Gastrojejunostomy

Subjects were recruited from an obesity treatment center in a university hospital in Taiwan. The obesity treatment center personnel comprised a multi-disciplinary team, and included a surgeon, internal physician, psychiatrist, urologist, obstetrics and gynecology doctor, nurse, case manager, dietician, and physical activity director. The obesity treatments in this center included non-surgical procedures: meal replacement, pharmacotherapy, psychiatric bio-feedback treatment and intra-gastric balloon, and surgery: bariatric surgery (sleeve, band, Roux-en-Y gastric bypass). First of all, the patients made up their mind as to the treatment modality. However, the patients who wanted to receive bariatric surgery had to meet the criteria of morbid obesity. They then needed to undergo a complete pre-operation evaluation, including a psychiatric evaluation. Our hospital has a committee in charge of determining whether the patients are eligible for bariatric surgery.
Patients received a complete physical evaluation during their first visit, and also completed two questionnaires: the Taiwanese Depression Questionnaire (TDQ) and the Chinese Health Questionnaire (CHQ). The TDQ is a 0-3-point, 18-question questionnaire used to screen clinical depressive disorder.
[22 (link)]. The cut-off point in the community population is 18/19 points. The CHQ
[23 (link)] is a 12-question, 2-reverse questions, 0-1-point questionnaire for screening “minor psychiatric disorders” such as anxiety disorder. The cut-off point in community surveys screening minor mental disorders is 4/5 points.
To avoid false negative results, we lowered the cut-off points for the CHQ and TDQ in our clinical practice. Those patients with CHQ <3 and TDQ <13 were regarded as having no psychiatric disorder. If any of the two scores were above the cut-off point (i.e., CHQ ≧3 or TDQ ≧13, or both), the patients would be referred to psychiatrists for further evaluation. The lifetime psychiatric diagnosis was made based on the psychiatrist’s diagnostic interview, using the Structured Clinical Interview for the DSM-IV (SCID).
We recruited all patients that visited the obesity treatment center of E-Da Hospital from January 2007 to December 2010. The exclusion criteria were age younger than 18 years, having incomplete BMI, TDQ or CHQ data, and refusal of psychiatric interview when needed.
All analyses were performed with the Statistical Package for Social Sciences, SPSS Version 17.0. The chi-square test was used to compare differences for categorical variables and the t-test was used to compare differences for continuous variables. The level of statistical significances was 0.05, two-tailed. Logistic regression was applied to examine whether BMI was associated with a psychiatric disorder.
This study was approved by the Institutional Review Board of E-Da Hospital, Taiwan (EMPR-098-073). The study design and performance complied with the Declaration of Helsinki.

A retrospective analysis was undertaken of a non-controlled patient cohort offered open-label liraglutide pharmacotherapy as an adjuvant in the event of inadequate weight loss (partial response) following bariatric surgery. In addition to weight loss, the tolerability and safety of liraglutide were evaluated in this population. Participants were aged 18–70 years and were recruited from patients who attended a routine post-bariatric surgery follow-up at a specialist clinic in Sydney, Australia. Ethics approval was granted by Ramsay Health Care NSW HREC (reference number: 2020-012).
Patients were offered at least 3 months of pharmacotherapy to achieve further weight loss. Included were patients at least one year post-laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYG) or at least 2 years post-laparoscopic gastric band (LGB) and had inadequate weight loss defined as BMI >35 (all patients), > 25% TWL (LSG, RYGBP), >20% TWL (LAGB), and in patients who self-identified as weight stable after surgery without meeting health or weight goals. As patients were required to self-fund therapy, they were a group who were motivated to lose more weight but had not achieved it with their chosen therapy. Patients with a surgical reason for weight regain, reported pregnancy, ischaemic heart disease, cardiac conduction disorders or contraindication to liraglutide were excluded.
Eligible patients were prescribed liraglutide using the dose-escalation protocol (1.8–3.0 mg subcut daily) outlined by the manufacturer [10 ]. Patients who did not lose at least 5% of their starting weight after 3 months of treatment were deemed non-responders to pharmacotherapy, and therapy was ceased.

This monocentric cross-sectional study was conducted at University Medicine Greifswald, a tertiary medical center with expertise in obesity treatment located in Northeastern Germany. Between July and September 2019 all patients attending their routine postoperative care visits after bariatric surgery were approached for study participation. Patients with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) and a postoperative period of 6 months or longer were eligible for inclusion. Wearing of a pacemaker, pregnancy, or a history of malignant or severe chronic disease were defined as exclusion criteria. The study was approved by the local institutional review board (registration no. BB 080/19) and registered at clinicaltrials.gov (NCT04587076). Written informed consent was obtained from all patients before study inclusion.