ABSTRACT
BACKGROUND AND METHODS: The relationships between cognitive restraint and the tendency to disinhibition, as assessed by the Three Factor Eating Questionnaire (TFEQ), and the weight loss at 1 year following gastric banding are evaluated. RESULTS: A significant predictability of the TFEQ Disinhibition score on the postoperative weight reduction was observed, while the amount of weight lost was negatively related to the preoperative TFEQ Cognitive Restraint score. CONCLUSION: It must then be hypothesized that the operated subjects feel a strong aversive stimulus and then they are led to reduce their food consumption only when they lose control and tend to overeat. The discomfort due to proximal gastric pouch distention facilitates the development of food aversion and then both the decrease of food intake and a change in eating behavior. The subjects must therefore be encouraged to adopt an eating style that cannot allow them to avoid such a feeling.
ABSTRACT
BACKGROUND: 239 pregnancies occurred in 1136 women who had undergone biliopancreatic diversion (BPD). METHODS: There were 73 abortions, and 14 pregnancies are presently in their course. The 152 term pregnancies (six twins) occurred in 129 women 2-173 months (mean 42.7) after BPD. Mean age and current excess weight were 31.4 years (20-42) and 29.1%(- 6.9-78.2), and mean excess weight loss was 72.9%(30.4-110.5). RESULTS: Mean weight gain during pregnancy was 6.2 kg (-21-25). In 32 patients (21%), parenteral nutritional support was needed. In all the other patients (79%), the usual supplementations were given. Of the newborns, 122 were delivered at term (84.7%) with a mean weight of 2842.4g (1760-4600g) and a mean length of 48.S cm (43-59 cm), while the 22 preterm babies (15.3%) weighed 2151.1 g (1400-3850 g) and had a length of 44.6 cm (33-56 cm). Forty infants (27.8%) were small for gestational age but 17 of them weighed more than 2500 g. Eleven twins (one, abortion at 26th week) were also delivered, with a mean weight of 2088.6 g (1200-3100 g) and a mean length of 45.6 cm (35-50 cm). Delivery was spontaneous in 85 instances (56%), while vacuum extractor was used in one, and 66 cesarean sections were performed. There were two birth malformations, one infant died after surgery for meconium obstruction and two died from unknown causes. Of the 129 women, 35 had been infertile before BPD. CONCLUSIONS: Disappearance of infertility and decrease of pregnancy risk are to be considered among the beneficial effects of weight reduction following BPD.
ABSTRACT
Resting energy expenditure (REE) was measured by Indirect calorimetry in three groups of subjects closely matched for body weight (BW) and body composition. Five subjects had reduced from lO3 kg (129-90) to normal BW by dieting. Fourteen subjects had normalized their weight (preop 120 kg, from 168 to 100) following biliopancreatic diversion (BPD). All subjects in both groups had essentially maintained a stable weight for at least 2 years before the study. Ten healthy volunteers who had never been obese served as controls. No differences in REE were observed between post-BPD and control subjects, while lower (p < 0.05) values of REE were found in post-diet subjects. A long-lasting reduction of REE, in spite of a normal body composition, might partly account for the very poor long-term results of conventional dietary treatment. The unreduced REE following BPD may contribute, along with the permanent intestinal malabsorption, to the excellent long-term weight maintenance caused by this surgical procedure.
ABSTRACT
Stomal ulcer occurs in about 5% of patients after biliopancreatic diversion (BPD). Seven females were given 150 or 300 mg of ranitidine orally. Blood samples found a pharmacologically effective concentration from 0.5 to 8 h after both doses. Intestinal absorption of ranitidine is maintained after BPD.
