Browsing by Author "Brebbia, John S."

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    Obesity Subtypes and Short Term Weight Loss After Vertical Sleeve Gastrectomy: A Retrospective Cohort Study
    Shah, Raj A.; Nath, Anand; Shope, Timothy R.; Pardo Lameda, Ivanesa L.; Brebbia, John S.; Koch, Timothy R. (2022-12)
    AIM: Vertical sleeve gastrectomy has become the most common surgical intervention for medically-complicated obesity. This study examines the hypothesis that a clinical subtype of obesity (psychosocial factors, genetic risk, or early life endocrine disruptors termed obesogens) can identify the best candidates for vertical sleeve gastrectomy. MATERIALS AND METHODS: This is a retrospective cohort study of 225 consecutive new individuals with medically-complicated obesity seen preoperatively in outpatient bariatric clinic in an urban community teaching hospital. Eighty-four individuals underwent sleeve gastrectomy with a minimum of 6 months of follow up. RESULTS: Among 3 subtypes, early life obesogen exposure has been identified in 14.5% of individuals, genetic risk in 24.5% of individuals, and psychosocial factors in 61% of individuals. Percent excess weight loss (mean+/-SD) at 6 months is different among the three groups (pANOVA = 0.024). Individuals with genetic risk (38%+/-14) have significantly less weight loss (p = 0.029) than individuals with psychosocial factors (47%+/-15), while there is no difference compared to the obesogen subtype (41%+/-8.9). CONCLUSION: The most common clinical subtype of obesity is psychosocial factors, and there is significantly higher short term weight loss after sleeve gastrectomy in individuals with psychosocial factors. Weight loss may be limited by an individual’s genetic risk and early life obesogen exposure. A prospective study is required to confirm these findings.
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    Prevalence of irritable bowel syndrome in morbidly obese individuals seek­ing bariatric surgery
    Andalib, Iman; Hsueh, William; Shope, Timothy R.; Brebbia, John S.; Koch, Timothy R. (ACT Publishing, 2018-01-01)
    AIM: An increased prevalence of irritable bowel syndrome has been reported in obese individuals. Factors important in weight loss after bariatric surgery are incompletely understood, and small intestinal bacterial overgrowth in individuals with type 2 diabetes mellitus is a potential risk factor. Our aims are to examine whether the increased prevalence of irritable bowel syndrome in obese individuals seeking bariatric surgery is associated with diabetes mellitus and whether weight loss after bariatric surgery is altered by irritable bowel syndrome. METHODS: This is a single-center, retrospective study performed in a large, urban community teaching hospital. Individuals seen in gastrointestinal bariatric clinic prior to bariatric surgery from 2010 to 2013 completed a Manning symptom criteria questionnaire prior to their medical evaluation; ≥3 Manning criteria is accepted as diagnostic of irritable bowel syndrome. Percent excess weight loss at 6-, 12-, and 24-months after bariatric surgery is recorded. RESULTS: Thirty percent of 278 individuals seeking bariatric surgery have ≥3 Manning criteria. There is no relationship between type 2 diabetes mellitus and the presence of ≥3 Manning criteria (p>.05), nor is body mass index a significant risk factor for irritable bowel syndrome (p>.05). At 6-, 12-, and 24-months after Roux-en-Y gastric bypass or vertical sleeve gastrectomy, there is no difference in percent excess weight loss in individuals with ≥3 Manning criteria compared to individuals with ≥2 Manning criteria (for both surgical procedures: p>.05). CONCLUSION: A diagnosis of diabetes mellitus or body mass index do not explain the high prevalence of irritable bowel syndrome identified in individuals with obesity seeking bariatric surgery, and irritable bowel syndrome does not alter weight loss after bariatric surgery.