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Background For severely obese patients, bariatric surgery has been recommended as an effective therapy. Objectives The Bariataric Surgery and Education (BaSE) study aimed to assess the efficacy of a videoconferencing-based psychoeducational group intervention in patients after bariatric surgery. Setting The BaSE study is a randomized, controlled multicenter clinical trial involving 117 patients undergoing bariatric surgery (mean preoperative body mass index [BMI] 49.9 kg/m 2 , SD 6.4). Patients were enrolled between May 2009 and November 2012 and were randomly assigned to receive either conventional postsurgical visits or, in addition, a videoconferencing-based 1-year group program. Methods Primary outcome measures were weight in kilograms, health-related quality of life (HRQOL), and general self-efficacy (GSE). Secondary outcome measures were depression symptoms and eating behavior. Results 94% of the patients completed the study. Mean weight loss for all patients was 45.9 kg (SD 16.4) 1 year after surgery (mean excess weight loss [EWL] 63%). Intention-to-treat analyses revealed no differences in weight loss, EWL, HRQOL, or self-efficacy between study groups at 1 year after surgery. However, patients with clinically significant depression symptoms (CSD) at baseline assigned to the intervention group (n = 29) had a significantly better HRQOL ( P = .03), lower depression scores ( P = .02), and a trend for a better EWL (.06) 1 year after surgery compared with the control group (n = 20). Conclusion We could not prove the efficacy of the group program for the whole study sample. However, results indicate that the intervention is effective for the important subgroup of patients with CSD.

Background Evidence regarding the efficacy of psychosocial interventions after bariatric surgery is rare and shows conflicting results. Objectives The Bariatric Surgery and Education (BaSE) study aimed to assess the efficacy of a psychoeducational group intervention in patients after bariatric surgery. Setting The BaSE study was a randomized, controlled, multicenter clinical trial involving 117 patients who underwent bariatric surgery. Patients received either conventional postsurgical visits or, in addition, a 1-year psychoeducational group program. The present study evaluated the sustained effects of the intervention program. Mean follow-up duration was 37.9 months (standard deviation [SD] 8.2 months) after surgery. Methods Outcome measures were as follows: body mass index (BMI), weight loss, self-efficacy, depression severity, and health-related quality of life (HRQOL). Groups were compared using an intention-to-treat approach with a mixed model for repeated measurements. Results A total of 74 patients (63.2%) completed the follow-up (T5) assessment. Mean weight loss for all patients was 43 kg (SD 15.5 kg) at T5 (mean BMI 35.1 kg/m 2 ). Mean excess weight loss was 60.4%. The effects of the surgery during the first postsurgical year were reflected, on average, by both decreasing weight and psychosocial burden. At the T5 time point, patients had slowly started to regain weight and to deteriorate regarding psychosocial aspects. However, at T5, patients who had participated in the intervention program (n = 39) showed significantly lower depression severity scores ( p = .03) and significantly higher self-efficacy ( p = .03) compared to the control group (n = 35). The 2 groups did not differ regarding weight loss and quality of life. Conclusion Psychoeducational intervention shows sustained effects on both depression severity scores and self-efficacy.

Roux-en-Ygastric bypass (RYGB) and sleeve gastrectomy (SG) rank among the most frequently applied bariatric procedures worldwide due to their positive risk/benefit correlation. A systematic review revealed a similar excess weight loss (EWL) 2 years postoperatively between SG and RYGB. However, there is a lack of randomized controlled multi-centre trials comparing SG and RYGB, not only concerning EWL, but also in terms of remission of obesity-related co-morbidities, gastroesophageal reflux disease (GERD) and quality of life (QoL) in the mid- and long-term. The BariSurg trial was designed as a multi-centre, randomized controlled patient and observer blind trial. The trial protocol was approved by the corresponding ethics committees of the centres. To demonstrate EWL non-inferiority of SG compared to RYGB, power calculation was performed according to a non-inferiority study design. Morbidity, mortality, remission of obesity-related co-morbidities, GERD course and QoL are major secondary endpoints. 248 patients between 18 and 70 years, with a body mass index (BMI) between 35–60 kg/m2 and indication for bariatric surgery according to the most recent German S3-guidelines will be randomized. The primary and secondary endpoints will be assessed prior to surgery and afterwards at discharge and at the time points 3–6, 12, 24, 36, 48 and 60 months postoperatively. With its five year follow-up, the BariSurg-trial will provide further evidence based data concerning the impact of SG and RYGB on EWL, remission of obesity-related co-morbidities, the course of GERD and QoL. The trial protocol has been registered in the German Clinical Trials Register DRKS00004766 .

With advancing age functional and morphological changes take place within the intestinal tract. The age-dependency of intestinal absorption has been studied using a d -xylose absorption test. The absorption rate (constant k 12 ), the time of appearance of the relative maximum of the d -xylose concentrations in the blood serum after oral administration (time t m ), and the extent of the relative absorption in the small intestine as a function of time RA ( t ) were determined by graphic-mathematical evaluation of the blood level kinetics of d -xylose after oral and intravenous administration. Within the age range of 3 to 96 yr, it has been proven that a slowing down of intestinal absorption occurs with advancing age. By prolonging the period during which the food components are absorbed in the small intestine (shift of t m towards later times) the old organism is just as capable of complete absorption as in the young one, even though the absorption processes take place at a slower rate. Absorption disorders in old age are due to morbidity and not, sui generis, to involution.

To test the absorption of orally administered D-xylose in the upper small intestine its concentration in the blood plasma must be measured. Absorption is determined as a function of time by subtraction of the blood values found after intravenous administration, which would indicate the rates of metabolism and extraction of xylose by the body. It is suggested that comparison with the behavior of a proposed four compartment model may give a biological interpretation of the results. The possible dependence of amount and rate of absorption can be determined if the same time after feeding of the same diet is used in each absorption measurement. It is suggested that the time point to be used for administration be that time at which the highest concentration of xylose in the peripheral blood is found.