The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them
IntroductionSuperobesity (SO) is defined as a BMI > 50 Kg/m2, and represents the extreme severity of the disease, resulting in a challenge for the surgeons.MethodsIn this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients.ResultsWe inc...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1100483/full |
| _version_ | 1828045950686330880 |
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| author | Fabio Medas Enrico Moroni Simona Deidda Luigi Zorcolo Angelo Restivo Gian Luigi Canu Federico Cappellacci Pietro Giorgio Calò Stefano Pintus Giovanni Fantola |
| author_facet | Fabio Medas Enrico Moroni Simona Deidda Luigi Zorcolo Angelo Restivo Gian Luigi Canu Federico Cappellacci Pietro Giorgio Calò Stefano Pintus Giovanni Fantola |
| author_sort | Fabio Medas |
| collection | DOAJ |
| description | IntroductionSuperobesity (SO) is defined as a BMI > 50 Kg/m2, and represents the extreme severity of the disease, resulting in a challenge for the surgeons.MethodsIn this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients.ResultsWe included in this study 154 MO patients, with a median preoperative BMI of 40.8 kg/m2, and 19 SO patients with median preoperative BMI of 54.9 kg/m2. The MO patients underwent sleeve gastrectomy (SG) in 62 (40.3%) cases, laparoscopic Roux-and-Y gastric bypass (LRYGBP) in 85 (55.2%) cases and One-Anastomosis Gastric Bypass (OAGB) in 7 (4.5%) cases. underwent OAGB. The patients in the SO group were submitted to SG in 11 (57.9%) cases, LRYGBP in 5 (26.3%) cases, and OAGB in 3 (15.8%). At 24-month follow-up, an excess weight loss (EWL) >50% was achieved in 129 (83.8%) patients in the MO group and in 15 (78.9%) in the SO group (p = 0.53). A BMI < 35 kg/m2 was achieved in 137 (89%) patients in the MO group and from 8 (42.2%) patients in the SO group (p < 0.001). The total weight loss was significantly directly related to the initial BMI. Superobesity was identified as independent risk factor for surgical failure when considering the outcome of BMI < 35 kg/m2.DiscussionOur study confirms that, although SO patients tend to gain a greater weight loss than MO patients, they less frequently achieve the desired BMI target. In this setting, it should be necessary to re-consider malabsorptive procedures as first choice. |
| first_indexed | 2024-04-10T18:19:04Z |
| format | Article |
| id | doaj.art-67588591d5b044808ea4a4a54c19bbfa |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-10T18:19:04Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-67588591d5b044808ea4a4a54c19bbfa2023-02-02T07:47:06ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-02-011010.3389/fsurg.2023.11004831100483The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake themFabio Medas0Enrico Moroni1Simona Deidda2Luigi Zorcolo3Angelo Restivo4Gian Luigi Canu5Federico Cappellacci6Pietro Giorgio Calò7Stefano Pintus8Giovanni Fantola9Department of Surgical Sciences, University of Cagliari, Cagliari, ItalyObesity Surgery Unit, Surgical Department, “ARNAS G. Brotzu” Hospital, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, Cagliari, ItalyObesity Surgery Unit, Surgical Department, “ARNAS G. Brotzu” Hospital, Cagliari, ItalyObesity Surgery Unit, Surgical Department, “ARNAS G. Brotzu” Hospital, Cagliari, ItalyIntroductionSuperobesity (SO) is defined as a BMI > 50 Kg/m2, and represents the extreme severity of the disease, resulting in a challenge for the surgeons.MethodsIn this retrospective study we aimed to compare the outcomes of SO patients compared to morbidly obese (MO) patients.ResultsWe included in this study 154 MO patients, with a median preoperative BMI of 40.8 kg/m2, and 19 SO patients with median preoperative BMI of 54.9 kg/m2. The MO patients underwent sleeve gastrectomy (SG) in 62 (40.3%) cases, laparoscopic Roux-and-Y gastric bypass (LRYGBP) in 85 (55.2%) cases and One-Anastomosis Gastric Bypass (OAGB) in 7 (4.5%) cases. underwent OAGB. The patients in the SO group were submitted to SG in 11 (57.9%) cases, LRYGBP in 5 (26.3%) cases, and OAGB in 3 (15.8%). At 24-month follow-up, an excess weight loss (EWL) >50% was achieved in 129 (83.8%) patients in the MO group and in 15 (78.9%) in the SO group (p = 0.53). A BMI < 35 kg/m2 was achieved in 137 (89%) patients in the MO group and from 8 (42.2%) patients in the SO group (p < 0.001). The total weight loss was significantly directly related to the initial BMI. Superobesity was identified as independent risk factor for surgical failure when considering the outcome of BMI < 35 kg/m2.DiscussionOur study confirms that, although SO patients tend to gain a greater weight loss than MO patients, they less frequently achieve the desired BMI target. In this setting, it should be necessary to re-consider malabsorptive procedures as first choice.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1100483/fullobesity surgerysuperobesitymorbidly obese patientslaparoscopic sleeve gastrectomylaparoscopic Roux-and-Y gastric bypass |
| spellingShingle | Fabio Medas Enrico Moroni Simona Deidda Luigi Zorcolo Angelo Restivo Gian Luigi Canu Federico Cappellacci Pietro Giorgio Calò Stefano Pintus Giovanni Fantola The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them Frontiers in Surgery obesity surgery superobesity morbidly obese patients laparoscopic sleeve gastrectomy laparoscopic Roux-and-Y gastric bypass |
| title | The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them |
| title_full | The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them |
| title_fullStr | The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them |
| title_full_unstemmed | The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them |
| title_short | The paradox of Zeno in bariatric surgery weight loss: Superobese patients run faster than morbidly obese patients, but can't overtake them |
| title_sort | paradox of zeno in bariatric surgery weight loss superobese patients run faster than morbidly obese patients but can t overtake them |
| topic | obesity surgery superobesity morbidly obese patients laparoscopic sleeve gastrectomy laparoscopic Roux-and-Y gastric bypass |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1100483/full |
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