Annals of Bariatric Surgery
Volume:10 Issue: 2, Summer and Autumn 2021

Due to the increasing prevalence of obesity and increasing the bariatric surgical procedures worldwide as the main treatments for severe obesity and the existence of calcium and vitamin D deficiency in these patients, it is necessary to evaluate and compare these elements in patients before and after bariatric surgery to perform proper treatment. Therefore, considering this necessity, the present review was designed. After searching in PubMed and Scopus database and screening the studies (in terms of quality and relevance), the contents were classified and the most important points were reported in this study.

The prevalence of body image dissatisfaction is considered high in both developed and developing countries. Studies on obese individuals have shown associations between the risks of obesity and its hazardous effects both on physical and mental health as well as on the body image. Development of body image dissatisfaction in Eastern communities has been increased in the past years. Despite many studies in Asian societies, In Iran, studies are scattered and limited. Preventing and alleviating body Image dissatisfaction among Iranian obese women is an important area for policy and practice, but the effectiveness of many interventions has been questioned because of the lack of evidence. A systematic review was conducted to determine the effectiveness of health promotion interventions that target body Image dissatisfaction in Iranian obese women. Quantitative outcome studies between March 2016 and February 2021 in English and Persian language were included. Articles were identified by searching electronic databases, journals and abstracts, and contacting key informants. Information was extracted and synthesized using a standard form. 9 studies were identified. their design, methods, quality and transferability varied considerably. Just 1 of the 10 effective interventions were group activities. The review suggests that all of interventions are effective, involving some form of mindfulness and emotion regulation training that targeted obese women.

Due to the reduction in micronutrients and proteins available to the body after LSG, we evaluated effects of various supplements and rate of hair loss in the postoperative period.

In this interventional study, we examined female candidates of LSG. individuals randomly divided into three groups. Group 1  received routine multivitamin mineral supplements, group 2 took received zinc + iron + B vitamins supplements plus routine multivitamin mineral until the end of the third month after surgery, and group 3 took supplements containing wheat and sesame proteins and methionine and cysteine in addition to Zinc + Iron + B vitamins supplements and routine multivitamin mineral supplements. number of hairs in the frontal area were counted  using trichoscope before surgery and after 3 month follow up.

  the mean number of hairs in the frontal area in group 1 before and after surgery was about143 and 100 hairs per cm² respectively, in group 2 was 142 and 116 and In group 3, 137 and 177 hairs per cm². the mean number of trichoscopic hairs in the frontal area, was significantly higher in group 3 than other groups. (p < 0.001) 

The present study clearly showed that the use of protein supplements, in addition to the use of micronutrients in individuals, more and better reduces the rate of hair loss after LSG. This can be considered and evaluated for future surgeries

Mandatory lockdown of COVID-19 has caused a great impact in patients lives. Meanwhile, people underwent bariatric surgery are very susceptible to adverse effects of this social isolation. This study investigates the effects of COVID-19 lockdown on patients undergone previous bariatric surgery.

Data source included PubMed and ScienceDirect. Articles were screened and eligible data was extracted. The outcomes of this study were the effects of lockdown on previous bariatric surgery that could lead to patient’s weight regain.

Our review study included 8 articles on 691 patients. COVID-19 lockdown had a profound effect on the lifestyle of people with a history of bariatric surgery. Many factors in the studies, including psychological factors such as depression, decreased social support, anxiety, eating habits such as reduced healthy food intake and lack of control over eating, and ultimately physical activity were negatively affected by the mandatory lockdown.

The results of this review study demonstrated that social isolation during COVID-19 pandemic has caused many complications for patients underwent bariatric surgery, which can eventually lead to weight regain and recurrence of comorbidities in these population.

Despite the improvement in health, function and quality of life of patients with morbid obesity following bariatric surgery, such intervention may result in some potential complications such as metabolic disturbances especially involving bone motabolism. The aim of this study was to evaluate the extent of Bone Mineral Density (BMD) changes in older patients with morbid obesity and its relation with bone metabolism indices.

This study was a single-center cross-sectional study on 50 new morbidly obese patients over 50 years old of age who were candidates for bariatric surgery. Before and 6 months after surgery, the values of BMD, anthropometric indices and metabolic serum biomarkers were assessed.

BMD examination before and 6 months after surgery showed decrease in the BMD in hip region from 1.242 ± 0.136 to 1.117 ± 0.112 g/cm2, in the femoral neck from 1.109 ± 0.131 to 0.987 ± 0.127 g/cm2, in the lumbar spine from 1.253 ± 0.146 to 1.190 ± 0.135 g/cm2. The analysis of BMD changes showed significant decrease in the bone density of all site measurement but with variable amounts. The decrement of BMD in the hip and femoral neck was significant but in the spine was not significant. The analysis on bone metabolism markers showed significant increase in 25-Hydroxy vitamin D and Alkaline phosphatase levels but decrease in calcium and parathyroid hormone (PTH) during 6 month follow up.

There is significant decrease in BMD at various skeletal areas including femoral neck and hip region. Such changes can be in line with the changes in some serum metabolic and hormonal biomarkers such as calcium, PTH, vitamin D and alkaline phosphatase.

The predictors of successful outcomes after sleeve gastrectomy are not yet well recognized. Therefore, the purpose of this study was to assess factors predicting successful weight loss after surgery.

This was a retrospective cohort study performed in Firoozgar hospital during 2017-2019. Overall, 128 patients with morbid obesity (103 females and 25 males; BMI range: 36.05 to 58.47 kg/m2) were included. The success of sleeve was defined either as Estimated Weight Loss (EWL) % >= 50% at 6 months or EWL% >= 65% at 12 months after surgery. We had two groups (successful and unsuccessful) at 6 and 12 months after surgery.

The mean ± SD of age, height, baseline weight and BMI (Body Mass Index) were 36.25 ± 11.11 year, 166.95 ± 9.65 cm, 119.40 ± 19.30 kg and 42.64 ± 4.03 kg/m2, respectively. Male and female patients were significantly different in reaching enough EWL% at 12 months after surgery (92.9% vs 56% respectively; p=0.012). The significant difference seen in mean ages between the two groups at 6 months (p=0.017) was disappeared at 12 months. In logistic regression analysis, the only independent factor to predict success was gender.

The patient’s gender, height, weight or BMI, may have a predictive value to reach to a desirable weight after sleeve gastrectomy. Further investigations with large sample size are necessary to elucidate and predict more detailed findings.