Article | Published:

Bariatric Surgery

The effects of provider-prescribed obesogenic drugs on post-laparoscopic sleeve gastrectomy outcomes: a retrospective cohort study

International Journal of Obesity (2018) | Download Citation

Abstract

Background:

Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedures and has proven effective in providing weight loss. However, considerable variance has been noted in the degree of weight loss. Physician prescription practices may be negatively affecting weight loss post-LSG and, thus, contributing to the broad range of weight loss outcomes. The aim of our study was to determine whether commonly prescribed obesogenic medications negatively affect weight loss outcomes post-LSG.

Subjects/methods:

This single center retrospective cohort study performed at a University hospital included 323 patients (≥18 years) within the University California, San Diego Healthcare System who underwent LSG between 2007 and 2016. We identified a list of 32 commonly prescribed medications that have weight gain as a side effect. We compared the percent excess weight loss (%EWL) of patients divided into two groups based on post-LSG exposure to obesogenic medications. A linear regression model was used to analyze %EWL at 12 months post-LSG while controlling for age, initial body mass index (BMI), and use of leptogenic medications.

Results:

A total of 150 patients (Meds group) were prescribed obesogenic medications within the one-year post-LSG follow up period, whereas 173 patients (Control group) were not prescribed obesogenic medications. The Meds group lost significantly less weight compared to the Control group (%EWL ± SEM at 12 months 53.8 ± 2.4 n = 78, 65.0 ± 2.6, n = 84 respectively, P = 0.002). This difference could not be attributed to differences in age, gender, initial BMI, co-morbidities, or prescription of leptogenic medications between the two groups.

Conclusions:

The use of provider-prescribed obesogenic medications was associated with worse weight loss outcomes post-LSG. Closer scrutiny of patient medications may be necessary to help improve outcomes of weight loss treatments.

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Acknowledgements

Grant Support: C.B.L. received support from UCSD Summer Research Training Program. A.D. received support from NIH T32 DK007202. S.B. received support from NIH F32 DK113721. A.Z. received support from NIH K08 DK102902 and AASLD Liver Scholar Award. The project described was partially supported by the NIH UL1 TR001442.

Author contributions

CBL, AD, SBH, EG, and AZ conceptualized and designed the study. CBL acquired the data. CBL, AD, and AZ analyzed and interpreted the data. EL and JAP verified statistical results. SBH, SH, SG, SB, and EG provided valuable intellectual input. CBL and AD wrote the manuscript. AZ supervised the entire study.

Author information

Author notes

  1. These authors contributed equally: Cecilia B. Leggett, Athanasios Desalermos.

Affiliations

  1. School of Medicine, University of California, San Diego, CA, USA

    • Cecilia B. Leggett
    • , Athanasios Desalermos
    • , Steven D. Brown
    • , Santiago Horgan
    • , Samir Gupta
    • , Eduardo Grunvald
    • , Samuel B. Ho
    •  & Amir Zarrinpar
  2. Division of Gastroenterology, University of California, San Diego, CA, USA

    • Athanasios Desalermos
    • , Steven D. Brown
    • , Samir Gupta
    • , Samuel B. Ho
    •  & Amir Zarrinpar
  3. Clinical and Translational Research Institute, University of California, San Diego, CA, USA

    • Steven D. Brown
    • , Euyhyun Lee
    • , James A. Proudfoot
    •  & Amir Zarrinpar
  4. Department of Surgery, University of California, San Diego, CA, USA

    • Santiago Horgan
  5. Bariatric and Metabolic Institute, University of California, San Diego, CA, USA

    • Santiago Horgan
    •  & Eduardo Grunvald
  6. Department of Medicine, University of California, San Diego, CA, USA

    • Samir Gupta
    • , Eduardo Grunvald
    • , Samuel B. Ho
    •  & Amir Zarrinpar
  7. Veterans Affairs San Diego Healthcare System, San Diego, CA, USA

    • Samir Gupta
    • , Samuel B. Ho
    •  & Amir Zarrinpar
  8. Division of General Internal Medicine, University of California, San Diego, CA, USA

    • Eduardo Grunvald
  9. Institute of Diabetes and Metabolic Health, University of California, San Diego, CA, USA

    • Amir Zarrinpar

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Amir Zarrinpar.

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DOI

https://doi.org/10.1038/s41366-018-0207-x