Weight Loss Surgery Improves Pain and Physical Function

According to a study titled, “Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity” published in JAMA, it found that a large percentage of patients with severe obesity that underwent bariatric surgery experienced improvement in pain, physical function and walking capacity over three years.

The study was designed to record and report changes in pain and physical function in the first three years following bariatric surgery and to identify factors associated with improvement. Up to date the authors had noted that variability and durability of improvements in pain and physical function following a gastric bypass or gastric band had not been well documented.

Stairs

The study was conducted at ten hospitals between February 2005 and February 2009 and led by Dr Wendy C King from the University of Pittsburgh, along with her colleagues they examined changes in pain and physical function in three years after bariatric surgery.

 

There were 2,458 patients included in the study, 70% underwent the gastric bypass and 25% had the gastric band procedure. Among the primary findings through three years of follow up approximately 50-70 percent of adults experienced clinically significant improvements in perceived bodily pain and physical function and in objectively measured walking capacity. Approximately three-fourths of participants with severe knee and hip pain experienced improvements in osteoarthritis symptoms.

Hips and knees

The study found that between year one and year three, rates of improvement significantly decreased for bodily pain and physical function but improvement rates for walk time, knee and hip pain, knee and hip function did not!

 

Indications that were associated with pre surgery to post surgery improvements at years one, two and three were:

  • Younger age
  • Male sex
  • Higher income
  • Lower BMI
  • Less depressive symptoms pre surgery
  • No diabetes
  • No swelling or ulcerations of the legs

This study’s large geographically diverse sample, inclusion of multiple validated measures of pain and physical function, longitudinal design and three year follow up make it one of the most informative studies following gastric bypass and gastric banding.

Reference: JAMA 2016;315(13):1362-1371.doi10.1001/jama2016.3010

Title: Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

Authors: Wendy C King, Jia-Yuh Chen, Steven h Belle, Anita p Courcoulas, Gregory F Dakin, Katherine A Elder,David R Flum, Marcelo W Hinojosa, James E Mitchell, Walter J Pories, Bruce M Wolfe and Susan Z Yanovski

 

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Post Op Assessments Aid Weight Loss

Researchers from the Neuropsychiatric Research Institute, Fargo, ND have published a paper on their study which assessed how certain weight control practices and eating behaviours can significantly influence the amount of weight loss after surgery.

 

The paper titled, “Postoperative Behavioural Variables and Weight Changes 3 Years After Bariatric Surgery”, was published in the well-respected JAMA Surgery and suggested that the utility of programmes to modify problematic eating behaviours and eating patterns should be addressed in research.

“The results of this study suggest that certain behaviours, many of which are modifiable, are associated with weight loss differences of significant impact in patients undergoing the gastric bypass or the adjustable gastric band”, the authors write. “The magnitude of this difference is large and clinically meaningful. In particular, the data suggest that developing positive changes in behaviour, including ceasing negative behaviours, can affect the amount of weight loss”.

Thinking of Food 2

Weight loss surgery has been proven to induce weight loss but the amount of weight loss that patients achieves varies. In the past, research has been focussed on pre-operative factors and post-operative predictors of weight loss have not been thoroughly researched. The aim of this study was to examine post-operative eating behaviours and weight control, and their effects on change in weight among adults undergoing their first time weight loss procedure.

 

Behaviours studied were divided into those that were never present, those who were always present and those that underwent a healthy change after surgery (development of a positive behaviour or omission of a negative behaviour).

 

The study included a total of 2,022 participants, 1,513 underwent the gastric bypass and 509 had the gastric band procedure. The researchers found that the three behaviours that predicted a patient to lose an average of 39% of their baseline weight, which is about 14% greater weight loss compared with patients who made no positive changes in these behaviours, and 6% greater weight loss compared with patients who always reported positively and attended follow up were:

stop-eating

 

No 1 – Weekly self-weighing

No 2- Stopping eating when feeling satisfied

No 3 – Stopping eating continuously during the day (grazing)

 

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Weekly self weighing

The outcomes suggest that structured programmes to modify problematic eating behaviours and eating patterns following surgery should be evaluated to improve weight loss outcomes which means that the post-operative period requires more targeting from the healthcare professionals to ensure success.

 

 

 

Title: Postoperative Behavioural Variables and Weight Change 3 Years After Bariatric Surgery

Authors: James E. Mitchell, MD; Nicholas J. Christian, PhD; David R. Flum, MD, MPH; Alfons Pomp, MD; Walter J. Pories, MD; Bruce M. Wolfe, MD; Anita P. Courcoulas, MD, MPH; Steven H. Belle, PhD, MScHyg

Reference: JAMA Surg. Published online April 20, 2016. doi:10.1001/jamasurg.2016.0395