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Background: Although bariatric surgery in patients over 65 years of age gives comparable results to treatment in the younger population, there are still controversies regarding the indications for surgery, risk assessment, and choice between different types of surgery. The study aimed to identify the factors contributing to weight loss success after bariatric surgery in patients over 65 years of age. Material and Methods: This is a retrospective, multicenter cohort study of patients with obesity aged over 65 years undergoing primary laparoscopic bariatric surgery in the years 2008-2022. Data came from 11 bariatric centers. Patients were divided into two groups: responders (R) who achieved more than 50% EWL and nonresponders (NR) who achieved less than 50% EWL. Both groups were compared. Uni- and multivariate logistic regression was used to identify predictors of weight loss success. Results: Out of 274 analyzed patients, the average BMI before surgery was 42.9 kg/m2. The most common obesity-related diseases were hypertension (85.1%) and type 2 diabetes (53.3%). Sleeve gastrectomy was the most frequently performed procedure (85.4%). Uni- and multivariate logistic regression analysis confirmed preoperative BMI (OR= 0.9, 95% CI: 0.82-0.98, P =0.02), duration of diabetes > 10 years (OR= 0.3, 95% CI: 0.09-0.82, P= 0.02), balloon placement (OR =10.6, 95% CI: 1.33-84.83, P =0.03), time since first visit (OR= 0.9, 95% CI: 0.84-0.99, P= 0.04), preoperative weight loss (OR= 0.9, 95% CI: 0.86-0.98, P=0.01), and OAGB (OR =15.7, 95% CI: 1.71-143.99, P= 0.02) to have a significant impact on weight loss success 1 year after bariatric surgery. Conclusions: Patients with higher preoperative weight loss may have a poorer response to surgery. OAGB emerged as the most beneficial type of surgery in terms of weight loss. Intragastric balloon placement before surgery may be effective in patients above 65 years of age and may be considered as a two-stage approach. [ABSTRACT FROM AUTHOR]

Background: The study aims to demonstrate whether weight loss with a low-calorie diet before laparoscopic sleeve gastrectomy (LSG) may affect the outcomes. Materials and Methods: A total of 305 patients undergoing primary LSG were included in the study. Each patient adopted a low-calorie diet (1000 calories) before LSG. The patients were stratified into two groups. Group A: Those who lost 3% or more of their total body weight loss (TBWL), Group B: Those who lost

Background: The study aims to demonstrate whether weight loss with a low-calorie diet before laparoscopic sleeve gastrectomy (LSG) may affect the outcomes. Materials and Methods: A total of 305 patients undergoing primary LSG were included in the study. Each patient adopted a low-calorie diet (1000 calories) before LSG. The patients were stratified into two groups. Group A: Those who lost 3% or more of their total body weight loss (TBWL), Group B: Those who lost <3% of their TBWL. Two groups were compared in terms of operative time, length of hospital stay, complications and weight loss outcomes. Results: One hundred and five patients (35%) were in Group A and 200 patients were in Group B. Median weight loss was 4 kg (3–20 kg). Pre-operative mean body mass index (BMI) was 40 ± 7.4 kg/m2 in Group A and 41 ± 5.9 kg/m2 in Group B (P = 0.06). At 1 year after the surgery, BMI regressed to 29.7 ± 4.9 kg/m2 in Group A and to 27 ± 4.2 kg/m2 in Group B (P < 0.001). One hundred and twenty-nine patients who completed 2 years of follow-up, mean BMI regressed to 29.4 ± 4.1 kg/m2 in Group A (n = 46) and to 27.2 ± 4.5 kg/m2 in Group B (n = 83) (P < 0.001). In Group B, one patient experienced post-operative bleeding. No other complications were observed in the study. There was no significant difference between the groups in terms of operative time (P = 0.53) and length of hospital stay (P = 0.9). Conclusion: Weight loss before LSG does not improve post-operative weight loss. [ABSTRACT FROM AUTHOR]

Background: Even though there aren't enough studies on long-term outcomes, laparoscopic sleeve gastrectomy (LSG) is the most common procedure among weight loss surgeries. In this study, we aimed to evaluate the histopathological results of resected stomach specimens of patients who underwent LSG and to analyze the effect of histopathological results on weight loss success., Methods: The patients were divided into two groups according to histopathological results of the pathology specimens: abnormal (chronic active gastritis, chronic inactive gastritis, neoplasias) and normal. If the excess weight loss percentage (EWL%) values were over 70% at the end of the first year following LSG, the patients were considered successful in terms of weight loss. The groups were compared in terms of age, gender, preoperative body mass index (BMI) value, as well as postoperative first-year BMI, EWL%, total weight loss percentage (TWL%), and successful patient percentage., Results: A total of 599 patients were included in this study. When the patients were dichotomized according to their pathology results as normal or abnormal, 101 (%83.5) of the patients with normal pathology results had EWL% greater than 70%. On the contrary, 356 (74.5%) of the patients with abnormal pathology results had EWL% greater than 70%, and this difference was statistically significant (p=0.038)., Conclusion: Patients with normal histopathologic examination results of resected gastric specimens after LSG are more successful than the patient population with abnormal histopathologic results in terms of the percentage of patients with EWL% above 70 at the end of the first postoperative year. We recommend routine histopathologic analysis of gastric specimens after LSG in severely obese patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Demirpolat et al.)

Lack of standard definitions of primary and secondary (non)responders after RYGB and SG makes it impossible to compare the literature. The aim was to analyze the different definitions used. MEDLINE® was searched for literature published between 01-07-2014 and 01-07-2017 concerning (1) patients who received a primary RYGB or SG and (2) the outcomes of primary and secondary (non)responders. One hundred twelve out of 650 papers were eligible. Forty out of 47 papers described a definition of weight loss success. Sixty-seven out of 112 papers mentioned weight loss failure of which 42 described a definition, in total 23 different definitions. Weight regain was mentioned in 77 papers; only 21 papers provided a definition. The recent literature regarding definitions of these outcomes is highly inconsistent. To compare the literature international consensus is required. [ABSTRACT FROM AUTHOR]

Summary This study examined what characteristics predict weight loss success with alternate day fasting (ADF). Four 8-week trials of ADF ( n = 121) were included in the analysis. Subjects aged 50–59 y achieved greater ( P = 0.01) weight loss than other age groups. Males and females achieved similar weight loss. Caucasian subjects achieved greater ( P = 0.03) weight loss than other races. Baseline body weight and baseline BMI did not predict degree of weight loss achieved with the diet. These findings may help clinicians to decide which population groups may benefit most from an ADF approach. [ABSTRACT FROM AUTHOR]

Background The prevention and treatment of overweight and obese individuals on a population-wide basis is challenging because patients have difficulties with adhering to weight loss programmes. The present study aimed to evaluate patients' adherence to the weight reduction programme by identifying factors predictive of both drop-out rate and weight loss success. Methods One-hundred and twenty-four obese patients participated in a 12-month weight reduction programme, involving group therapy during an intensive 5-day educational intervention, followed by five, 2-h follow-up visits. The primary outcome measures included drop-out rate and percentage weight loss. Sociodemographic and clinical characteristics, as well as type of diet, were explored as potential predictive factors. Type of diet was assigned based on randomisation. Regression analyses were conducted to identify predictive variables of drop-out and weight loss success. Results In total, 33.1% of all recruited participants were deemed successful because they reduced the initial weight by more than 5% after the 12-month intervention. The overall attrition rate was 32.3%. In a multiple regression model, initial weight loss and marital status were the strongest predictors of weight loss success after 1-year period ( r2 = 0.481, P < 0.001). In a separate analysis, subjects more likely to drop-out were those with a lower educational level [odds ratio ( OR) = 3.26, 95% confidence interval ( CI) = 1.22-8.70, P = 0.018] and a higher level of obesity ( OR = 0.974, 95% CI = 0.95-0.99, P = 0.010). Conclusions The present study demonstrates that initial weight loss at 1 month made the strongest unique contribution to the prediction of percentage weight loss after 12 months, whereas being married was a negative predictor. Those with a lower educational level and a higher level of obesity were more likely to drop-out. [ABSTRACT FROM AUTHOR]

Background: This study aimed to test the hypothesis that the amount of weight lost on a mandatory 2-week pre-operative very-low-calorie diet (VLCD) would predict the longer-term outcomes of laparoscopic adjustable gastric banding (LAGB). Methods: All patients treated with a primary LAGB from 21 October 2008 until 30 June 2010, who were prescribed a 2-week pre-operative VLCD, have been included in the study. Patient age, weight, BMI and excess weight (defined as weight above a BMI of 25) were extracted on the day of first visit, day of surgery and at the post-operative visits at 3, 12 and 24 months. From these data, percent excess weight loss (EWL) was calculated and compared at all time points. Results: The weight loss achieved on a mandatory 2-week pre-operative diet did not predict weight outcomes at 2 years ( r = −0.008; p = 0.931). Using multivariate analysis, the best predictor of 24-month percent EWL was percent EWL at 3 months post operation (sr = 0.34; p = 0.003). Conclusions: Results from a pre-operative diet should not be used to predict the ultimate outcome of bariatric surgery. The weight loss at 3 months following LAGB was a strong predictor of longer-term outcomes. There may be potential for improving longer-term results with LAGB by better supporting patients who are not achieving good weight loss at this early time point. [ABSTRACT FROM AUTHOR]

The efficacy of anti-obesity drugs usually does not consider the high degree of interindividual variability in responses to the drug which could affect the decision to withdraw the drug early due to ineffectiveness or to continue therapy according to specific expectations of success. The aim of this study was to analyze body weight loss in kilograms during the first month (1 mo-BWLkg) of treatment with 30 mg phentermine and development of tolerance to phentermine, on its 6-month efficacy. One hundred sixty-six subjects with obesity were individually or jointly analyzed in the study. Subjects with 1 mo-BWLkg of <1 kg, 1–3 kg, 3–5 kg, and ≥5 kg reached 6-month mean percentage body weight reductions (BWR%) of approximately 3%, 5%, 10%, and 15%, respectively. Development of late tolerance (4–6 months) to phentermine had a lower impact than early tolerance (2–3 months). Subjects with 1 mo-BWLkg < 3 kg who developed early tolerance did not achieve relevant BWR% (≥5%) at month 6, while the rest of the subgroups achieved increasing and progressive BWR%, according to their 1 mo-BWLkg range and time of onset of tolerance. The 1 mo-BWLkg and development of tolerance to phentermine could be useful to predict the expected 6-month efficacy trends in obese patients treated with 30 mg phentermine. [ABSTRACT FROM AUTHOR]

Background: Alternate-day fasting (ADF) has gained popularity in recent years. The diet consists of a "fast day" where an individual consumes 0-25% of their energy needs, alternated with a "feast day" where a person is permitted to eat ad libitum., Aim: This study examined eating behavior traits of successful weight losers during alternate day fasting., Methods: Obese participants ( n = 34) took part in 12 months of ADF and were grouped into a high (≥5%) or low-weight-loss (<5%) group post-treatment., Results: The high-weight-loss group demonstrated increased ( p = 0.04) fullness, decreased ( p = 0.03) hunger, increased dietary protein intake (15% to 20% of kcal, p = 0.04), and better adherence to fast-day calorie goals., Conclusions: Thus, individuals who achieve clinically significant weight loss with ADF demonstrate improved satiety, increased protein intake, and better adherence to fast-day calorie goals.

Objective: To investigate whether bariatric patients experience changes in the enjoyment of health-promoting behaviors, and how those changes relate to weight loss success. Materials and Methods: Online lifestyle survey for bariatric patients ≥18 years old who had undergone gastric bypass or sleeve gastrectomy ≥1 year earlier. Changes in the enjoyment of eating behaviors and exercise were surveyed, and associations with weight loss success were analyzed. The role of obtaining external support since surgery was investigated. Results: Of 877 respondents, 475 were eligible (95% women, 53.3 ± 9.0 years, body mass index 34.2 ± 8.0 kg/m 2 ), of whom 21%, 36%, and 43% had had surgery 12-24, 24-60, and >60 months earlier, respectively. Postsurgery, patients enjoyed eating healthy foods more (63%), exercise more (46%), eating junk food less (66%), and overeating less (95%). Increased enjoyment of healthy foods and exercise were only associated with weight loss success among patients with surgery ≥24 months previously. While obtaining external support was associated with successful weight loss overall, external support correlated with enjoying healthy food and exercise more in patients who had had their surgery at least 60 months previously. Discussion: Learning to enjoy health-promoting behaviors after bariatric surgery may not coincide with improved weight loss outcomes before 2 years have passed. † This article is a revised version of a previously published article that was withdrawn due to a large number of reporting and formatting errors. This version was published on June 26, 2018. For further details, see the official withdrawal notice at http://online.liebertpub.com/doi/full/10.1089/bari.2016.0036.withdraw or on page 94 in volume 13, number 2, 2018 of the Journal.