Treatment of weight re-gaining after gastric bypass operation in female patient with morbid obesity and diabetes mellitus

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Abstract

Abstract. Obesity (OB) is a common disease that leads to a significant increase in cardiovascular risk due to the development of insulin resistance, carbohydrate metabolism disorders, and dyslipidemia. The most effective method for treating OB and OB-associated conditions is bariatric surgery. In recent years, the data on weight regain (WR) and recurrence of OB in patients who were not complying with postoperative diet recommendations, physical activity, and doctor visits are accumulated in the literature. As a rule, WR leads to worsening glycemic control, deepens insulin resistance and dyslipidemia. In addition, the restrictive and malabsorptive components of modern bariatric interventions require taking vitamin and mineral supplements, since developing deficiency conditions can lead to serious complications. The article presents a clinical case of a female patient with morbid OB and type 2 diabetes mellitus, who developed WR and complications caused by vitamin and mineral deficiency.

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About the authors

Galina V. Semikova

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: Semikovagv@yandex.ru
ORCID iD: 0000-0003-0791-4705
SPIN-code: 4534-0974

MD, PhD (Medicine), assistant

Russian Federation, Saint Petersburg

Anna R. Volkova

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: volkovaa@mail.ru
ORCID iD: 0000-0002-5189-9365
SPIN-code: 4007-1288

MD, Dr. Sci.(Medicine), professor 

Russian Federation, Saint Petersburg

Yuri Sh. Khalimov

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: yushkha@gmail.com
ORCID iD: 0000-0002-7755-7275
SPIN-code: 7315-6746

MD, Dr. Sci. (Medicine), professor

Russian Federation, Saint Petersburg

Anna V. Lisker

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: a.lisker@mail.ru
ORCID iD: 0000-0003-4295-1202
SPIN-code: 3688-1505

MD, PhD (Medicine)

Russian Federation, Saint Petersburg

Valentina S. Mozgunova

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: sidelnikovavalya@mail.ru
ORCID iD: 0000-0002-0841-3438

MD, assistant

Russian Federation, Санкт-Петербург

Elena N. Ostroukhova

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: elenikos9@gmail.com

MD, PhD (Medicine), associate professor

Russian Federation, Saint Petersburg

References

  1. Shukla A.P., He D., Saunders K.H. Current concepts in management of weight regain following bariatric surgery. Expert Rev Endocrinol Metab. 2018; 13(2): 67–76. https://doi.org/10.1080/17446651.2018.1447922. PMID: 30058859.
  2. Mechanick J.I., Apovian C., Brethauer S. et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: Cosponsored by American Association of Clinical Endocrinologists / American College of Endocrinology, the Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists – executive summary. Endocr Pract. 2019; 25(12): 1346–59. https://doi.org/10.4158/gl-2019-0406. PMID: 31682518.
  3. Trevino R.P., Pina C., Fuentes J.C., Nunez M. Evaluation of medicare’s intensive behavioral therapy for obesity: The BieneStar experience. Am J Prev Med. 2018; 54(4): 497–502. https://doi.org/10.1016/j.amepre.2018.01.018. PMID: 29449133.
  4. Wadden T., Tsai A., Tronieri J. A protocol to deliver intensive behavioral therapy (IBT) for obesity in primary care settings: The MODEL-IBT program. Obesity (Silver Spring). 2019; 27(10): 1562–66. https://doi.org/10.1002/oby.22594. PMID: 31544345. PMCID: PMC6786257.
  5. Magro D.O., Geloneze B., Delfini R. et al. Long-term weight regain after gastric bypass: A 5-year prospective study. Obes Surg. 2008; 18(6): 648–51. https://doi.org/10.1007/s11695-007-9265-1. PMID: 18392907.

Supplementary files

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2. Fig. 1. Dynamics of body weight of the observed patient before bariatric intervention

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3. Fig. 2. Dynamics of body weight of the observed patient after gastric bypass

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