Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.
-
Upload
helen-dorsey -
Category
Documents
-
view
215 -
download
3
Transcript of Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.
![Page 1: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/1.jpg)
Shah Faisal MBBS
Mentor
Joseph A. Caruana MD
![Page 2: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/2.jpg)
Aim and Objective
![Page 3: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/3.jpg)
Aim and ObjectiveSome patients after Roux-en-Y Gastric Bypass undergo
“Sub-optimal” Weight Loss (SWL).
![Page 4: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/4.jpg)
Aim and ObjectiveSome patients after Roux-en-Y Gastric Bypass undergo
“Sub-optimal” Weight Loss (SWL).Age, Gender and BMI are the major contributors to
weight loss pattern.
![Page 5: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/5.jpg)
Aim and ObjectiveSome patients after Roux-en-Y Gastric Bypass undergo
“Sub-optimal” Weight Loss (SWL).Age, Gender and BMI are the major contributors to
weight loss pattern.Are there any more subtle and/or modifiable variables
which play a role?
![Page 6: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/6.jpg)
Problem of Obesity
![Page 7: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/7.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese.
![Page 8: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/8.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to.
![Page 9: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/9.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to. Known association with some common cancers:
![Page 10: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/10.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to. Known association with some common cancers:
Liver, kidney, breast, endometrial, prostate, colon…
![Page 11: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/11.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to. Known association with some common cancers:
Liver, kidney, breast, endometrial, prostate, colon…Huge burden on healthcare cost:
![Page 12: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/12.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to. Known association with some common cancers:
Liver, kidney, breast, endometrial, prostate, colon…Huge burden on healthcare cost:
25 % greater among subjects with a BMI 30 to 34.9
![Page 13: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/13.jpg)
Problem of Obesity Two thirds of individuals living in the US are
overweight, and of those, almost half are obese. DM-2, dyslipidemia, CAD, HTN, OSA are a few of the
myriad complications that obesity predisposes to. Known association with some common cancers.
Liver, kidney, breast, endometrial, prostate, colon…Huge burden on healthcare cost:
25 % greater among subjects with a BMI 30 to 34.944 % greater among those with a BMI > 35
![Page 14: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/14.jpg)
Treatment
![Page 15: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/15.jpg)
TreatmentMedical treatment:
![Page 16: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/16.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.
![Page 17: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/17.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.Medications.
![Page 18: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/18.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.Medications.
Surgical treatment:
![Page 19: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/19.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.Medications.
Surgical treatment:Roux-en-Y Gastric By-pass.
![Page 20: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/20.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.Medications.
Surgical treatment:Roux-en-Y Gastric By-pass.Adjustable Gastric Banding.
![Page 21: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/21.jpg)
TreatmentMedical treatment:
Diet, exercise and life style modification.Medications.
Surgical treatment:Roux-en-Y Gastric By-pass.Adjustable Gastric Banding.Diet, exercise and life style modification are part of surgical
treatment.
![Page 22: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/22.jpg)
Dietary and Exercise recommendation after Gastric Bypass
![Page 23: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/23.jpg)
Dietary and Exercise recommendation after Gastric BypassDiet:
1200-1400 Cal per day.60-80 g protein per day.4-5 small meals (especially breakfast).32 oz water per day.
![Page 24: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/24.jpg)
Dietary and Exercise recommendation after Gastric BypassDiet:
1200-1400 Cal per day.60-80 g protein per day.4-5 small meals (especially breakfast).32 oz water per day.
Exercise:Walking 30 min/day, five to seven days per week.
![Page 25: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/25.jpg)
Roux en Y Gastric By-pass
![Page 26: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/26.jpg)
Adjustable Gastric band
![Page 27: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/27.jpg)
Weight Loss after Gastric Bypass
![Page 28: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/28.jpg)
Weight Loss after Gastric BypassHow do Age, Gender and BMI influence weight loss?
![Page 29: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/29.jpg)
Weight Loss after Gastric BypassHow do Age, Gender and BMI influence weight loss?Recent work done by Dr Caruana:
![Page 30: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/30.jpg)
Weight Loss after Gastric BypassHow do Age, Gender and BMI influence weight loss?Recent work done by Dr Caruana:
Weight Loss Curves.
![Page 31: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/31.jpg)
Weight Loss after Gastric BypassHow do Age, Gender and BMI influence weight loss?Recent work done by Dr Caruana:
Weight Loss Curves.Effect of Age, Gender and BMI on weight loss.
![Page 32: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/32.jpg)
959075
50
25 10 5
![Page 33: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/33.jpg)
9590755025 10 5
Red Lines >41 yrBlack Lines <41 yr
![Page 34: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/34.jpg)
Red Lines FemalesBlack Lines Males
9590755025 10 5
![Page 35: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/35.jpg)
Red Lines BMI>55Black Lines BMI<55
9590755025 10 5
![Page 36: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/36.jpg)
Sub-Optimal Weight Loss (SWL)
![Page 37: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/37.jpg)
Sub-Optimal Weight Loss (SWL)SWL < 40% (to 50%) Excess Body Weight (EBW) lost.
![Page 38: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/38.jpg)
Sub-Optimal Weight Loss (SWL)SWL < 40% (to 50%) Excess Body Weight (EBW) lost.EBW is actual weight minus Ideal Body Weight (IBW).
![Page 39: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/39.jpg)
Sub-Optimal Weight Loss (SWL)SWL < 40% (to 50%) Excess Body Weight (EBW) lost.EBW is actual weight minus Ideal Body Weight (IBW).IBW from 1983 Metropolitan Height and Weight Tables.
![Page 40: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/40.jpg)
Sub-Optimal Weight Loss (SWL)SWL < 40% (to 50%) Excess Body Weight (EBW) lost.EBW is actual weight minus Ideal Body Weight (IBW).IBW from 1983 Metropolitan Height and Weight Tables.Around 10% (to 20%) of Gastric Bypass patients have
SWL:
![Page 41: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/41.jpg)
Sub-Optimal Weight Loss (SWL)SWL < 40% (to 50%) Excess Body Weight (EBW) lost.EBW is actual weight minus Ideal Body Weight (IBW).IBW from 1983 Metropolitan Height and Weight Tables.Around 10% (to 20%) of Gastric Bypass patients have
SWL:Most of the patients actually regain the weight.
![Page 42: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/42.jpg)
Methods
![Page 43: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/43.jpg)
MethodsMatched Case-Control Study.
![Page 44: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/44.jpg)
MethodsMatched Case-Control Study.Controls matched to cases for Age, Gender & BMI.
![Page 45: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/45.jpg)
MethodsMatched Case-Control Study.Controls matched to cases for Age, Gender & BMI. Four matched controls for every case.
![Page 46: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/46.jpg)
Inclusion/Exclusion Criteria
![Page 47: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/47.jpg)
Inclusion/Exclusion CriteriaGastric bypass between Jan ’00 and Dec ‘07.
![Page 48: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/48.jpg)
Inclusion/Exclusion CriteriaGastric bypass between Jan ’00 and Dec ‘07. Followed up at 18 (±2) months after surgery.
![Page 49: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/49.jpg)
Inclusion/Exclusion CriteriaGastric bypass between Jan ’00 and Dec ‘07. Followed up at 18 (±2) months after surgery. At 18 (± 2) months:
![Page 50: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/50.jpg)
Inclusion/Exclusion CriteriaGastric bypass between Jan ’00 and Dec ‘07. Followed up at 18 (±2) months after surgery. At 18 (± 2) months:
If lost < 40% EBW—Case.
![Page 51: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/51.jpg)
Inclusion/Exclusion CriteriaGastric bypass between Jan ’00 and Dec ‘07. Followed up at 18 (±2) months after surgery. At 18 (± 2) months:
If lost < 40% EBW—Case. If lost >40% EBW—Potential Control.
![Page 52: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/52.jpg)
Cases Controls
Break Down of Cases & Controls
![Page 53: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/53.jpg)
Cases Controls
Number 21 84
Break Down of Cases & Controls
![Page 54: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/54.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Break Down of Cases & Controls
![Page 55: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/55.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Age (Years) MeanRange
4535
4538
Break Down of Cases & Controls
![Page 56: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/56.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Age (Years) MeanRange
4535
4538
BMI MeanRange
5537
5540
Break Down of Cases & Controls
![Page 57: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/57.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Age (Years) MeanRange
4535
4538
BMI MeanRange
5537
5540
Working (%) YesNo
6040
6436
Break Down of Cases & Controls
![Page 58: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/58.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Age (Years) MeanRange
4535
4538
BMI MeanRange
5537
5540
Working (%) YesNo
6040
6436
Smoking (%) YesNo
1090
1783
Break Down of Cases & Controls
![Page 59: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/59.jpg)
Cases Controls
Number 21 84
Gender
FemalesMales
201
804
Age (Years) MeanRange
4535
4538
BMI MeanRange
5537
5540
Working (%) YesNo
6040
6436
Smoking (%) YesNo
1090
1783
Race (%) WhiteBlack
9010
8317
Break Down of Cases & Controls
![Page 60: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/60.jpg)
Data CollectionRetrospective Chart Review.
![Page 61: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/61.jpg)
Data CollectionRetrospective Chart Review.Variables:
![Page 62: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/62.jpg)
Data CollectionRetrospective Chart Review.Variables:
DemographicAnthropometricSocialComplianceDisease CharacteristicsCo-morbiditiesRelated DiseasesPeri-operative
![Page 63: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/63.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
![Page 64: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/64.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
![Page 65: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/65.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
![Page 66: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/66.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
![Page 67: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/67.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
Disease Characteristics
Duration of ObesityFamily H/O Obesity
![Page 68: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/68.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
Disease Characteristics
Duration of ObesityFamily H/O Obesity
Co-morbidities No. of Co-morbidities (DM, HTN, Dyslipidemia, OSA, Arthritis, and GERD)Hepatic SteatosisNo. of Prescription MedicationsSeverity of DM, HTN and Dyslipidemia
![Page 69: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/69.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
Disease Characteristics
Duration of ObesityFamily H/O Obesity
Co-morbidities No. of Co-morbidities (DM, HTN, Dyslipidemia, OSA, Arthritis, and GERD)Hepatic SteatosisNo. of Prescription MedicationsSeverity of DM, HTN and Dyslipidemia
Related Diseases DepressionThyroid DysfunctionH/O Major Surgeries
![Page 70: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/70.jpg)
Type of Variable
Variables
Demographic Race, (Age and Gender Matched)
Anthropometric (BMI Matched)
Social Work StatusSmoking Status
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
Disease Characteristics
Duration of ObesityFamily H/O Obesity
Co-morbidities No. of Co-morbidities (DM, HTN, Dyslipidemia, OSA, Arthritis, and GERD)Hepatic SteatosisNo. of Prescription MedicationsSeverity of DM, HTN and Dyslipidemia
Related Diseases DepressionThyroid DysfunctionH/O Major Surgeries
Peri-operative Cholecystectomy done at ORPost-op LeakPost-op PEReturn to OR in 30 days
![Page 71: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/71.jpg)
Statistical Analysis
![Page 72: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/72.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:
![Page 73: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/73.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:Common odds ratio with a corresponding exact 95%
confidence interval was estimated.
![Page 74: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/74.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:Common odds ratio with a corresponding exact 95%
confidence interval was estimated.Mixed linear—Between-group Mean Difference.
![Page 75: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/75.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:Common odds ratio with a corresponding exact 95%
confidence interval was estimated.Mixed linear—Between-group Mean Difference. A nominal significance level of 0.05 was used.
![Page 76: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/76.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:Common odds ratio with a corresponding exact 95%
confidence interval was estimated.Mixed linear—Between-group Mean Difference. A nominal significance level of 0.05 was used.A multivariate model was constructed using a stepwise
conditional logistic regression procedure.
![Page 77: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/77.jpg)
Statistical AnalysisBinary predictors between the case and control group—
the exact Cochran-Mantel-Haenszel test:Common odds ratio with a corresponding exact 95%
confidence interval was estimated.Mixed linear—Between-group Mean Difference. A nominal significance level of 0.05 was used.A multivariate model was constructed using a stepwise
conditional logistic regression procedure.SAS version 9.1.3 statistical software (Cary, NC).
![Page 78: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/78.jpg)
Variable OR 95% CI p- Value
Diabetes Y vs. N 0.6 (0.1931, 2.4302) 0.567
Binary Predictors—the exact Cochran-Mantel-Haenszel test
![Page 79: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/79.jpg)
Variable OR 95% CI p- Value
Diabetes Y vs. N 0.6 (0.1931, 2.4302) 0.567
Binary Predictors—the exact Cochran-Mantel-Haenszel test
Binary Predictor—Yes or No
![Page 80: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/80.jpg)
Variable OR 95% CI p- Value
Diabetes Y vs. N 0.6 (0.1931, 2.4302) 0.567
Binary Predictors—the exact Cochran-Mantel-Haenszel test
Binary Predictor—Yes or No
Odds of normal weight loss if DM =0.6Odds of normal weight loss if not DM
![Page 81: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/81.jpg)
Variable OR 95% CI p- Value
Diabetes Y vs. N 0.6 (0.1931, 2.4302) 0.567
Binary Predictors—the exact Cochran-Mantel-Haenszel test
Binary Predictor—Yes or No
Odds of normal weight loss if DM =0.6Odds of normal weight loss if not DM
95% Confidence that OR lies between (0.1931, 2.4302)
![Page 82: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/82.jpg)
Variable OR 95% CI p- Value
Diabetes Y vs. N 0.6 (0.1931, 2.4302) 0.567
Binary Predictors—the exact Cochran-Mantel-Haenszel test
Binary Predictor—Yes or No
Odds of normal weight loss if DM =0.6Odds of normal weight loss if not DM
95% Confidence that OR lies between (0.1931, 2.4302)
P-Value < 0.05 for a relationship to be statistically significant, otherwise could be just by chance
![Page 83: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/83.jpg)
Variable Estimated Mean Difference(Control—Case)
95% CI p- Value
No. of Medications @ follow-up -1.4 (0.5079, 2.4206) 0.0031
Mixed Linear Models—Between-group mean difference
![Page 84: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/84.jpg)
Variable Estimated Mean Difference(Control—Case)
95% CI p- Value
No. of Medications @ follow-up -1.4 (0.5079, 2.4206) 0.0031
Mixed Linear Models—Between-group mean difference
Linear Variable—Number
![Page 85: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/85.jpg)
Variable Estimated Mean Difference(Control—Case)
95% CI p- Value
No. of Medications @ follow-up -1.4 (0.5079, 2.4206) 0.0031
Mixed Linear Models—Between-group mean difference
Linear Variable—Number
Average number of extra medications taken by Controls
![Page 86: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/86.jpg)
Results—UnivariateVariable Comment
![Page 87: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/87.jpg)
Results—UnivariateVariable Comment
Demographic RaceAgeGender
InsignificantMatchedMatched
![Page 88: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/88.jpg)
Results—UnivariateVariable Comment
Demographic RaceAgeGender
InsignificantMatchedMatched
Anthropometric BMI Matched
![Page 89: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/89.jpg)
Results—UnivariateVariable Comment
Demographic RaceAgeGender
InsignificantMatchedMatched
Anthropometric BMI Matched
Social Work StatusSmoking Status
InsignificantInsignificant
![Page 90: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/90.jpg)
Results—UnivariateVariable Comment
Demographic RaceAgeGender
InsignificantMatchedMatched
Anthropometric BMI Matched
Social Work StatusSmoking Status
InsignificantInsignificant
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
InsignificantSignificantInsignificant
![Page 91: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/91.jpg)
Results—UnivariateVariable Comment
Demographic RaceAgeGender
InsignificantMatchedMatched
Anthropometric BMI Matched
Social Work StatusSmoking Status
InsignificantInsignificant
Compliance Total Number of Follow-up VisitsDietary Compliance at Follow-upExercise Compliance at Follow-up
InsignificantSignificantInsignificant
Disease Characteristics
Duration of ObesityFamily H/O Obesity
InsignificantInsignificant
![Page 92: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/92.jpg)
Results—UnivariateVariables Comment
![Page 93: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/93.jpg)
Results—UnivariateVariables Comment
Co-morbidities No. of Co-morbiditiesHepatic SteatosisDM
InsignificantInsignificantInsignificant
![Page 94: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/94.jpg)
Results—UnivariateVariables Comment
Co-morbidities No. of Co-morbiditiesHepatic SteatosisDM
InsignificantInsignificantInsignificant
DyslipidemiaOn Anti-dyslipidemic Medications @ Baseline @Follow-up
Insignificant
InsignificantInsignificant
![Page 95: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/95.jpg)
Results—UnivariateVariables Comment
Co-morbidities No. of Co-morbiditiesHepatic SteatosisDM
InsignificantInsignificantInsignificant
DyslipidemiaOn Anti-dyslipidemic Medications @ Baseline @Follow-up
Insignificant
InsignificantInsignificant
HTN On Anti-HTN Medications @ Baseline @Follow-up
Insignificant
SignificantInsignificant
![Page 96: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/96.jpg)
Results—UnivariateVariables Comment
Co-morbidities No. of Co-morbiditiesHepatic SteatosisDM
InsignificantInsignificantInsignificant
DyslipidemiaOn Anti-dyslipidemic Medications @ Baseline @Follow-up
Insignificant
InsignificantInsignificant
HTN On Anti-HTN Medications @ Baseline @Follow-up
Insignificant
SignificantInsignificant
Prescription Medications @ Baseline @Follow-up
InsignificantSignificant
![Page 97: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/97.jpg)
Results—UnivariateVariable Comment
![Page 98: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/98.jpg)
Results—UnivariateVariable Comment
Related Diseases H/O DepressionH/O Thyroid dysfunctionH/O Major Surgeries
InsignificantInsignificantInsignificant
![Page 99: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/99.jpg)
Results—UnivariateVariable Comment
Related Diseases H/O DepressionH/O Thyroid dysfunctionH/O Major Surgeries
InsignificantInsignificantInsignificant
Peri-operative Cholecystectomy done at ORPost-op LeakPost-op PEReturn to OR in 30 days
InsignificantInsignificantInsignificantInsignificant
![Page 100: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/100.jpg)
Variable
Compliance Dietary Compliance at Follow-up Significant
Co-morbidities Prescriptions Medications at Follow-up Significant
Results—Multivariate
![Page 101: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/101.jpg)
ConclusionAfter negating effects of Age, Gender and BMI:
Dietary non-compliance (reported by patients) predisposes to SWL.
![Page 102: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/102.jpg)
ConclusionAfter negating effects of Age, Gender and BMI:
Dietary non-compliance (reported by patients) predisposes to SWL.
This should be stressed to patients before and after gastric bypass surgery.
![Page 103: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/103.jpg)
ConclusionAfter negating effects of Age, Gender and BMI:
Dietary non-compliance (reported by patients) predisposes to SWL.
This should be stressed to patients before and after gastric bypass surgery.
“Self-reported loss of control over eating was related to weight regain after Gastric Bypass surgery and may be an important target for clinical intervention” (Kalarchian, Obes Surg 2002 Apr;12(2):270-5).
![Page 104: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/104.jpg)
ConclusionAfter negating effects of Age, Gender and BMI:
Dietary non-compliance (reported by patients) predisposes to SWL.
This should be stressed to patients before and after gastric bypass surgery.
“Self-reported loss of control over eating was related to weight regain after Gastric Bypass surgery and may be an important target for clinical intervention” (Kalarchian, Obes Surg 2002 Apr;12(2):270-5).
Gradual enlargement of the gastric pouch.
![Page 105: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/105.jpg)
Dietary and Exercise recommendation after Gastric BypassDiet:
1200-1400 Cal per day.60-80 g protein per day.4-5 small meals (especially breakfast).32 oz water per day.
Exercise:Walking 30 min/day, five to seven days per week.
![Page 106: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/106.jpg)
Roux en Y Gastric By-pass
![Page 107: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/107.jpg)
ConclusionAnti-HTN at baseline:
Probably a direct effect of a more serious disease and hence more SWL.
![Page 108: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/108.jpg)
ConclusionAnti-HTN at baseline:
Probably a direct effect of a more serious disease and hence more SWL.
Prescription medications at follow-up:An indirect clue that patients who (were non-compliant and)
did not loose enough weight continued to need more medications.
![Page 109: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/109.jpg)
Bigger and more powerful studies could potentially show other significant associations.
Conclusion
![Page 110: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/110.jpg)
Bigger and more powerful studies could potentially show other significant associations.
Being a retrospective study, cause-effect relationship cannot be established—results show only associations.
Conclusion
![Page 111: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/111.jpg)
Bigger and more powerful studies could potentially show other significant associations.
Being a retrospective study, cause-effect relationship cannot be established—results show only associations.
Data was partly patient reported/subjective- potential recall bias.
Conclusion
![Page 112: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/112.jpg)
References1. WHO Fact sheet N°311, September 2006 2. Walter J. Pories; Who Would Have Thought It? ANNALS OF SURGERY
Vol. 222, No. 3, 339-352 3. Sjöström L; Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years
after Bariatric Surgery. N Engl J Med 2004;3512683-93 4. Walter J. Pories; Bariatric Surgery: Risks and Rewards, J Clin Endocrinol
Metab 93: S89–S96, 2008) 5. Sjöström L; Effects of Bariatric Surgery on Mortality in Swedish Obese
Subjects. N Eng J Med 2007; 357: 741-52 6. Buchwald H; Yoav Avidor; Eugene Braunwald; et al. JAMA.
2004;292(14):1724-37 7. National Center for Health Statistics NHANES IV Report. Available at:
http://www.cdc.gov/nchs /product/pubs/pubd/hestats/obes/obese99 .htm2002. Accessed September 9, 2002.
![Page 113: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/113.jpg)
References8. Halverson JK, Koehler RE. Gastric bypass: analysis of weight loss
and factors determining success. Surgery. 1981;90:446-455. 9. Brolin RE, Kenler HA, Gorman RC, Cody RP. The dilemma of
outcome assessment after operations for morbid obesity. Surgery. 1989;105:337-346.
10. Carbonell AM, Wolfe LG, Meador JG, et al. Does diabetes affect weight loss after gastric bypass? Surg Obes Relat Dis 2008;4:441-4.
11. Caruana et al; The Weight Loss Curve: A Nomogram for Monitoring the Response to Gastric Bypass
12. 12 Branson R; Impact of age, sex and body mass index on outcomes at four years after gastric banding: Obesity Surgery. 15(6):834-42, 2005 Jun-Jul
![Page 114: Shah Faisal MBBS Mentor Joseph A. Caruana MD. Aim and Objective.](https://reader038.fdocuments.us/reader038/viewer/2022110321/56649ceb5503460f949b7219/html5/thumbnails/114.jpg)
References13. Melton GB; Suboptimal weight loss after gastric bypass surgery:
correlation of demographics, comorbidities, and insurance status with outcomes: Journal of Gastrointestinal Surgery. 12(2):250-5, 2008 Feb
14. . Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Rouxen-Y—500 patients: technique and results, with 3–60 month follow-up. Obes Surg 2000;10(3):233–239, Jun
15. Prachand VN, Davee RT, Alverdy JC. Duodenal switch provides superior weight loss in the super-obese (BMI > or =50 kg/m2) compared with gastric bypass. Ann Surg 2006;244(4):611–619,Oct
16. Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg 2002;12(4):540–545, Aug.
17. Metropolitan Life Insurance Company