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Obesity Treatment Alternatives: Foods to Surgery

The purpose of these studies was to explore the roles of dietary strategies and bariatric surgery in obesity treatment. The breakfast study was a randomized, crossover trial used to evaluate the role of egg proteins, and a retrospective chart review was conducted to obtain comparative information about two different bariatric surgeries. The breakfast study included 20 subjects who were randomized to receive an egg breakfast (EB) or a cereal breakfast (CB) matched for energy density and macronutrient composition but different protein quality for one week. Following a washout period, each subject was crossed over to receive the opposite breakfast for one week. The EB resulted in lower cumulative lunchtime food intake (p=0.05), reduced hunger on day 1 (p=0.001), greater feelings of fullness on days 1 and 7 (p=0.02), and decreased desire to eat on day 1 (p=0.03). Acylated ghrelin was lower on day 1 of the EB compared to the CB (p=0.005) but not on day 7. PYY was greater at 120 minutes (p=0.006) and 180 minutes (p=0.001) on day 1 and at 180 minutes on day 7 (p=0.03) after the EB. The bariatric surgery studies examined 835 Roux-en-Y gastric bypass (RYGB) patients and 766 vertical sleeve gastrectomy (VSG) patients. Study one focused on patients diagnosed with type 2 diabetes (T2D). The acute effect bariatric surgery had on resolving T2D was measured by calculating the number of patients who discontinued their hypoglycemic medication use post-operatively. Upon discharge, 95 of the 123 (77.2%) RYGB patients and 107 of the 139 (77.0%) VSG patients had been taken off their medication. Eight weeks post-operatively, 30 of the 38 (~79%) RYGB patients and 59 of the 71 (83%) VSG patients with follow-up data remained off medication. Study two examined differences in weight loss, early post-operative surgical complications, and insurance coverage between RYGB and VSG patients. RYGB patients lost more weight at one and two years (p<0.001 for both). There was no significant difference in the percentage of weight loss or complications in insured versus self-pay patients. RYGB patients experienced a higher incidence of major complications than VSG patients (p<0.001).

Identiferoai:union.ndltd.org:LSU/oai:etd.lsu.edu:etd-10312011-102824
Date31 October 2011
CreatorsBayham, Brooke Erwin
ContributorsTuuri, Georgianna, O'Neil, Carol, Greenway, Frank
PublisherLSU
Source SetsLouisiana State University
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://etd.lsu.edu/docs/available/etd-10312011-102824/
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