The number of bariatric procedures has exponentially increased in the past decade, as a result of the lack of successful clinical weight-loss interventions. The main reasons for the failure of clinical obesity management are:(1) anti-obesity medications are administered as monotherapies (or pre-combined drugs);(2) lack of combination between pharmacotherapy and non-pharmacological modalities;(3) short duration of pharmacotherapy for obesity;(4) lack of weight-loss maintenance strategies;(5) misunderstanding of the complex …

Background Laparoscopic greater curvature plication (LGCP) is a newer metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report outcomes in a cohort of LGCP patients at 5-year follow-up. Methods Body mass index (BMI, kg/m 2) evolution, excess weight loss (% EWL), excess BMI loss (% EBMIL), and total weight loss (% TWL) were recorded. Repeated measures analysis of variance (ANOVA) was used to assess BMI change over 5 years. Two-step cluster analysis was used to profile LGCP …

Background Patients with morbid obesity selected for bariatric surgery have a high prevalence of nonalcoholic steatohepatitis (NASH); however, the incidence is varied and depends on race. The prevalence of NASH in obese Japanese patients is unknown. We evaluated the prevalence of NASH in a prospective cohort of Japanese patients with morbid obesity. Methods From October 2009 to July 2011, consecutive patients requiring bariatric surgery underwent a liver biopsy during the operation. The indications for bariatric surgery …

Laparoscopic Roux-en-Y gastric bypass (LRYGBP) reduces appetite and induces significant and sustainable weight loss. Circulating gut hormones changes engendered by LRYGBP are implicated in mediating these beneficial effects. Laparoscopic sleeve gastrectomy (LSG) is advocated as an alternative to LRYGBP, with comparable short-term weight loss and metabolic outcomes. LRYGBP and LSG are anatomically distinct procedures causing differential entero-endocrine cell nutrient exposure and thus potentially different gut …

Objective To assess the rapid improvement of insulin sensitivity and β‐cell function following biliopancreatic diversion with duodenal switch (BPD‐DS) and determine the role played by caloric restriction in these changes. Methods Standard meals were administrated before and on day 3, 4, and 5 after BPD‐DS to measure total caloric intake, glucose excursion, insulin sensitivity, and secretion in matched type 2 diabetes and normoglycemic (NG) subjects. In a second set of study, other subjects with type 2 diabetes had the same meal tests prior to and …

Objective: Pronounced weight loss after bariatric surgery was demonstrated to have significant beneficial effects on surrogates of early atherosclerosis. The aim of this prospective examination was to investigate whether these improvements of endothelial function and vascular structure are persistent in the long‐term. Design and Methods: A total of 52 obese adults were examined before and 5 years after bariatric surgery. Carotid intima media thickness (IMT), brachial flow‐mediated dilation (FMD), abdominal fat distribution …

Background Weight loss may decrease the energy expenditure (EE) because of changes in body composition (BC). The reduction in EE may contribute, in part, to weight regain. Experimental studies in animals indicate that Roux-en-Y Gastric Bypass (RYGB) increases the resting metabolic rate (RMR) when adjusted for body weight (BW). Thus, the aim of this study was to assess the clinical effects of RYGB on EE in patients who have undergone RYGB. Methods The study was prospective and included 46 RYGB patients whose RMR …

Eur J Clin Invest 2010; 40 (3): 277–280 Abstract Background Subclinical inflammation in obesity is critical for development of several obesity‐associated disorders. We set out to investigate the effect of pronounced weight loss on circulating chemerin levels, a chemoattractant protein that also influences adipose cell function by paracrine and autocrine mechanisms. Material and methods Thirty‐two obese patients undergoing bariatric surgery were tested before and on an average of 18 months after gastric banding or gastric bypass …

Aims To bridge the beneficial metabolic effects of pronounced weight loss on one side and the data on morbidity and mortality on the other side, we investigated the impact of profound weight loss on structural and functional markers of early atherosclerosis. Methods and results Thirty-seven obese adults were examined before and 18 months after bariatric surgery. Carotid intima–media thickness (CIMT), brachial flow-mediated dilation (FMD), nitroglycerine-mediated dilation, and abdominal fat distribution were assessed by high …