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Review
. 2024 Dec 23:11:1510403.
doi: 10.3389/fnut.2024.1510403. eCollection 2024.

Prognosticating post-bariatric surgery outcomes and management of postoperative recurrent weight gain and diabetes recurrence

He Xiao #  1   2 , Yudie Du #  1   2 , Yuanyuan Tan  1   2 , Yixing Ren  1   2   3
Affiliations
Review

Prognosticating post-bariatric surgery outcomes and management of postoperative recurrent weight gain and diabetes recurrence

He Xiao et al. Front Nutr. .

Abstract

Bariatric surgery stands as the most potent treatment for achieving substantial weight reduction and alleviating the complications associated with obesity. However, it is not the treatment of choice for patients with obesity combined with type 2 diabetes mellitus, and the benefit of bariatric surgery varies widely among individuals. There is a noticeable inconsistency in the outcomes following these procedures. The ability to predict how an individual will respond to bariatric surgery is a valuable asset in clinical practice. And the importance of postoperative interventions should not be underestimated. Proactive measures targeting both pre- and post-operative eating habits and lifestyle adjustments are of greater significance than the investigation into pre-operative factors alone. The judicious application of medication, endoscopic intervention and conversional surgeries after bariatric surgery can yield superior outcomes in managing recurrent weight regain and the recurrence of diabetes, albeit with consideration for the associated complication rates.

Keywords: bariatric surgery; conversional surgery; glucagon-like peptide-1; recurrent weight gain; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Function of GLP-1. (A) Molecular mechanism of GLP-1. (B) Effects of GLP-1 on the body. GLP-1, glucagon-like peptide-1; glucose-stimulated insulin secretion.
Figure 2
Figure 2
Efficacy of different conversional surgeries after SG on BMI. BMI, body mass index; SG, sleeve gastrectomy; RYGB, Roux-en-Y gastric bypass; OAGB, one-anastomosis gastric bypass; SADI, single-anastomosis duodeno-ileal bypass; DS, duodenal switch.
Figure 3
Figure 3
Efficacy of different conversional surgeries after RYGB on BMI. BMI, body mass index; RYGB, Roux-en-Y gastric bypass; LGB, laparoscopic gastric band; D-RYGB, distalization- Roux-en-Y gastric bypass; GJA, gastrojejunal anastomosis; DS, duodenal switch.
Figure 4
Figure 4
Effects of different types of hypoglycemic agents on the body. GLP-1, glucagon-like peptide-1; GLP-1 RA, glucagon-like peptide-1 receptor agonists; DPP-4i, dipeptidyl peptidase-4 inhibitors; SGLT-2i, sodium–glucose cotransporter 2 inhibitors; TZDs, thiazolidinediones.
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