• Development and Reproduction
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• v.27 no.3
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• pp.117-126
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• 2023

Bariatric surgery is an effective treatment option for obesity, but its effects on reproductive hormones are not well understood. This study aimed to investigate the impact of bariatric surgery on estrogen and progesterone levels in women with obesity. This was a prospective study that included 87 women with obesity who underwent bariatric surgery and 87 control women with obesity who did not. Blood samples were collected at baseline and at 3-month and 6-month follow-up periods to measure reproductive hormones and Adiponectin as well as medical history and physical examination for endometriosis and polycystic ovary syndrome (PCOS). The study found that sleeve gastrectomy significantly increased follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in the bariatric surgery group compared to the control group at 3 and 6-month follow-up. There was no significant difference in the mean levels of estrogen and progesterone between the two groups at the 3-month follow-up period. Bariatric surgery leads to significant weight loss in women with obesity, but it does not seem to have a significant impact on estrogen and progesterone levels in the short-term. Future studies with longer follow-up periods are needed to investigate the long-term effects of bariatric surgery on reproductive hormones.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.260-273
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• 2023

Purpose: This study aimed to explore the weight loss experience of highly obese young people who underwent bariatric surgery. Methods: Data were collected, from October 2021 to April 2022, through individual in-depth interviews with eight highly obese young adults who underwent bariatric surgery and analyzed using Colaizzi's phenomenological method. Results: The following four theme clusters were extracted. First, 'The unbearable sorrow of obese people' explains the process of choosing bariatric surgery after fluctuations and frustration despite countless repeated weight loss attempts. Second, 'The impact aftermath of bariatric surgery' revealed participants struggling in the face of unexpected changes due to bariatric surgery. Third, 'Efforts to rebuild a healthy myself' demonstrated the struggle to regain health by using the surrounding support system to overcome the difficulties of this surgical procedure. Lastly, 'Facing life by getting rid of the yoke of obesity' displayed the experiences of the participants who felt ambivalent about their changed appearance, but coping positively with the new life. Conclusion: This study provides an in-depth understanding of the weight loss experiences of highly obese adolescents who underwent bariatric surgery and presents a new perspective on clinical practice. The results of this study are expected to be useful in developing and applying systematic and customized nursing interventions before and after bariatric surgery.

• Journal of Korean Medicine for Obesity Research
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• v.4 no.1
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• pp.13-22
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• 2004

Objectives: The purpose of this study was to investigate the prevalence of eating disorder high risk group and eating disorder among whom visit bariatric clinic for diet and its relationship with sex, ages and body measurement. Methods: 742 subjects who visit our clinic both at Seocho and Bundang from January to October in 2004 were surveyed by using EAT-26 to assess their eating attitude. Results: The prevalence of eating disorder high risk group was 17.9% and that of eating disorder was 3.2%. Mean score of EAT-26 was higher in females$(13.22{\pm}8.52)$ than males$(8.95{\pm}5.44)$ and was significantly higher in twenties than the thirties in females(p<0.05). Mean weight, BMI and % body fat were significantly lower in eating disorder high risk group than normal group(p<0.05). Conclusions: Eating disorder symptomatology was highly prevalent among whom visit bariatric clinic for diet.

• Clinical Endoscopy
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• v.55 no.3
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• pp.401-407
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• 2022

Background/Aims: Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population. Methods: From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion. Results: Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion. Conclusions: Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage.

• Sleep Medicine and Psychophysiology
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• v.23 no.2
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• pp.93-96
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• 2016

Obstructive sleep apnea syndrome (OSAS) has negative effects on health, including increased mortality, risk of cardiovascular disease, and neurocognitive difficulties. OSAS is common in obese patients and obesity is an important risk factor of OSAS. A 41-year-old female OSAS patient with severe obesity (body mass index [BMI] ${\geq}35$) who failed dietary weight loss underwent bariatric surgery. After surgery, there were improvements in BMI (from 36.9 to $31.7kg/m^2$) and polysomnographic data, including the apnea-hypopnea index (from 25.1 to 11.2 events/hr) and minimum SaO2 (from 69 to 82%). This case demonstrates that bariatric surgery may be an effective therapeutic option to reduce sleep-disordered breathing in severely obese patients with moderate OSAS. Bariatric surgery as a treatment option for OSAS should be considered in OSAS patients with severe obesity who failed dietary weight loss.

• Archives of Plastic Surgery
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• v.42 no.5
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• pp.567-571
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• 2015

Background Bariatric surgeries performed in the USA has increased twelve-fold in the past two decades. The effects of rapid weight loss on facial features has not been previously studied. We hypothesized that bariatric surgery will mimic the effects of aging thus giving the patient an older and less attractive appearance. Methods Consecutive patients were enrolled from the bariatric surgical clinic at our institution. Pre and post weight loss photographs were taken and used to generate two surveys. The surveys were distributed through social media to assess the difference between the preoperative and postoperative facial photos, in terms of patients' perceived age and overall attractiveness. 102 respondents completed the first survey and 95 respondents completed the second survey. Results Of the 14 patients, five showed statistically significant change in perceived age (three more likely to be perceived older and two less likely to be perceived older). The patients were assessed to be more attractive postoperatively, which showed statistical significance. Conclusions Weight loss does affect facial aesthetics. Mild weight loss is perceived by survey respondents to give the appearance of a younger but less attractive patient, while substantial weight loss is perceived to give the appearance of an older but more attractive patient.

• Journal of Obesity & Metabolic Syndrome
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• v.27 no.4
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• pp.213-222
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• 2018

Bariatric surgery has evolved from a surgical measure for treating morbid obesity to an epochal remedy for treating metabolic syndrome as a whole, which is represented by type 2 diabetes mellitus. Numerous clinical trials have advocated bariatric or metabolic surgery over nonsurgical interventions because of markedly superior metabolic outcomes in morbidly obese patients who satisfy traditional criteria for bariatric surgery (body mass index [BMI] >$35kg/m^2$) and in less obese or simply overweight patients. Nevertheless, not all diabetes patients achieve the most desirable outcomes; i.e., diabetes remission after metabolic surgery. Thus, candidates for metabolic surgery should be carefully selected based on comprehensive preoperative assessments of the risk-benefit ratio. Predictors for diabetes remission after metabolic surgery may be classified into two groups based on mechanism of action. The first is indices for preserved pancreatic beta-cell function, including younger age, shorter duration of diabetes, and higher C-peptide level. The second is the potential for an insulin resistance reduction, including higher baseline BMI and visceral fat area. Several prediction models for diabetes remission have been suggested by merging these two to guide the joint decision-making process between clinicians and patients. Three such models, DiaRem, ABCD, and individualized metabolic surgery scores, provide an intuitive scoring system and have been validated in an independent external cohort and can be utilized in routine clinical practice. These prediction models need further validation in various ethnicities to ensure universal applicability.

• Clinical Endoscopy
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• v.57 no.3
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• pp.309-316
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• 2024

The treatment of obesity and its comorbidities ranges from clinical management involving lifestyle changes and medications to bariatric and metabolic surgery. Various endoscopic bariatric and metabolic therapies recently emerged to address an important therapeutic gap by offering a less invasive alternative to surgery that is more effective than conservative therapies. This article comprehensively reviews the technical aspects, mechanism of action, outcomes, and future perspectives of one of the most promising endoscopic bariatric and metabolic therapies, named duodenojejunal bypass liner. The duodenojejunal bypass liner mimics the mechanism of Roux-en-Y gastric bypass by preventing food contact with the duodenum and proximal jejunum, thereby initiating a series of hormonal changes that lead to delayed gastric emptying and malabsorptive effects. These physiological changes result in significant weight loss and improved metabolic control, leading to better glycemic levels, preventing dyslipidemia and non-alcoholic fatty liver disease, and mitigating cardiovascular risk. However, concern exists regarding the safety profile of this device due to the reported high rates of severe adverse events, particularly liver abscesses. Ongoing technical changes aiming to reduce adverse events are being evaluated in clinical trials and may provide more reliable data to support its routine use in clinical practice.

• Archives of Obesity and Metabolism
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• v.2 no.1
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• pp.17-24
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• 2023

Obesity is a major public health problem worldwide, with several methods having been proposed as a means of weight loss. If diet, exercise, and medication are insufficient, a healthcare professional may suggest weight loss treatments, including bariatric surgery or medical devices. Antiobesity medical devices are an option for patients who do not want to undergo bariatric surgery. Compared with bariatric surgery, medical devices have the advantage of being reversible and easier to operate. The U.S. Food and Drug Administration (FDA) regulates medical devices, including those used for weight loss and weight management. This article provides an overview of the FDA-regulated weight loss and weight management devices.

• 대한위암학회:학술대회논문집
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• 2005.09a
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• pp.30-36
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• 2005