Abstract：
BACKGROUND: Over half of Americans and up to 78% of US Veteran population meet criteria for obesity. Perioperatively placed intragastric balloon (IGB) can accelerate weight loss goals for safe surgical candidacy, however weight regain is common after removal. Glucagon-like peptide-1-receptor agonists (GLP1RA) may provide a more sustainable weight loss solution after surgery. We hypothesize that weight regain will be less at 1 year after initiation of GLP1RA than IGB placement in Veterans.
METHODS: Retrospective review of prospective databases of perioperatively placed intragastric balloon cohort from 1/2019-1/2023 compared to patients who received initiatory GLP1RA from 6/2021-8/2022 at a VA Medical Center(VAMC). All patients were enrolled in the VAMC MOVE! multidisciplinary weight management program for a minimum of 12 weeks. Outcomes measured were patients\' weights at 0, 3, 6, and 12 months and weight change for these intervals. Exclusion criteria included history of bariatric surgery and incomplete weight loss data.
RESULTS: Two-hundred-twenty-three patients met inclusion criteria; 110 (49%) patients excluded. Mean age was 54 ± 11 years, the majority (78, 69%) were male, and the mean initial BMI was 37 ± 5.9 kg/m2. Seventeen (15%) patients underwent IGB placement and 96 (85%) patients received semaglutide. Weight (kg) change was measured at intervals: 0-3 months:- 11.8(- 17,- 9.5) IGB vs. - 5.1(- 7.4,- 2.3) semaglutide, p < 0.0001; 0-6 months:- 12.7(- 18.4,- 9.9) vs. - 9.4(- 12.6,- 6.1), p = 0.03; 3-6 months:- 0.5(- 2.3,2.3) vs. - 4.3(- 6.8,- 1.6), p < 0.0001; 6-12 months:3(0,7.3) vs. - 1.9(- 4.7,1), p = 0.0006.
CONCLUSIONS: Weight loss occurs more rapidly in the first 6 months after intragastric balloon placement compared to semaglutide (- 12.7 vs. - 9.4 kg, p = 0.03). Despite ongoing attendance in a comprehensive weight loss program, weight regain is common after IGB removal by an average of 3 kg (23.6%) at 1 year. In contrast, patients on GLP1RA (semaglutide) continue to lose weight during this period. Further studies are needed to determine if optimal long-term outcomes may result from combination therapy with intragastric balloon and semaglutide.
METHODS: Retrospective review of prospective databases of perioperatively placed intragastric balloon cohort from 1/2019-1/2023 compared to patients who received initiatory GLP1RA from 6/2021-8/2022 at a VA Medical Center(VAMC). All patients were enrolled in the VAMC MOVE! multidisciplinary weight management program for a minimum of 12 weeks. Outcomes measured were patients\' weights at 0, 3, 6, and 12 months and weight change for these intervals. Exclusion criteria included history of bariatric surgery and incomplete weight loss data.
RESULTS: Two-hundred-twenty-three patients met inclusion criteria; 110 (49%) patients excluded. Mean age was 54 ± 11 years, the majority (78, 69%) were male, and the mean initial BMI was 37 ± 5.9 kg/m2. Seventeen (15%) patients underwent IGB placement and 96 (85%) patients received semaglutide. Weight (kg) change was measured at intervals: 0-3 months:- 11.8(- 17,- 9.5) IGB vs. - 5.1(- 7.4,- 2.3) semaglutide, p < 0.0001; 0-6 months:- 12.7(- 18.4,- 9.9) vs. - 9.4(- 12.6,- 6.1), p = 0.03; 3-6 months:- 0.5(- 2.3,2.3) vs. - 4.3(- 6.8,- 1.6), p < 0.0001; 6-12 months:3(0,7.3) vs. - 1.9(- 4.7,1), p = 0.0006.
CONCLUSIONS: Weight loss occurs more rapidly in the first 6 months after intragastric balloon placement compared to semaglutide (- 12.7 vs. - 9.4 kg, p = 0.03). Despite ongoing attendance in a comprehensive weight loss program, weight regain is common after IGB removal by an average of 3 kg (23.6%) at 1 year. In contrast, patients on GLP1RA (semaglutide) continue to lose weight during this period. Further studies are needed to determine if optimal long-term outcomes may result from combination therapy with intragastric balloon and semaglutide.
摘要：
背景：超过一半的美国人和高达78%的美国退伍军人符合肥胖标准。围手术期放置的胃内球囊（IGB）可以加速减肥目标，以实现安全的手术候选，然而，体重恢复是常见的去除后。胰高血糖素样肽-1-受体激动剂（GLP1RA）可以在手术后提供更可持续的减肥解决方案。我们假设在开始GLP1RA后1年的体重恢复将小于IGB在退伍军人中的安置。
方法：回顾性审查1/2019-1/2023围手术期放置的胃内球囊队列的前瞻性数据库，与6/2021-8/2022在VA医学中心（VAMC）接受初始GLP1RA的患者相比。所有患者都参加了VAMCMOVE！多学科体重管理计划，为期至少12周。测量的结果是患者在0、3、6和12个月时的体重和这些间隔的体重变化。排除标准包括减肥手术史和不完整的体重减轻数据。
结果：二百二十三例患者符合纳入标准；110例（49%）患者被排除。平均年龄为54±11岁,大多数（78，69％）是男性，平均初始BMI为37±5.9kg/m2。17例（15％）患者接受了IGB放置，96例（85％）患者接受了司马鲁肽。测量体重（kg）变化的间隔：0-3个月：-11.8（-17，-9.5）IGBvs.-5.1（-7.4，-2.3）塞马鲁肽，p<0.0001；0-6个月：-12.7（-18.4，-9.9）与-9.4（-12.6，-6.1），p=0.03；3-6个月：-0.5（-2.3,2.3）vs.-4.3（-6.8，-1.6），p<0.0001；6-12个月：3（0,7.3）vs.-1.9（-4.7,1），p=0.0006。
结论：与司马鲁肽相比，在胃内球囊放置后的前6个月体重减轻更快（-12.7vs.-9.4kg,p=0.03)。尽管正在参加一项全面的减肥计划，IGB去除后1年平均3公斤(23.6%)体重恢复是常见的。相比之下,在此期间，服用GLP1RA（司马鲁肽）的患者继续减肥。需要进一步的研究来确定与胃内球囊和司马鲁肽联合治疗是否可能产生最佳的长期结果。
方法：回顾性审查1/2019-1/2023围手术期放置的胃内球囊队列的前瞻性数据库，与6/2021-8/2022在VA医学中心（VAMC）接受初始GLP1RA的患者相比。所有患者都参加了VAMCMOVE！多学科体重管理计划，为期至少12周。测量的结果是患者在0、3、6和12个月时的体重和这些间隔的体重变化。排除标准包括减肥手术史和不完整的体重减轻数据。
结果：二百二十三例患者符合纳入标准；110例（49%）患者被排除。平均年龄为54±11岁,大多数（78，69％）是男性，平均初始BMI为37±5.9kg/m2。17例（15％）患者接受了IGB放置，96例（85％）患者接受了司马鲁肽。测量体重（kg）变化的间隔：0-3个月：-11.8（-17，-9.5）IGBvs.-5.1（-7.4，-2.3）塞马鲁肽，p<0.0001；0-6个月：-12.7（-18.4，-9.9）与-9.4（-12.6，-6.1），p=0.03；3-6个月：-0.5（-2.3,2.3）vs.-4.3（-6.8，-1.6），p<0.0001；6-12个月：3（0,7.3）vs.-1.9（-4.7,1），p=0.0006。
结论：与司马鲁肽相比，在胃内球囊放置后的前6个月体重减轻更快（-12.7vs.-9.4kg,p=0.03)。尽管正在参加一项全面的减肥计划，IGB去除后1年平均3公斤(23.6%)体重恢复是常见的。相比之下,在此期间，服用GLP1RA（司马鲁肽）的患者继续减肥。需要进一步的研究来确定与胃内球囊和司马鲁肽联合治疗是否可能产生最佳的长期结果。
