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bariatric surgery

Classification: 1) gastric restrictive surgeries a) stapled gastroplasty [2,3] b) gastric banding [2,3] c) Roux-en-Y gastric bypass* [4] 2) biliopancreatic diversion with duodenal switch [1] 3) AspireAssist device * gastric bypass superior to gastric banding [6,83], but more complications [15,83] Indications: - BMI >= 40 - BMI < 40 associated with better outcomes at 1 year [74] - BMI >= 35 with obesity-related complications [18,27] - BMI >= 35 with type 2 diabetes in poor glycemic control [60] - BMI thresholds for Asians should be reduced by 2.5 kg/m2 [60] - obesity, more than 100 lbs overweight - *outperforms medical therapy in obese patients with diabetes mellitus type 2 [21,37] - *lowers risk of diabetes mellitus type 2 (RR=0.2) [23,46] - *increases likelihood of remission of type 2 diabetes [37] - *improves glycemic control after 1 & 3 years [48] - lowers risk for gestational diabetes & fetal macrosomia [40] - improves quality of life after 1 & 3 years [37,48] - may reduce pain & improve function after 1 year [57] - benefits decline by 3 years [57] - lowers risk of cardiovascular events & all-cause mortality in obese patients with type 2 diabetes [88] - weight reduction drives benefit for diabetes mellitus type-2 [96] - *control of type 2 diabetes in non-morbidly obese patients - *some effectiveness [28] - *postoperative complications & uncertain long-term results - *remission at 2 years is 72% vs 16% for medically managed patients [39] - *remission at 15 years is 30% vs 6% for medically managed patients [39] - factors favoring 5 year remission of diabetes - younger age - no hypglycemic agent use - lower HgbA1c [58] - better glycemic control than intensive medical therapy even after 5 years [67] - lowers hemoglobin A1c at 7 years (mean 1.4%) & 12 years (mean 1.1%) [110] - increases likelihood of discontinuing diabetes meds [79] - decreased microvascular disease in type 2 diabetes 17% vs 35% [81] - lowers mortality & use of antihypertensives in patients with obesity & hypertension [95] - adolescents (mean BMI = 53) appear to benefit [51] - long-term weight loss & diminished cardiovascular risk profile in obese adolecents [66] * other benefits - improves both prevalence & severity of depression [55] - lowers all-cause mortality vs usual care at 4 years (1.3% vs 2.3%) benefit for laparoscopic banding, Roux-en-Y gastric bypass, & laparoscopic sleeve gastrectomy [78] - associated with longer life expectancy [98] - associated with significantly lower all-cause mortality (RR=0.51) & an estimated 6.1-year longer median life expectancy [101] - treatment effect greater for those with diabetes - relative mortality (RR=0.41 vs 0.70) - median estimated life-expectancy gains for diabetics 9.3 vs 5.1 years - lower risk for cancer, including: - colon cancer [93], postmenopausal breast cancer, & endometrial cancer (cancers with obesity as a risk factor) [89] - lowers 10 year risk of cancer 2.9% vs 4.9% [104] - lowers 10 year mortality from cancer 0.8% vs 1.4% [104] - hypertension remission (32% vs 12%) & less likely to develop new-onset hypertension (4% vs 12%) within 6.5 years [78] - lowers macrovascular risk (cardiovascular risk) in patients with diabetes mellitus type 2 [82] - bariatric surgery before pregnancy may lower risk of birth defects in offspring [90] - may reduce risk of skin cancer (RR-0.41) & of melanoma (RR=0.57) [91] - weight loss through bariatic surgery associated with improved outcomes in Covid-19 [102] - reduces fibrosis in 40% of patients with non-alcoholic fatty liver disease (NAFLD) &/or non-alcoholic steatohepatitis (NASH) [105] * other considerations - likelihood of achieving weight reduction without surgical intervention - operative risk - patient understanding of risk, benefits & alternatives - commitment to non-surgical management as guide to compliance with postoperative management - patient understanding of how their behavior must change after the procedure (meal size, mastication, medications to avoid, recommended supplementation) - psychologic factors affecting the surgery - commitment to a lifetime of regular follow-up - evaluation by a mutidisciplinary team including medical, surgical, nutritional & psychiatric input [18] Contraindications: - comorbidites not absolute contraindication - coronary artery disease is NOT a contraindication [8] - bariatric surgery is associated with lower 5- & 10-year mortality in male veterans with substantial comorbidities [47] - does NOT reduce health care spending [26] - less effective for weight loss in diabetics, elderly < 65 yrs), blacks or hispanics [83] * psychiatric disease in adolescents not a contraindication [80] Laboratory: - thyroid function testing (prerequisite for referral Veterans Administration) - blood glucose: improved glycemic control common * also see ARUP consult [92] Special laboratory: 1) sleep study 2) pulmonary function testing (PFT) 3) echocardiogram 4) persantine thallium (if chest pain) Complications: 1) mortality a) perioperative mortality 0.8%-1.9%, twice as high in men vs women b) 6 month mortality 0.2-0.3% [9,10,38] 2) 7% readmitted to the hospital within 6 months [10], 19% within 1 year [9] 3) complication rates [10] a) 22% during initial hospitalization b) 40% during 6 months of follow-up c) overall complications 17% [38] d) reoperation rate 7% [38] - revisional surgeries occur mainly within the first 10 years - indications vary [84] 4) older patients more likely with prolonged length of stay [71] 5) gastrointestinal symptoms: - vomiting, diarrhea, dysphagia, GERD (20%) - dumping syndrome - nausea/vomiting (intestinal obstruction, stomal stenosis, marginal ulcer) 6) anastomotic problems (12%) a) anastomotic leak: sustained tachycardia > 120 beats/min b) absence of gastrointestinal bleeding c) evaluate with upper GI radiographs using water-soluble oral contrast or with abdominal CT [18] 7) abdominal hernia (7%) 8) infections (6%) 9) venous thromboembolism (< 4%) [14] 10) intestinal obstruction, stomal stenosis 11) hemorrhage, gastrointestinal hemorrhage 12) wound infection 13) bacterial overgrowth (blind loop syndrome) - common after Roux-en-Y gastric bypass - trial of empiric antibiotics indicated [18] 14) gastric ulceration or marginal ulceration 15) staple line dehiscence 16) nutritional deficiencies are common a) iron deficiency [97] b) vitamin B12 deficiency c) folic acid deficiency d) calcium deficiency e) vitamin D deficiency f) copper deficiency [18] g) thiamine deficiency (Wernicke encephalopathy) [30] h) vitamin A deficiency [18] in 11% despite vitamin supplements i) magnesium deficiency [18] j) selenium deficiency [18] k) zinc deficiency [18] 16) 30-day mortality 0.3% [14] - pulmonary embolism accounts for 50% of deaths 17) gastric bypass associated with more complications than gastric banding 18) risk factors for complications: a) very high BMI b) history of venous thromboembolism c) history of obstructive sleep apnea 19) increased risk for self harm - 3.63 events per 1000 patients annually, 50% higher than preoperative rate [50] - risk factors: rural living, low income, age > 35 [50] - increased risk of suicide may be confounded by comorbidities [19,25] - elevated risk for suicide & nonfatal self-harm [77] 20) substance abuse a) increased risk of alcohol abuse [22] - transition to alcohol abuse after surgery [99] b) opioid use is higher in patients who undergo bariatric surgery than in the general population & seems to increase after surgery [31] 21) stone formation: kidney stone, gallstones - calcium oxalate kidney stones with gastric bypass surgery 22) fracture risk may differ before & after bariatric surgery - no increase in risk of fractures within 2 years [24] - within 4 1/2 years increase in fracture risk (RR=1.3) [61] - before surgery, fractures obesity-related (distal lower limb) - after surgery, fractures occur in an pattern typical of osteoporosis (vertebrae, hip, femur) [61[ - roux-en-Y gastric bypass associated wth a higher fracture risk than adjustable gastric banding [85] - nonvertebral fracture risk 6.6 vs 4.6 per 1000 person-years 23) hypotension, intracranial hypotension [44] 24) hypoglycemia 25) increased risk of preterm delivery [34] 26) increased risk for perinatal complications within 2 years of bariatric surgery [63] - increased risk for small-for-gestational-age infants [40] - risk for internal herniation [68] Management: 1) dietary * exercise measure (VA MOVE program) - factors associated with sustained weight reduction - weekly weights - stop eating when satiated - not eating continuously throughout the day [58] - patients must consume < 800 kcal/day for 1st 12-18 months - diet 1000-1200 kcal/day (after 1st 12-18 months) in 3 small high-protein meals 3 times/day - avoid sugar, refined carbohydrates & fats to prevent dumping syndrome - avoiding refined carbohydrates more important than low-fat diet [106] 2) medications to avoid (after surgery) a) anti-inflammatory agents: - NSAIDs, salicylates, corticosteroids - increased risk of injury to pouch by prostaglandin inhibition b) oral bisphosphonates - increased risk of reflux esophagitis c) ethanol - increased absorption following Roux-en-Y gastric bypass d) extended-release or controlled-release medications - long-acting insulin: glargine, Lantus, Lemevir, PZI, NPH, Ultralente - sulfonylureas e) products containing sucrose, corn syrup, maltose, fructose, lactose, honey, mannitol, sorbitol - increased risk of dumping syndrome, more common following Roux-en-Y gastric bypass f) medications that cause gastroesophageal reflux - calcium channel blockers, beta-blockers, nitrates, - anticholinergics - tricyclic antidepressants - some antihistamines g) medications that cause weight gain h) medications which are associated with gallstones - gemfibrozil 3) supplements recommended (after surgery) [108] a) mulivitamin with minerals b) calcium supplements - calcium citrate 1500 mg QD c) fat-soluble vitamins may be obtained in multivitamin - vitamin A 2500 IU QD - vitamin D 400-800 IU QD - vitamin E 10 IU QD d) folic acid may be obtained in multivitamin - 1 mg/day for women of child-bearing age [18] e) iron 80-100 mg QD [18] - iron is absorbed in first part of intestine which is bypassed in Roux-en-Y gastric bypass - Roux-en-Y gastric bypass may produce achlorhydria - ferrous sulfate less well absorbed, especially without acidic environment f) thiamine 25-50 mg QD g) vitamin B12 0.5-1.0 mg QD - gastric acid & intrinsic factor reduced with Roux-en-Y gastric bypass 4) medications recommended (after surgery) - ursodiol (Actigall, Urso) - liraglutide may lower HbA1c in patients with persistent diabetes mellitus after bariatric surgery [87] - liraglutide may add an additional 8% weight loss after bariatric surgery [107] 5) delay pregnancy >= 1-2 years after gastric bypass surgery [68] Notes: - sleeve gastrectomy more common than Roux-en-Y bypass [43] - sleeve gastrectomy with fewer 30 day complications than Roux-en-Y bypass [18] - after 5 years, health-related quality of life or major complications similar [18] - sleeve gastrectomy in patients > 60 years of aged associated with less total weight loss than in younger patients [69,72] - no differences in total weight loss observed in patients > or < 60 years of age [70] (only 3 patients in each group) - mean excess weight loss in patients > 60 years = 54% [73] - sleeve gastrectomy less likely than Roux-en-Y gastric bypass to need abdominal surgery within 5 years [94] - in obese patients with diabetes mellitus gastric bypass more likely to result in diabetes remission (HgbA1c < 6%) without hypoglycemic use (74% vs 47%) than sleeve gastrectomy & associated with less overall hypoglycemic use (15% vs 37%); weight loss after 1 year greater with gastric bypass; hepatic steatosis similiar between the teo procedures [103] - sleeve gastrectomy preferred to gastric banding due to complications of band erosion & slippage [18] - gastric bypass associated with twice as much weight loss as laparoscopic gastric banding, at the cost of more short-term complications & long-term hospitalizations [45] - sustained 10 year weight loss with gastric bypass surgery [62] - post surgical: gastric banding: - smaller stomach, slower gastric emptying - diabetes remission in 50% of patients with biliopancreatic diversion vs 25% of patients with roux-en-Y gastric bypass [100] - benefits: - benefits sustained at 6 years [25]; > 10 years [75] - long-term mortality benefit [11,12,20] - 10 year follow-up associated with favorable changes in glucose metabolism, lipid profile & blood pressure [5] - diabetes remits in ~90% of patients [38] - reduces blood pressure & weight [109] - reduces cancer risk in women [13] - better sexual function in women [34] - reduces urinary incontinence in men & women [49] - at 5 years, patients with weight reduction of 12-17 BMI units [38] - safe in adolescents [34,76] - younger teens more likely than older teens to achieve remission of dyslipidemia [76] - in mice, binding of bile acids to the nuclear receptor FXR plays a role in benefits of vertical sleeve gastrectomy [42] - higher levels of circulating bile acids - improves both prevalence & severity of depression [55] - no mental health condition with consistent effect on postoperative weight outcomes [55] - most common mental health conditions before bariatric surgery are depression (19%) & binge eating disorder (17%) vs 8% & 1-5% in the general population, respectively) - bariatric surgery mitigates risk of atrial fibrillation [65] - health impairments while working - 63% before surgery, 32% at 1 year, 41% at 3 years - disability 14% unchanged by surgery - absenteeism lower at 1 year, but not at 3 years [64]

Related

management of obesity: ACP clinical guidelines, 2005 obesity

Specific

AspireAssist device biliopancreatic diversion with duodenal switch gastric banding (Lap Band, Swedish Adjustable Gastric Band) gastric bypass surgery; Roux-en-Y gastric bypass intragastric balloon system (Orbera Intragastric Balloon System, ReShape Integrated Dual Balloon System) sleeve gastrectomy vertical banded gastroplasty

General

gastrointestinal surgery (GI surgery) abdominal surgery

References

  1. Brolin RE Bariatric surgery and long-term control of morbid obesity. JAMA. 2002 Dec 11;288(22):2793-6. Review. No abstract available. PMID: 12472304
  2. Journal Watch, Mass Med Soc 20(18):143 (Sept) 2000 Weisner W et al Adjustable laparoscopic gastric banding in patients with morbid obesity: radiographic management, results, and postoperative complications. Radiology 216:389, 2000 PMID: 10924559
  3. Journal Watch 24(2):19, 2004 Morino M et al Laparoscopic adjustable silicone gastric banding versus vertical banded gastroplasty in morbidly obese patients: a prospective randomized controlled clinical trial. Ann Surg 238:835, 2003 PMID: 14631220
  4. Journal Watch, Mass Med Soc 20(17):138 (Sept) 2000 Balsiger BM et al Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clin Proc 75:673, 2000 PMID: 10907381
  5. Journal Watch 25(2):19, 2005 Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjostrom CD, Sullivan M, Wedel H; Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004 Dec 23;351(26):2683-93. PMID: 15616203
  6. Journal Watch 25(2):19, 2005 Weber M, Muller MK, Bucher T, Wildi S, Dindo D, Horber F, Hauser R, Clavien PA. Laparoscopic gastric bypass is superior to laparoscopic gastric banding for treatment of morbid obesity. Ann Surg. 2004 Dec;240(6):975-82; discussion 982-3. PMID: 15570203
  7. Prescriber's Letter 12(3): 2005 Effect of Bariatric Surgery on Drug Absorption Detail-Document#: 210301 (subscription needed) http://www.prescribersletter.com
  8. Lopez-Jimenez F, Bhatia S, Collazo-Clavell ML, Sarr MG, Somers VK. Safety and efficacy of bariatric surgery in patients with coronary artery disease. Mayo Clin Proc. 2005 Sep;80(9):1157-62. PMID: 16178495
  9. Flum DR, Salem L, Elrod JA, Dellinger EP, Cheadle A, Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005 Oct 19;294(15):1903-8. PMID: 16234496 - Zingmond DS, McGory ML, Ko CY. Hospitalization before and after gastric bypass surgery. JAMA. 2005 Oct 19;294(15):1918-24. PMID: 16234498
  10. Smoot TM, Xu P, Hilsenrath P, Kuppersmith NC, Singh KP. Gastric bypass surgery in the United States, 1998-2002. Am J Public Health. 2006 Jul;96(7):1187-9. Epub 2006 May 30. PMID: 16735625 - Encinosa WE, Bernard DM, Chen CC, Steiner CA. Healthcare utilization and outcomes after bariatric surgery. Med Care. 2006 Aug;44(8):706-12. PMID: 16862031
  11. Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Agren G, Carlsson LM; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007 Aug 23;357(8):741-52. PMID: 17715408 - Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007 Aug 23;357(8):753-61. PMID: 17715409
  12. Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Agren G, Carlsson LM; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007 Aug 23;357(8):741-52. PMID: 17715408
  13. Sjostrom L et al Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): A prospective, controlled intervention trial. Lancet Oncol 2009 Jun 24; PMID: 19556163 http://dx.doi.org/10.1016/S1470-2045(09)70159-7
  14. Wahed AS et al, The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery N Engl J Med 361:445-454 July 30, 2009 PMID: 19641201 http://content.nejm.org/cgi/content/short/361/5/445
  15. Nguyen NT et al A prospective randomized trial of laparoscopic gastric bypass versus laparoscopic adjustable gastric banding for the treatment of morbid obesity: Outcomes, quality of life, and costs. Ann Surg 2009 Oct; 250:631 PMID: 19730234
  16. Prescriber's Letter 16(11): 2009 CHART: Bariatric Surgery and Medication Use COMMENTARY: Bariatric Surgery and Medication Use CHART: Medications That Should Not Be Crushed Detail-Document#: 251025 (subscription needed) http://www.prescribersletter.com
  17. Miller AD, Smith KM. Medication and nutrient administration considerations after bariatric surgery. Am J Health Syst Pharm 2006;63:1852-57. PMID: 16990631
  18. Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 2009, 2012, 2015, 2018, 2022. - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  19. Tindle HA et al. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med 2010 Nov; 123:1036. PMID: 20843498
  20. Sjostrom L et al Bariatric Surgery and Long-term Cardiovascular Events JAMA 2012;307(1):56-65 PMID: 22215166 http://jama.ama-assn.org/content/307/1/56.short - Livingston EH Inadequacy of BMI as an Indicator for Bariatric Surgery JAMA 2012;307(1):88-89 PMID: 22215170 http://jama.ama-assn.org/content/307/1/88.short
  21. Journal Watch: Physician's First Watch Massachusetts Medical Society - Leonetti F et al Obesity, Type 2 Diabetes Mellitus, and Other Comorbidities A Prospective Cohort Study of Laparoscopic Sleeve Gastrectomy vs Medical Treatment Arch Surg. Published online April 16, 2012 PMID: 22508671 http://archsurg.ama-assn.org/cgi/content/abstract/archsurg.2012.222
  22. King WC et al Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery JAMA, June 18, 2012 PMID: 22710289 http://jama.jamanetwork.com/article.aspx?articleID=1185618
  23. Physician's First Watch, Aug 27 2012 Massachusetts Medical Society http://www.jwatch.org - Carlsson LMS et al Bariatric Surgery and Prevention of Type 2 Diabetes in Swedish Obese Subjects N Engl J Med 2012; 367:695-704, August 23, 2012 PMID: 22913680 http://www.nejm.org/doi/full/10.1056/NEJMoa1112082 - Jacobs DO Bariatric Surgery - From Treatment of Disease to Prevention? N Engl J Med 2012; 367:764-765, August 23, 2012 PMID: 22913687 http://www.nejm.org/doi/full/10.1056/NEJMe1207860
  24. Lalmohamed A et al. Risk of fracture after bariatric surgery in the United Kingdom: Population based, retrospective cohort study. BMJ 2012 Aug 7; 345:e5085 PMID: 22867649
  25. Adams TD et al Health Benefits of Gastric Bypass Surgery After 6 Years JAMA. 2012;308(11):1122-1131 PMID: 22990271 http://jama.jamanetwork.com/article.aspx?articleid=1360861 - Courcoulas AP Progress in Filling the Gaps in Bariatric Surgery JAMA. 2012;308(11):1160-1161 PMID: 22990275 http://jama.jamanetwork.com/article.aspx?articleid=1360844
  26. Weiner JP et al Impact of Bariatric Surgery on Health Care Costs of Obese Persons. A 6-Year Follow-up of Surgical and Comparison Cohorts Using Health Plan Data. JAMA Surg. 2013;():1-8. Feb 20, 2013 PMID: 23426865 http://archsurg.jamanetwork.com/article.aspx?articleid=1653574 - Livingston EH Is Bariatric Surgery Worth It? Comment on "Impact of Bariatric Surgery on Health Care Costs of Obese Persons" JAMA Surg. 2013;():1. Feb 20, 2013 PMID: 23426942 http://archsurg.jamanetwork.com/article.aspx?articleid=1653577
  27. Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003641 PMID: 19370590
  28. Maggard-Gibbons M et al Bariatric Surgery for Weight Loss and Glycemic Control in Nonmorbidly Obese Adults With Diabetes. A Systematic Review. JAMA. 2013;309(21):2250-2261 PMID: 23736734 http://jama.jamanetwork.com/article.aspx?articleid=1693893 - Ikramuddin S et al Roux-en-Y Gastric Bypass vs Intensive Medical Management for the Control of Type 2 Diabetes, Hypertension, and Hyperlipidemia. The Diabetes Surgery Study Randomized Clinical Trial. JAMA. 2013;309(21):2240-2249 PMID: 23736733 http://jama.jamanetwork.com/article.aspx?articleid=1693889 - Wolfe BM et al Treating Diabetes With Surgery. JAMA. 2013;309(21):2274-2275 PMID: 23736737 http://jama.jamanetwork.com/article.aspx?articleid=1693867
  29. Bellorin O, Abdemur A, Sucandy I, Szomstein S, Rosenthal RJ. Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity. Obes Surg. 2011 Jun;21(6):707-13 PMID: 20582574
  30. Aasheim ET. Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg. 2008 Nov;248(5):714-20 PMID: 18948797
  31. Raebel MA et al. Chronic use of opioid medications before and after bariatric surgery. JAMA 2013 Oct 2; 310:1369 PMID: 24084922 http://jama.jamanetwork.com/article.aspx?articleid=1745677 - Alford DP. Weighing in on opioids for chronic pain: The barriers to change. JAMA 2013 Oct 2; 310:1351 PMID: 24084920 http://jama.jamanetwork.com/article.aspx?articleid=1745654
  32. Frank P, Crookes PF. Short- and long-term surgical follow-up of the postbariatric surgery patient. Gastroenterol Clin North Am. 2010 Mar;39(1):135-46 PMID: 20202586
  33. Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition. 2010 Nov-Dec;26(11-12):1031-7 PMID: 20363593
  34. Roos N et al Perinatal outcomes after bariatric surgery: nationwide population based matched cohort study. BMJ 2013;347:f6460 PMID: 2422248
  35. Courcoulas AP et al Weight Change and Health Outcomes at 3 Years After Bariatric Surgery Among Individuals With Severe Obesity. JAMA. Published online November 04, 2013 PMID: 24189773 http://jama.jamanetwork.com/article.aspx?articleid=1765797 - Sarwer DB et al Changes in Sexual Functioning and Sex Hormone Levels in Women Following Bariatric Surgery. JAMA. Published online November 04, 2013 PMID: 24190440 http://archsurg.jamanetwork.com/article.aspx?articleid=1764857 - Inge TH et al Perioperative Outcomes of Adolescents Undergoing Bariatric Surgery The Teen - Longitudinal Assessment of Bariatric Surgery (Teen-LABS) Study JAMA Pediatr. Published online November 04, 2013 PMID: 24189578 http://archpedi.jamanetwork.com/article.aspx?articleid=1765638 - Ikramuddin S and Livingston EH New Insights on Bariatric Surgery Outcomes JAMA. Published online November 04, 2013 PMID: 24189645 http://jama.jamanetwork.com/article.aspx?articleid=1765795
  36. Gloy VL et al. Bariatric surgery versus non-surgical treatment for obesity: A systematic review and meta-analysis of randomised controlled trials. BMJ. 2013 Oct 22;347:f5934 PMID: 24149519 http://www.bmj.com/content/347/bmj.f5934
  37. Maciejewski ML, Livingston EH, Smith VA et al Survival among high-risk patients after bariatric surgery. JAMA. 2011 Jun 15;305(23):2419-26 PMID: 21666276
  38. Chang SH The Effectiveness and Risks of Bariatric Surgery. An Updated Systematic Review and Meta-analysis, 2003-2012. JAMA Surg. Published online December 18, 2013 PMID: 24352617 http://archsurg.jamanetwork.com/article.aspx?articleid=1790378
  39. Sjostrom L et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 2014 Jun 11; 311:2297. PMID: 24915261
  40. Johansson K et al. Outcomes of pregnancy after bariatric surgery. N Engl J Med 2015 Feb 26; 372:814. PMID: 25714159 http://www.nejm.org/doi/full/10.1056/NEJMoa1405789
  41. The Lancet Diabetes Endocrinology Bariatric surgery: why only a last resort? The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622698 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2814%2970020-8/fulltext - Pomp A Safety of bariatric surgery. The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622703 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2814%2970009-9/fulltext - Dixon JB and Blazeby JM Quality of life after bariatric surgery/ The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622704 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2814%2970021-X/fulltext - Miras AD and le Roux CW Metabolic surgery: shifting the focus from glycaemia and weight to end-organ health. The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622718 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2813%2970158-X/fulltext - Madsbad S et al Mechanisms of changes in glucose metabolism and bodyweight after bariatric surgery. The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622719 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2813%2970218-3/fulltext - Stein EM and Silverberg SJ Bone loss after bariatric surgery: causes, consequences, and management. The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622720 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2813%2970183-9/fulltext - Cummings DE and Cohen RV Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. The Lancet Diabetes & Endocrinology. Feb 2014 PMID: 24622721 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2813%2970198-0/fulltext
  42. Ryan KK et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature 2014 May 8; 509:183 PMID: 24670636
  43. Reames BN et al Changes in Bariatric Surgery Procedure Use in Michigan, 2006-2013. JAMA. 2014;312(9):959-961. PMID: 25182106 http://jama.jamanetwork.com/article.aspx?articleid=1900499
  44. Schievink WI et al Bariatric surgery as a possible risk factor for spontaneous intracranial hypotension. Neurology. October 22, 2014 PMID: 25339216 http://www.neurology.org/content/early/2014/10/21/WNL.0000000000000985
  45. Arterburn D et al Comparative Effectiveness of Laparoscopic Adjustable Gastric Banding vs Laparoscopic Gastric Bypass. JAMA Surg. Published online October 29, 2014 PMID: 25353723 http://archsurg.jamanetwork.com/article.aspx?articleid=1919066 - Dimick JB, Finks JF The Beginning of the End for Laparoscopic Banding. JAMA Surg. Published online October 29, 2014 PMID: 25353359 http://archsurg.jamanetwork.com/article.aspx?articleid=1919064
  46. Booth H et al Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study. The Lancet Diabetes & Endocrinology, 3 November 2014 PMID: 25466723 http://www.thelancet.com/journals/landia/article/PIIS2213-8587%2814%2970214-1/abstract
  47. Arterburn DE et al. Association between bariatric surgery and long-term survival. JAMA 2015 Jan 6; 313:62. PMID: 25562267
  48. Schauer PR et al Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 3-year Outcomes. N Engl J Med. March 31, 2014 PMID: 24679060 http://www.nejm.org/doi/full/10.1056/NEJMoa1401329
  49. Subak LL et al Urinary Incontinence Before and After Bariatric Surgery. JAMA Intern Med. Published online June 22, 2015 PMID: 26098620 http://archinte.jamanetwork.com/article.aspx?articleID=2323413 - Myers DL Bariatric Surgery and Urinary Incontinence JAMA Intern Med. Published online June 22, 2015 PMID: 26098294 http://archinte.jamanetwork.com/article.aspx?articleID=2323410
  50. Bhatti JA et al Self-harm Emergencies After Bariatric Surgery. A Population- Based Cohort Study. JAMA Surg. Published online October 07, 2015 PMID: 26444444 - Ghaferi AA, Lindsay-Westphal C. Bariatric Surgery-More Than Just an Operation. JAMA Surg. 2015 Oct 7:1 PMID: 26445107
  51. Inge TH, Courcoulas AP, Jenkins TM et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med 2015 Nov 6 PMID: 26544725
  52. Hammer HF Medical complications of bariatric surgery: focus on malabsorption and dumping syndrome. Dig Dis. 2012;30(2):182-6 PMID: 22722436
  53. Heber D , Greenway FL, Kaplan LM et al Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2010 Nov;95(11):4823-43 PMID: 21051578 corresponding NGC guideline withdrawn Feb 2016
  54. Strohmayer E, Via MA, Yanagisawa R Metabolic management following bariatric surgery. Mt Sinai J Med. 2010 Sep-Oct;77(5):431-45 PMID: 20960547
  55. Dawes AJ et al Mental Health Conditions Among Patients Seeking and Undergoing Bariatric SurgeryA Meta-analysis. JAMA. 2016;315(2):150-163 http://jama.jamanetwork.com/article.aspx?articleid=2481004
  56. Mechanick JI, Youdim A, Jones DB et al Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract. 2013 Mar-Apr;19(2):337-72. PMID: 23529351 Free PMC Article
  57. King WC et al. Change in pain and physical function following bariatric surgery for severe obesity. J JAMA 2016 Apr 5; 315:136 PMID: 27046364
  58. Wood GC, Mirshahi T, Still CD, Hirsch AG. Association of DiaRem Score With Cure of Type 2 Diabetes Following Bariatric Surgery. JAMA Surg. Published online April 20, 2016. PMID: 27097158 http://archsurg.jamanetwork.com/article.aspx?articleid=2513888 - Mitchell JE, Christian NJ, Flum DR Postoperative Behavioral Variables and Weight Change 3 Years After Bariatric Surgery. JAMA Surg. Published online April 20, 2016 PMID: 27096225 http://archsurg.jamanetwork.com/article.aspx?articleid=2513889 - Ghaferi AA, Woodruff M, Arnould J. The Behavior and Biology Behind Bariatric Surgery Outcomes. JAMA Surg. Published online April 20, 2016 PMID: 27097015 http://archsurg.jamanetwork.com/article.aspx?articleid=2513887
  59. Mechanick JI, Youdim A, Jones DB et al Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013 Mar;21 Suppl 1:S1-27. PMID: 23529939 Free PMC Article
  60. Rubino F et al Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Diabetes Care 2016 Jun; 39(6): 861-877 PMID: 27222544 http://care.diabetesjournals.org/content/39/6/861 - Cefalu WT et al Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care. Diabetes Care 2016 Jun; 39(6): 857-860 PMID: 27222543 http://care.diabetesjournals.org/content/39/6/857
  61. Rousseau C, Jean S, Gamache P et al Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study BMJ 2016;354:i3794 PMID: 27814663 Free PMC Article http://www.bmj.com/content/354/bmj.i3794 - Bueter B Bariatric surgery and fractures. BMJ 2016;354:i4057 PMID: 27814662 http://www.bmj.com/content/354/bmj.i4057
  62. Maciejewski ML, Arterburn DE, Van Scoyoc L et al Bariatric Surgery and Long-term Durability of Weight Loss. JAMA Surg. Published online August 31, 2016 PMID: 27579793 http://archsurg.jamanetwork.com/article.aspx?articleid=2546331 - Gould JC Myths Surrounding Bariatric Surgery. JAMA Surg. Published online August 31, 2016 PMID: 27579624 http://archsurg.jamanetwork.com/article.aspx?articleid=2546323
  63. Parent B, Martopullo I, Weiss NS et al Bariatric Surgery in Women of Childbearing Age, Timing Between an Operation and Birth, and Associated Perinatal Complications. JAMA Surg. Published online October 19, 2016 PMID: 27760265 http://jamanetwork.com/journals/jamasurgery/fullarticle/2569812 - Dawes AJ, Dawes DM, Maggard-Gibbons M Corrected vs Uncorrected Obesity in Childbearing Women - What Really Drives Fetal Risks? JAMA Surg. Published online October 19, 2016 PMID: 27760247 http://jamanetwork.com/journals/jamasurgery/article-abstract/2569807
  64. Alfonso-Cristancho R, King WC, Mitchell JE et al Longitudinal Evaluation of Work Status and Productivity After Bariatric Surgery. JAMA. 2016 Oct 18;316(15):1595-1597. PMID: 27755626
  65. Monaco K. Bariatric Surgery Mitigates Afib Risk MedPage Today. Dec 6, 2016 http://www.medpagetoday.com/Endocrinology/Obesity/61861
  66. Inge TH, Jenkins TM, Xanthakos SA et al Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. The Lancet Diabetes & Endocrinology. Jan 5, 2017 PMID: 28065736 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(16)30315-1/fulltext - Olbers T, Beamish AJ, Gronowitz E et al Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. The Lancet Diabetes & Endocrinology. Jan 5, 2017 PMID: 28065734 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(16)30424-7/fulltext
  67. Schauer PR, Bhatt DL, Kirwan JP et al Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med 2017; 376:641-651. February 16, 2017 PMID: 28199805 Free Article http://www.nejm.org/doi/full/10.1056/NEJMoa1600869
  68. Barbieri RL Keep a Close Eye on Women Who Become Pregnant Too Soon After Gastric Bypass Surgery NEJM Journal Watch. April 14, 2017 Massachusetts Medical Society (subscription needed) http://www.jwatch.org - Stuart A, Kallen K. Risk of abdominal surgery in pregnancy among women who have undergone bariatric surgery. Obstet Gynecol 2017 Apr 4; PMID: 28383368
  69. Navarrete A, Corcelles R, Del Gobbo GD et al Sleeve gastrectomy in the elderly: A case-control study with long-term follow-up of 3 years. Surg Obes Relat Dis. 2016 Dec 14. pii: S1550-7289(16)30855-3. PMID: 28214166
  70. Hayashi A, Maeda Y, Takemoto M Outcomes of laparoscopic sleeve gastrectomy in elderly obese Japanese patients. Geriatr Gerontol Int. 2017 Mar 30. PMID: 28371292
  71. Dorman RB, Abraham AA, Al-Refaie WB, et al. Bariatric surgery outcomes in older patients: an ACS NSQUIP study. J Gastrointest Surg. 2012 Jan;16(1):35-44 PMID: 22038414
  72. Caceres BA, Moskowitz D, O'Connell T. A review of the safety and efficacy of bariatric surgery in adults over the age of 60: 2002-2013. J Am Assoc Nurse Pract. 2015;27:403-410 PMID: 25736716
  73. Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627-1635 PMID: 26508845 PMCID: Free PMC Article
  74. Varban OA, Cassidy RB, Bonham A et al Factors Associated With Achieving a Body Mass Index of Less Than 30 After Bariatric Surgery. JAMA Surg. Published online July 26, 2017 PMID: 28746723 http://jamanetwork.com/journals/jamasurgery/article-abstract/2645760 - Wolfe BM, Walker E. It's About the Weight Loss. JAMA Surg. Published online July 26, 2017 PMID: 28746716 http://jamanetwork.com/journals/jamasurgery/article-abstract/2645756
  75. Adams TD, Davidson LE, Litwin SE et al Weight and Metabolic Outcomes 12 Years after Gastric Bypass. N Engl J Med 2017; 377:1143-1155. September 21, 2017 PMID: 28930514 http://www.nejm.org/doi/full/10.1056/NEJMoa1700459
  76. Michalsky MP, Inge TH, Jenkins TM et al Cardiovascular Risk Factors After Adolescent Bariatric Surgery. Pediatrics. January 2018 PMID: 29311357 http://pediatrics.aappublications.org/content/early/2018/01/04/peds.2017-2485
  77. Neovius M, Bruze G, Jacobson P et al Risk of suicide and non-fatal self-harm after bariatric surgery: results from two matched cohort studies. Lancet Diabetes & Endocrinology. Jan 9, 2018 PMID: 29329975 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30437-0/fulltext - Spittal MJ, Fruhbeck G. Bariatric surgery: many benefits, but emerging risks. Lancet Diabetes & Endocrinology. Jan 9, 2018 PMID: 29329974 http://www.thelancet.com/journals/landia/article/PIIS2213-8587(17)30435-7/fulltext
  78. Reges O, Greenland P, Dicker D et al Association of Bariatric Surgery Using Laparoscopic Banding, Roux-en-Y Gastric Bypass, or Laparoscopic Sleeve Gastrectomy vs Usual Care Obesity Management With All-Cause Mortality. JAMA. 2018;319(3):279-290. PMID: 29340677 https://jamanetwork.com/journals/jama/article-abstract/2669726 - Jakobsen GS, Smastuen MC, Sandbu R et al Association of Bariatric Surgery vs Medical Obesity Treatment With Long-term Medical Complications and Obesity-Related Comorbidities. JAMA. 2018;319(3):291-301 PMID: 29340680 https://jamanetwork.com/journals/jama/article-abstract/2669729 - Salminen P, Helmio M, Ovaska J et al Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients With Morbid ObesityThe SLEEVEPASS Randomized Clinical Trial. JAMA. 2018;319(3):241-254 PMID: 29340676 https://jamanetwork.com/journals/jama/article-abstract/2669725 - Peterli R, Wolnerhanssen BK, Peters T et al Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity. The SM-BOSS Randomized Clinical Trial. JAMA. 2018;319(3):255-265 PMID: 29340679 https://jamanetwork.com/journals/jama/article-abstract/2669728 - Arterburn D, Gupta A. Comparing the Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for Severe Obesity. JAMA. 2018;319(3):235-237. PMID: 29340659 https://jamanetwork.com/journals/jama/article-abstract/2669707
  79. Thereaux J, Lesuffleur1 T, Czernichow S et al Association Between Bariatric Surgery and Rates of Continuation, Discontinuation, or Initiation of Antidiabetes Treatment 6 Years Later. JAMA Surg. Published online Feb 14, 2018 PMID: 29450469 https://jamanetwork.com/journals/jamasurgery/fullarticle/2672216 - Gagner M Toward a National Surgical Strategy for Type 2 Diabetes Resolution. Can We Do Better? JAMA Surg. Published online Feb 14, 2018 PMID: 29450454 https://jamanetwork.com/journals/jamasurgery/article-abstract/2672212
  80. Mackey ER, Wang J, Harrington C, Nadler EP. Psychiatric Diagnoses and Weight Loss Among Adolescents Receiving Sleeve Gastrectomy. Pediatrics. June 2018 PMID: 29858452 http://pediatrics.aappublications.org/content/early/2018/05/30/peds.2017-3432
  81. O'Brien R, Johnson E, Haneuse S. Microvascular Outcomes in Patients With Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study. Ann Intern Med. 2018 Aug 7 PMID: 30083761 http://annals.org/aim/article-abstract/2696493/microvascular-outcomes-patients-diabetes-after-bariatric-surgery-versus-usual-care - le Roux CW, Schauer PR Prevention Is Better Than Cure: The Next Frontier for Bariatric Surgery? Ann Intern Med. 2018 Aug 7 PMID: 30083758 http://annals.org/aim/article-abstract/2696663/prevention-better-than-cure-next-frontier-bariatric-surgery
  82. Fisher DP, Johnson E, Haneuse S et al Association Between Bariatric Surgery and Macrovascular Disease Outcomes in Patients With Type 2 Diabetes and Severe Obesity. JAMA. 2018;320(15):1570-1582 PMID: 30326126 https://jamanetwork.com/journals/jama/fullarticle/2707461 - Sheka AC, Wirth KM, Ikramuddin S Preventing Macrovascular Events With Bariatric Surgery. JAMA. 2018;320(15):1545-1547. PMID: 30326109 https://jamanetwork.com/journals/jama/fullarticle/2707442
  83. Arterburn D et al. Comparative effectiveness and safety of bariatric procedures for weight loss: A PCORnet cohort study. Ann Intern Med 2018 Dec 4; 169:741. PMID: 30383139 http://annals.org/aim/fullarticle/2711394/comparative-effectiveness-safety-bariatric-procedures-weight-loss-pcornet-cohort-study - Puzziferri N, Wolfe BM. PCORnet bariatric surgery outcomes: Strength in numbers. Ann Intern Med 2018 Dec 4; 169:806. PMID: 30383123 http://annals.org/aim/article-abstract/2711441/pcornet-bariatric-surgery-outcomes-strength-numbers
  84. Hjorth S, Naslund I, Andersson-Assarsson JC et al Reoperations After Bariatric Surgery in 26 Years of Follow-up of the Swedish Obese Subjects Study. JAMA Surg. Published online January 2, 2019. PMID: 30601881 https://jamanetwork.com/journals/jamasurgery/fullarticle/2719269
  85. Yu EW, Kim SC, Sturgeon DJ et al Fracture Risk After Roux-en-Y Gastric Bypass vs Adjustable Gastric Banding Among Medicare Beneficiaries JAMA Surg. Published online May 15, 2019. PMID: 31090893 https://jamanetwork.com/journals/jamasurgery/article-abstract/2733040 - Smith ME, Ghaferi AA. Understanding the Long-term Effects of Bariatric Surgery. From Weight Loss to Bone Health. JAMA Surg. Published online May 15, 2019. PMID: 31090877 https://jamanetwork.com/journals/jamasurgery/fullarticle/2733036
  86. Inge TH, Courcoulas AP, Jenkins TM et al Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults. N Engl J Med. 2019 May 30;380(22):2136-2145. PMID: 31116917 https://www.nejm.org/doi/full/10.1056/NEJMoa1813909
  87. Miras AD, Perez-Pevida B, Aldhwayan M et al Adjunctive liraglutide treatment in patients with persistent or recurrent type 2 diabetes after metabolic surgery (GRAVITAS): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes & Endocrinology. June 4, 2019 PMID: 31174993 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30157-3/fulltext - Mingrone G Treatment of persistent or recurrent type 2 diabetes after metabolic surgery. Lancet Diabetes & Endocrinology. June 4, 2019 PMID: 31174992 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30195-0/fulltext
  88. Aminian A, Zajichek A, Arterburn DE et al. Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. JAMA 2019 Sep 2 PMID: 31475297 https://jamanetwork.com/journals/jama/fullarticle/2749478
  89. NEJM Knowledge+ Question of the Week. October 8, 2019 https://knowledgeplus.nejm.org/question-of-week/1779/ - Schauer DP, Feigelson HS, Koebnick C et al. Bariatric surgery and the risk of cancer in a large multisite cohort. Ann Surg. 2019 Jan;269(1):95-101. PMID: 28938270
  90. Neovius M, Pasternak B,Naslund I et al Association of Maternal Gastric Bypass Surgery With Offspring Birth Defects. JAMA. 2019;322(15):1515-1517. Oct 15 PMID: 31613339 https://jamanetwork.com/journals/jama/article-abstract/2752915
  91. Taube M, Peltonen M, Sjoholm K Association of Bariatric Surgery With Skin Cancer Incidence in Adults With Obesity. A Nonrandomized Controlled Trial. JAMA Dermatol. Published online October 30, 2019. PMID: 31664428 https://jamanetwork.com/journals/jamadermatology/article-abstract/2753269
  92. ARUP Consult: Gastric Bypass - Bariatric Surgery Nutritional Assessment The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/gastric-bypass
  93. Bailly L, Fabre R, Pradier C, Iannelli A. Colorectal Cancer Risk Following Bariatric Surgery in a Nationwide Study of French Individuals With Obesity. JAMA Surg. Published online March 11, 2020 PMID: 32159744 https://jamanetwork.com/journals/jamasurgery/fullarticle/2762521 - Davidson LE, Adams TD Does Bariatric Surgery Increase or Reduce Colorectal Cancer Risk - Is the Jury Still Out? JAMA Surg. Published online March 11, 2020 PMID: 32159737 https://jamanetwork.com/journals/jamasurgery/fullarticle/2762516
  94. Courcoulas A, Coley RY, Clark JM et al. Interventions and operations 5 years after bariatric surgery in a cohort from the US National Patient-Centered Clinical Research Network bariatric study. JAMA Surg 2020 Jan 15; 155:194 PMID: 31940024 https://jamanetwork.com/journals/jamasurgery/fullarticle/2758646
  95. Doumouras AG, Hong D, Lee Y et al Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System. Ann Intern Med. Aug 18, 2020 PMID: 32805135 https://www.acpjournals.org/doi/10.7326/M19-3925 - Schiavon CA, Bhatt DL, Ikeoka D et al Three-Year Outcomes of Bariatric Surgery in Patients With Obesity and Hypertension. Ann Intern Med. Aug 18, 2020 PMID: 32805133 https://www.acpjournals.org/doi/10.7326/M19-3781 - Wee CC Bariatric Surgery for Patients With Obesity: The Earlier the Better?. Ann Intern Med. Aug 18, 2020 PMID: 32805129 https://www.acpjournals.org/doi/10.7326/M20-5199
  96. Yoshino M et al Effects of Diet versus Gastric Bypass on Metabolic Function in Diabetes. N Engl J Med 2020; 383:721-732 PMID: 32813948 https://www.nejm.org/doi/full/10.1056/NEJMoa2003697
  97. Gowanlock Z et al. Iron deficiency following bariatric surgery: A retrospective cohort study. Blood Adv 2020 Aug 11; 4:3639 PMID: 32766854 PMCID: PMC7422111 Free PMC article https://ashpublications.org/bloodadvances/article/4/15/3639/461716/Iron-deficiency-following-bariatric-surgery-a
  98. Carlsson LMS et al Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study. N Engl J Med 2020; 383:1535-1543 PMID: 33053284 PMCID: PMC7580786 https://www.nejm.org/doi/full/10.1056/NEJMoa2002449
  99. Maciejewski ML, Smith VA, Berkowitz TSZ et al. Association of bariatric surgical procedures with changes in unhealthy alcohol use among US veterans. JAMA Netw Open 2020 Dec 21; 3:e2028117 PMID: 33346846 Free PMC article https://www.jwatch.org/na53009/2021/01/07/unhealthy-alcohol-use-after-bariatric-surgery
  100. Mingrone G, Panunzi S, De Gaetano A et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2021 Jan 23; 397:293. PMID: 33485454 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32649-0/fulltext
  101. Syn NL, Cummings DE, Wang LZ et al. Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: A one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants. Lancet 2021 May 15; 397:1830 PMID: 33965067 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00591-2/fulltext
  102. Aminian A, Tu C, Milinovich A et al. Association of weight loss achieved through metabolic surgery with risk and severity of COVID-19 infection. JAMA Surg 2021 Dec 29; [e-pub]. PMID: 34964827 PMCID: PMC8717211 (available on 2022-12-29) https://jamanetwork.com/journals/jamasurgery/fullarticle/2787613
  103. Hofso D, Fatima F, Borgeraas H et al. Gastric bypass versus sleeve gastrectomy in patients with type 2 diabetes (Oseberg): A single-centre, triple-blind, randomised controlled trial. Lancet Diabetes Endocrinol 2019 Dec; 7:912. PMID: 31678062 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30344-4/fulltext - Seeberg KA, Borgeraas H, Hofso D et al. Gastric bypass versus sleeve gastrectomy in type 2 diabetes: Effects on hepatic steatosis and fibrosis: A randomized controlled trial. Ann Intern Med 2022 Jan; 175:74. PMID: 34843380 https://www.acpjournals.org/doi/10.7326/M21-1962
  104. Aminian A et al. Association of bariatric surgery with cancer risk and mortality in adults with obesity. JAMA 2022 Jun 3; [e-pub]. PMID: 35657620 https://jamanetwork.com/journals/jama/fullarticle/2793220
  105. Verrastro O et al. Bariatric-metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): A multicentre, open-label, randomised trial. Lancet 2023 Apr 20;S0140-6736(23)00634-7 PMID: 37088093 Free article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00634-7/fulltext
  106. NEJM Knowledge+ Endocrinology
  107. Mok J et al. Safety and efficacy of liraglutide, 3.0 mg, once daily vs placebo in patients with poor weight loss following metabolic surgery: The BARI-OPTIMISE randomized clinical trial. JAMA Surg 2023 Jul 26; [e-pub]. PMID: 37494014 PMCID: PMC10372755 Free PMC article. https://jamanetwork.com/journals/jamasurgery/fullarticle/2807724
  108. O'Kane M. Nutritional consequences of bariatric surgery - prevention, detection and management. Curr Opin Gastroenterol. 2021;37:135-44. PMID: 33332915
  109. Schiavon CA et al Randomized Trial of Effect of Bariatric Surgery on Blood Pressure After 5 Years. J Am Coll Cardiol. 2024 Feb, 83 (6) 637-648 PMID: 38325988 Clinical Trial. https://www.jacc.org/doi/10.1016/j.jacc.2023.11.032
  110. Courcoulas AP et al. Long-term outcomes of medical management vs bariatric surgery in type 2 diabetes. JAMA 2024 Feb 27; 331:654. PMID: 38411644 PMCID: PMC10900968 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2815401