Young Adults: a Dutch Registry Study

Background The most commonly performed bariatric procedures worldwide are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), yet outcomes following these procedures in young adults are limited. Therefore, the objective of this study was to compare weight loss outcomes between RYGB and SG in young adults.Methods This is a nationwide retrospective cohort study of young adults, aged 18-25 years, who underwent RYGB or SG between 2015 and 2019, with data from the Dutch Audit Treatment of Obesity (DATO). The primary outcome was weight loss expressed as percentage total weight loss (%TWL) in a period of 3 years after surgery. Secondary outcomes were the incidence of complications (<30 days) and progression of obesity-related comorbidities.Results In total, 2313 patients were included, 1246 in the RYGB group and 1067 in the SG group. Percentage TWL was significantly higher in the RYGB group compared to the SG group at 1, 2, and 3 years after surgery (respectively 2.4%, 2.9%, and 3.3% higher, p < 0.001). RYGB was associated with an on-average 2.75 higher %TWL compared to SG in females (p < 0.001), although this was not seen in males (beta= 0.63, p =0.514). No differences were found in the incidence of complications, nor the progression of obesity-related comorbidities except for gastroesophageal reflux disease (GERD). There was more improvement or resolution of GERD in the RYGB group (95.2% vs. 56.3%, p < 0.001).Conclusion Similar numbers of RYGB and SG were performed in young adults, whereas RYGB was associated with greater weight loss in the short- and midterm, particularly in females

Emotional eating as predictor of weight loss 2 years after Roux‐en‐Y

There has been little agreement on the predictive value of emotional eating on weight loss outcomes after bariatric surgery. The aim of this study was to examine the predictive value of preoperative emotional eating, in response to clearly labelled emotions and diffuse emotions, on excess weight loss (EWL) and total weight loss (TWL) 2 years after Roux-en-Y gastric bypass (RYGB). All participants included in this retrospective cohort study were screened for RYGB surgery by a multidisciplinary team. The level of emotional eating was derived from the Dutch Eating Behaviour Questionnaire (DEBQ); the level of psychological variables from the Symptom Checklist-90. Participants were clustered, based on their DEBQ score, in high and low emotional eaters. Multiple linear regression analyses were performed to examine the association between preoperative emotional eating and EWL, and TWL. There were no significant differences in EWL of the 172 included participants, defined as either high or low emotional eaters (EWL 82.7% +/- 18.2 versus 82.4% +/- 21.3, respectively). Based on the regression analysis, emotional eating was not significantly associated with EWL, nor with TWL. When corrected for psychological, demographic and biological variables, preoperative emotional eating in response to diffuse emotions negatively affected EWL (beta = -0.16, P = 0.048), although this was not applicable for TWL. Preoperative emotional eating does not seem to influence EWL, nor TWL 2 years after RYGB. Since this study faced multiple limitations, further investigation is required regarding the predictive value of emotional eating