Stanford Fatima Cody, Alfaris Nasreen, Gomez Gricelda, Ricks Elizabeth T, Shukla Alpana P, Corey Kathleen E, Pratt Janey S, Pomp Alfons, Rubino Francesco, Aronne Louis J
MGH Weight Center, Gastrointestinal Unit-Department of Medicine, Massachusetts General Hospital, Boston, MA; Endocrine Unit, Department of Pediatrics, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
MGH Weight Center, Gastrointestinal Unit-Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Obesity, Metabolism and Nutrition Institute, Massachusetts General Hospital, Boston, MA.
Surg Obes Relat Dis. 2017 Mar;13(3):491-500. doi: 10.1016/j.soard.2016.10.018. Epub 2016 Oct 27.
Patients who undergo bariatric surgery often have inadequate weight loss or weight regain.
We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain.
Two academic medical centers.
We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014. From this cohort, we identified patients who were placed on weight loss pharmacotherapy postoperatively for inadequate weight loss or weight regain. We extracted key demographic data, medical history, and examined weight loss in response to surgery and after the initiation of weight loss pharmacotherapy.
A total of 319 patients (RYGB = 258; sleeve gastrectomy = 61) met inclusion criteria for analysis. More than half (54%; n = 172) of all study patients lost≥5% (7.2 to 195.2 lbs) of their total weight with medications after surgery. There were several high responders with 30.3% of patients (n = 96) and 15% (n = 49) losing≥10% (16.7 to 195.2 lbs) and≥15% (25 to 195.2 lbs) of their total weight, respectively, Topiramate was the only medication that demonstrated a statistically significant response for weight loss with patients being twice as likely to lose at least 10% of their weight when placed on this medication (odds ratio = 1.9; P = .018). Regardless of the postoperative body mass index, patients who underwent RYGB were significantly more likely to lose≥5% of their total weight with the aid of weight loss medications.
Weight loss pharmacotherapy serves as a useful adjunct to bariatric surgery in patients with inadequate weight loss or weight regain.
接受减肥手术的患者往往体重减轻不足或体重反弹。
我们试图确定减肥药物疗法作为减肥手术辅助手段对体重减轻不足或体重反弹患者的效用。
两个学术医疗中心。
我们完成了一项回顾性研究，以确定2000年至2014年期间接受过Roux-en-Y胃旁路术（RYGB）或袖状胃切除术形式减肥手术的患者。从该队列中，我们确定了术后因体重减轻不足或体重反弹而接受减肥药物治疗的患者。我们提取了关键的人口统计学数据、病史，并检查了手术前后以及开始减肥药物治疗后的体重减轻情况。
共有319例患者（RYGB = 258例；袖状胃切除术 = 61例）符合纳入分析标准。所有研究患者中，超过一半（54%；n = 172）在术后使用药物后体重减轻了≥5%（7.2至195.2磅）。有几位高反应者，分别有30.3%的患者（n = 96）和15%（n = 49）体重减轻了≥10%（16.7至195.2磅）和≥15%（25至195.2磅）。托吡酯是唯一一种对体重减轻有统计学显著反应的药物，使用该药物的患者体重减轻至少10%的可能性是未使用该药物患者的两倍（优势比 = 1.9；P = 0.018）。无论术后体重指数如何，接受RYGB手术的患者在减肥药物的帮助下体重减轻≥5%的可能性显著更高。
减肥药物疗法是减肥手术对体重减轻不足或体重反弹患者的有用辅助手段。
