Identifying mechanisms that predict weight trajectory after bariatric surgery: rationale and design of the biobehavioral trial.

Abstract

Bariatric surgery is currently the most efficacious and durable intervention for severe obesity. The most commonly performed procedures in the United States are the Roux-en-Y gastric bypass and the sleeve gastrectomy, which involve significant anatomic and physiologic alterations that lead to changes in behavior and biology. Unfortunately, many patients experience suboptimal weight loss and/or substantial weight regain. Eating and physical activity/sedentary behaviors, mood, cognition, and the gut microbiome all change postoperatively and have an association with weight change. The longitudinal relationship between changes in the gut microbiome and postoperative weight trajectory has not been explored thoroughly, and the interactive associations among the gut microbiome and the other variables that impact weight have been similarly understudied. The following is a methods and design description for a prospective, 24-month longitudinal study of 144 bariatric surgery patients, at 2 sites, that aimed to identify predictors of weight loss trajectories over 24 months after Roux-en-Y gastric bypass and the sleeve gastrectomy. Specifically, the study will examine the relationships between empirically supported behavioral and biological variables and their combined impact on postoperative weight trajectories. Novel data collection will include intensive measurement of problematic eating behaviors and diet and physical activity postoperatively, which may be altered in parallel with, or in response to, changes observed in the gut microbiota. Identifying postoperative predictors of weight loss and co-morbidity resolution should inform development of novel interventions that are tailored to individual patients' risk profiles to optimize and sustain more favorable weight trajectories.

• Authors: Leslie J Heinberg, Dale S Bond, Ian Carroll, Ross Crosby, Anthony Fodor, Farnaz Fouladi, John Gunstad, James Mitchell, Christine Peat, Kristine Steffen
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) Vol. 16 Issue 11 Pg. 1816-1826 (Nov 2020) ISSN: 1878-7533 [Electronic] United States
• PMID: 32768295 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Topics

• Bariatric Surgery
• Body-Weight Trajectory
• Gastrectomy
• Gastric Bypass
• Humans
• Longitudinal Studies
• Obesity, Morbid (surgery)
• Prospective Studies