Efecto de los patrones de conducta alimentaria y de la pérdida de peso preoperatoria sobre los resultados a corto y medio plazo en pérdida de peso tras gastrectomía vertical laparoscópica

doi:10.1016/j.ciresp.2014.04.010

Cirugía Española

Volume 93, Issue 4, April 2015, Pages 241-247

https://doi.org/10.1016/j.ciresp.2014.04.010 Get rights and content

Resumen

Introducción

En la gastrectomía vertical, la pérdida de peso depende directamente de la adherencia a la dieta postoperatoria. El objetivo de este estudio es evaluar el efecto de los patrones alimentarios preoperatorios y de la adherencia a la dieta pautada antes de la cirugía, sobre la pérdida de peso a corto y medio plazo.

Material y métodos

Se realizó un estudio prospectivo de todos los pacientes obesos mórbidos intervenidos mediante una gastrectomía vertical laparoscópica como procedimiento bariátrico entre 2008 y 2012. Se evaluaron los hábitos alimentarios preoperatorios de los pacientes y se registró la pérdida de peso pre- y postoperatoria a los 12 y 24 meses de la cirugía.

Resultados

Se incluyó a 50 pacientes en el estudio con un IMC preoperatorio medio de 51,2 + 7,9 kg/m². Todos los pacientes presentaban un patrón alimentario de grandes comedores. Además, el 44% de los pacientes presentaba un patrón de picoteador, el 40% reconocían ingesta abundante de dulces y el 48% tomaban refrescos «light» como bebida en las comidas. El porcentaje de exceso de peso perdido (PEP) medio preoperatorio fue de 13,4% (rango 10-31,4%). Al año el PEP era de 83,7% y a los 2 años, de 82,4%. La pérdida de peso y el PEP preoperatorios mostraron una correlación directa con la pérdida obtenida a los 12 y 24 meses. El PEP medio a los 12 y 24 meses fue significativamente peor en pacientes picoteadores, tomadores de dulces y bebedores de refrescos «light».

Conclusión

La pérdida de peso preoperatoria se correlaciona con la pérdida de peso al año y a los 2 años. Aquellos pacientes, que además de grandes comedores, también son picoteadores, tomadores de dulces o de bebidas «light», logran una menor pérdida de peso.

Abstract

Introduction

Weight loss depends directly on the adhesion to the postoperative diet in patients undergoing a sleeve gastrectomy. The aim of this study is to evaluate the effect of different preoperative feeding patterns and the adhesion to a preoperative diet on short and mid- term postoperative weight loss.

Material and methods

A prospective study of all morbidly obese patients undergoing a laparoscopic sleeve gastrectomy as a bariatric procedure between 2008 and 2012 was performed. Preoperative feeding patterns and weight loss, preoperatively and postoperatively at 12 and 24 months, were evaluated.

Results

A total of 50 patients were included, with a mean preoperative BMI of 51,2 + 7,9 kg/m². All the patients presented a feeding pattern of big eaters, 44% of snackers, 40% of sweet eaters and 48% reported regular ingestion of «light» soft drinks. Mean preoperative excess weight loss (EWL) was 13,4% (range 10-31,4%). At 12 months mean EWL was 83,7% and at 24 months 82,4%. Pre and postoperative EWL showed a direct correlation at 12 and 24 months. Mean EWL was significantly lower in snackers, sweet eaters and those drinking «light» soft drinks regularly.

Conclusion

Preoperative weight loss correlates directly with postoperative weight loss at 1 and 2 years. Snackers, sweet eaters and «light» soft drink consumers, associated with a big eater pattern, achieve a significantly lower postoperative weight loss.

Section snippets

Introducción

La obesidad es una de las enfermedades más prevalentes en países desarrollados. En España, su prevalencia para ambos sexos es del 15,5%, observándose un aumento progresivo en los últimos años1, 2. El tratamiento inicial de la obesidad debe basarse en la dieta hipocalórica y el ejercicio físico. Sin embargo, en pacientes con obesidad mórbida, la cirugía bariátrica ha demostrado ser el método más eficaz para conseguir una pérdida de peso sustancial y mantenida en el tiempo, además de conseguir

Pacientes y métodos

Se realizó un estudio prospectivo de todos los pacientes obesos mórbidos intervenidos mediante GVL como procedimiento bariátrico entre febrero de 2008 y enero de 2012.

Resultados

Se incluyó a un total de 50 pacientes en el estudio, 44 mujeres (88%) y 6 varones (12%), con una edad media de 43,2 ± 10,2 años, con un intervalo entre 20 y 62 años. Las comorbilidades que presentaban los pacientes incluían diabetes mellitus tipo 2 en el 26% de los casos, dislipidemia en el 50% (40% hipercolesterolemia y 10% hipertrigliceridemia), hipertensión arterial en el 30%, osteoartritis en el 18% y síndrome de apnea obstructiva del sueño en el 14%. Todos los pacientes diabéticos,

Discusión

La GVL es una técnica bariátrica segura y efectiva, con la que se consigue una pérdida de peso significativa y un alto porcentaje de resolución de comorbilidades. Esto ha hecho que en los últimos años haya ganado relevancia, posicionándose como la segunda técnica bariátrica más realizada en nuestro medio, tras el bypass gástrico. En términos de pérdida de peso, se estima que con ella se consigue una PEP en torno al 70%⁷. Llama la atención que en nuestra serie el PEP al año era del 83,7% y a los

Conflicto de intereses

Los autores declaran no tener ningún conflicto de intereses.

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Food insecurity is linked to poorer dietary quality in prebariatric surgery patients
2021, Surgery for Obesity and Related Diseases
Research exploring dietary quality patterns within bariatric populations is limited, despite the significance of eating behaviors for postoperative outcomes. Recent studies revealed associations between food insecurity and disordered eating behavior in bariatric patients; however, the relationship between food insecurity and dietary quality is not known.
To examine the association between dietary quality and levels of food security within a sample of presurgical bariatric patients.
One academic medical center in central Pennsylvania, United States of America.
Patients completed three self-report measures as part of their presurgical psychological assessment process. Food security status was measured by the United States Department of Agriculture’s Food Security Module, modified for self-reports. Participants also completed the Rapid Eating Assessment for Participants, short version, which is a measure of dietary quality with scores ranging from 13–39, and the Adult Eating Behavior Questionnaire. Hierarchical multiple regressions were used to assess relationships between dietary quality and food security levels, and mediation models were built to explore associations between variables.
Of the 197 participants, 35.5% reported high food security, while 35.0% and 29.5% reported marginal food security and food insecurity, respectively. Compared with patients with high food security, the dietary quality scores of food-insecure patients were 1.3 points lower (95% confidence interval [CI], −3.3 to .7; P = .2) of and marginally food-secure patients were 1.2 points lower (95% CI, −2.9 to .5) than those reporting high food security (P = .2).
Our findings indicate a need for further exploration into the barriers that prebariatric patients may face when attempting to adhere to pre- and postoperative dietary requirements, particularly for those reporting marginal food security and food insecurity. Future research should target postoperative outcomes, including weight gain, weight regain, and dietary adherence, among the most economically vulnerable bariatric patients.
Reliability and responsiveness of virtual portion size creation tasks: Influences of context, foods, and a bariatric surgical procedure
2020, Physiology and Behavior
Citation Excerpt :
Therefore, we predicted that virtual portions created by controls would be stable over time and that baseline portions would be highly correlated with follow-up portions; this stability in portion creation over time would illustrate test-retest reliability of VPCTs. Bariatric surgery patients consume less food and lose weight after bariatric surgery [22], therefore, we predicted portions created by patients would significantly decrease after surgery. Because the energy requirements of individuals with obesity is higher than individuals of normal weight [23], we predicted that portions created by patients would be higher than controls at baseline, but similar to controls at follow-up.
Food portion size influences energy intake and sustained high-energy intake often leads to obesity. Virtual portion creation tasks (VPCTs), in which a participant creates portions of food on a computer screen, predict intake in healthy individuals. The objective of this study was to determine whether portions created in VPCTs are stable over time (test-retest reliability) and responsive to factors known to influence food intake, such as eating contexts and food types, and to determine if virtual portions can predict weight loss. Patients with obesity scheduled for bariatric surgery (n = 29), and individuals with a normal BMI (18.5–24.9 kg/m², controls, n = 29), were instructed to create virtual portions of eight snack foods, which varied in energy density (low and high) and taste (sweet and salty). Portions were created in response to the following eating situations, or “contexts”: What they would a) eat to stay healthy (healthy), b) typically eat (typical), c) eat to feel comfortably satisfied (satisfied), d) consider the most that they could tolerate eating (maximum), and e) eat if nothing was limiting them (desired). Tasks were completed before, and 3 months after, surgery in patients, and at two visits, 3 months apart, in controls. Body weight (kg) was recorded at both visits. Virtual portions differed significantly across groups, visits, eating contexts, energy densities (low vs. high), and tastes (sweet vs. salty). Portions created by controls did not change over time, while portions created by patients decreased significantly after surgery, for all contexts except healthy. For patients, desired and healthy portions predicted 3-month weight loss. VPCTs are replicable, responsive to foods and eating contexts, and predict surgical weight loss. These tasks could be useful for individual assessment of expectations of amounts that are eaten in health and disease and for prediction of weight loss.
Preoperative administration of Omega-3 fatty acids on postoperative pain and acute-phase reactants in patients undergoing Roux-en-Y gastric bypass: A randomized clinical trial
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Citation Excerpt :
Nutritional formulas may be superior to regular diets because compliance is better controlled and lower energy intake is more likely to be accomplished [1]. Moreover, many nutritional formulas present a high protein content, essential for the process of postoperative healing, mainly in those patients who present hypoproteinemia despite their morbidly obese condition [1,2]. The term “Immunonutrition” (IMN) describes the enteral administration of certain substrates (omega-3 fatty acids (O3FA), arginine, glutamine, nucleotides and antioxidants) with an eventual immunomodulating function.
The term “Immunonutrition” (IMN) describes the enteral administration of certain substrates with a theoretical immunomodulating function. From all the elements conforming these IMN formulas, Omega-3 fatty acids (O3FA) are hypothesized to be the most important component for immunomodulation, with increased anti-inflammatory and antioxidant effect.
A prospective randomized clinical trial of all the patients undergoing laparoscopic Roux-en-Y gastric bypass was performed. Patients were randomly assigned into 2 groups: those patients receiving a preoperative balanced energy high-protein formula (Control Group) and those ones who received the same preoperative nutritional formula enriched with O3FA (Experimental Group). In both groups, there was a restriction to 900 Kcal/day. Nutritional intervention started 10 days before surgery and was maintained up to 8 h before the surgical act. Preoperative weight loss, postoperative pain, complications and acute phase reactants were investigated.
40 patients were included in the study, 20 in each group. Preoperative excess weight loss (EWL) with the prescribed treatment was 10.6 ± 7.7% in Control Group and 14.1 ± 5.8% in the Experimental Group (p = 0.024). Mean postoperative pain was 25 ± 9.2 mm in Control group and 10,9 ± 4,4 mm in Experimental Group (p = 0.015). CRP determined 24 h after surgery was significantly lower in the Experimental Group than in the Control Group. There were not significant differences in complications, mortality or readmission rates between groups.
The use of a nutritional supplement enriched with O3FA is associated with a greater preoperative weight loss, reduced postoperative pain and decreased postoperative levels of C reactive protein.
Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy
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Dietary Patterns in Adolescent Obesity as Predictors of Long-Term Success Following an Intensive Inpatient Lifestyle Programme
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Higher Preoperative Weight loss Is Associated with Greater Weight Loss up to 12 Months After Bariatric Surgery
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View all citing articles on Scopus

¹: Los integrantes del Grupo OBELCHE se relacionan en el anexo.

View full text

Resumen

Introducción

Material y métodos

Resultados

Conclusión

Abstract

Introduction

Material and methods

Results

Conclusion

Section snippets

Introducción

Pacientes y métodos

Resultados

Discusión

Conflicto de intereses

Cir Esp

Med Clin (Barc)

Surg Obes Relat Dis

Surg Obes Relat Dis

Cir Esp

Act Diet

Am J Public Health

Bariatric surgery: A systematic review of the clinical and economic evidence

J Gen Intern Med

Surgery for obesity

Cochrane Database Syst Rev

Complications of bariatric surgery: Presentation and emergency management - a review

Ann R Col Surg Engl

Sleeve gastrectomy–a food limiting operation

Obes Surg